Prioritising emergency calls to ambulance services during periods of peak demands such as on New Year's Eve does not work, according to new research by the Centre for Primary Health Care Studies at University of Warwick. Call prioritisation aims to ensure that ambulances are sent to the most urgent cases first, when services are stretched, rather than the traditional "first come, first served" basis. The system was introduced before New Year's Eve two years ago.
The research by Dr Matthew Cooke focused on all calls logged to the West Midlands Ambulance Service, which serves a large urban area, during the first eight hours of 1998. The call rate and response times were compared with the same time period in the first week of December. Almost 500 calls were logged on New Year's Eve, with up to 88 calls in an hour: the normal rate is about 16 an hour, peaking at around 30.
There were four times the number of calls between 1am and 2am on New Year's Eve as there were during the same period in early December. Over one in four calls was a category A - the most serious; over half were category B. Around one in five were minor category C - almost double the rates recorded during early December for this type of call. The target time for responding to a category A call is eight minutes; for B and C calls it is 14.
Delays of over 30 minutes occurred in 19 cases, five of which were category A calls, with the worst delays occurring between 1.30 and 2.30am. During this period, only two out of 15 A calls and fewer than half of the B calls were responded to within their target times. Two B calls waited for over an hour. Either the system was not being used properly or available resources were inadequate to cope even with the most urgent cases, say the researchers. They suggest that resources may need to be quadrupled to cope with demand on New Year's Eve, just to maintain normal response standards, and that even this may not be adequate for Millennium Eve. Dr Cooke said:
If the prioritisation system is not being utilised at times of maximum workload, then its use overall is put into question. At present [it] appears to represent a large investment that is failing to deliver benefits in resource utilisation during periods of high demand.
For further information contact:
Dr Matthew Cooke, Centre for Primary Health Care
Studies, University of Warwick
Tel: 02476 573005 or 07074 782 377