There has been a significant decrease in the number of experienced emergency healthcare professionals in recent years. The spotlight seems to finally be turning towards this element of a struggling NHS as documented by a a recent BBC report, which shed some light on the pressures the ambulance services are facing. High demand, no respite and long hours are what these professionals face on a daily basis, which has resulted in a large exit of paramedics from ambulance trusts across the country.
The demand for medical treatment is at the highest it has ever been. The UK population is growing and the ageing population are living longer. Financial and human resources are not only feeling the pressure of this demand, but are thinning considerably. GP services are feeling a lot of the pressure - many with exceptionally long waiting lists and lacking out of hours services. A&E's are inundated on a daily basis and bed occupancy on the wards are often at a maximum.
For this reason, one of the many reasons the ambulance services are struggling, is because they are expected to the fill the gap when the general public expect instantaneous access to healthcare - whatever time of day. This results in emergency care specialists being dispatched to non-emergency calls, doing things like changing dressings or checking a blood pressure. Dispatchers need then to try and triage calls on a daily basis in an attempt to ensure the correct level of medical services are sent to the appropriate patients - a vicious cycle with no real solution in sight.
One of the ways the NHS Trusts are trying to combat the pressures is to offer contracts to private ambulance companies to work alongside the NHS staff. These private companies are used in a variety of roles, from basic patient transfers between hospitals to front line response work. The problems however remain the same. The staff have to mirror ambulance trust staff in their qualifications and driving requirements, only that these companies are less likely to invest in staff in the long term due to profit margins. In addition to this, private companies rarely offer full time employment and expect paramedics to register as self employed; paying by the hour, resulting in no progression, no depth and a ultimately a superficial solution that cannot last.
A paramedic with 15 years experience on the front line, who preferred to remain anonymous, confirmed that the way they treat patients has considerably changed: "We are now with our patients for longer than we have ever been before," he confirmed. "10 years ago, there was always a hospital open for any patient and we spent less time with them. We are with our patients longer now, hospitals are always closed. It would make sense to increase our capabilities based on what we feel will better a patient outcome without immediate access to definitive care."
There are fundamental changes that need to occur in the ambulance services to combat this problem.They have become a dumping ground to a far bigger issue which seems unlikely to be resolved in the near future. Paramedic training needs to be revisited, including the revision of competencies and capabilities in accordance with the current issues. A large amount of the red tape needs to be cut and ambulance trusts need to steer away from a target driven culture, focusing on a solution to best suit patients and at the same time consider the well being of their paramedics.
Without significant change it is unlikely the public will, for much longer, have well trained, much needed experienced paramedics arriving at calls. They'll burn out long before. #Medicine