Wales’ new ambulance strategy is cruel and distressing for patients and those dialling 999

Emily Price

Call handler: “Ambulance, is the patient breathing?”

It’s early on a school day and my worst fears have happened before my eyes. My 11-year-old daughter has collapsed in front of me.

B had been fine all morning, we had breakfast together and chatted about the news stories I was planning to write up that day – she loves hearing about the latest drama in Welsh politics.

Then as she put on her coat to leave for school, her face suddenly dropped, she stumbled forward, fell and started clutching her stomach.

Her face was burning up as she gritted her teeth, she couldn’t answer any of my questions as she gasped out in pain. She couldn’t even get through a sentence without crying out for help.

My heart was pounding in my chest. I had never been so frightened in all my life.

As I stammered out my address and explained what had happened to the 999 call handler, I was suddenly put on hold.

Astonished, the merry hold music began to eerily mix with the sounds of B sobbing as she continued to clutch at her hip and stomach.

Minutes ticked by before the call handler came back on the line and asked if B was hot or cold to touch?
“She’s hot,” I said. “Boiling hot and crying out and I don’t know why.”

I realised the call handler was going through the motions of the Welsh Government’s new ambulance framework which categorises how serious a call is.

Health Minister Jeremy Miles announced the new response model in July. He claimed it would improve outcomes for patients with serious conditions.

Paramedic

The call handler was cutting out the middle man of a trained paramedic by asking me to carry out certain checks on B.

I started to become frustrated as the call handler put me on hold again. I realised that for some reason my call had already been deemed non-urgent.

I write news for a living – I’m well aware that unfortunately there are foolish people out there who dial 999 for non-life threatening illnesses like chipping a tooth or an ingrown toenail.

But I had dialled 999 because my child had gone from being perfectly well to hitting the ground in front of me and screaming in agony.

I’m not a doctor. But I knew that a burst appendix, gallstones or stomach ulcers were all serious conditions that required urgent medical attention.

I couldn’t believe the lack of urgency in the call handler’s tone. The lack of advice. She came back on the line before putting me on hold again. B started curling up as a wave of pain hit.

Then. The line went dead. I stared at the phone in my hand my heart hammering in my chest. It was like one of those bad dreams where you need to be somewhere but can’t quite make it.

I held on to B’s hand and tried to focus. Should I move her when I didn’t know what was wrong with her? The phone started to ring and I answered it. The call handler casually said she’d been cut off.
Then, she placed me on hold again.

Music played in my ear for a third time. I started to realise help wasn’t going to come.

I began working out in my head if I could move B myself and get her to a doctor quickly without an ambulance.

Driving license

I’m epileptic and not allowed a driving licence. The nearest hospital was a train and a bus ride away. My doctor’s surgery was two bus rides after all the local surgeries in the surrounding villages were closed and merged into one health centre miles away.

I clutched the phone and ran to the front door ready to shout to my neighbour for help. I looked out on the street and saw his car was gone. He’d already left for work.

The call handler came back on the line.

“Hi sorry for the delay. I’ve spoken to a doctor and you need to get your daughter to A&E urgently. You cannot wait. It’s very important you go now.”

“Yes I know,” I said, “that’s why I called 999. I don’t know what to do. She can’t walk. I don’t know how I can move her alone.”

Then to my astonishment the call handler told me to physically pick up my 11 year old daughter who is nearly as tall as me and carry her to A&E.

Chatty

As B cried out in pain, the call handler bizarrely began to reel off chatty pleasantries about how she hoped I got her sorted at the hospital.

I hung up the call mid script without saying goodbye. I was on my own.

The phone showed I had been on the line – much of it on hold – for almost half an hour. I’d wasted time.

I rang my husband who was at work and several miles away. I told him to come quick, that B had collapsed. That I’d called for an ambulance half hour ago but help wasn’t going to come.

I tried to help my daughter up. I’d heard stories of how people can gain sudden strength in moments of extreme stress. Although I could just about lift B, she screamed and writhed in agony every time I moved her. After what felt like an age, my husband burst through the door. He grabbed B in his arms and carried her to the car. The drive to the hospital was about 40 minutes and my daughter’s cries became weaker and weaker as we drove.

As my husband carried her to the entrance she looked ashen. Then B began to vomit uncontrollably. Whatever was happening to her was getting worse by the minute. She was as pale as a ghost and still weakly clutching at her waist and hip. I ran ahead to the desk and we were raced to the paediatric department.

Nurses sprang into action. They said all her symptoms pointed to appendicitis. A life threatening infection that required surgery fast.

I told them I’d called 999 but that they wouldn’t send an ambulance and I’d had to wait for a lift.

Some of the medical staff raised their eyebrows.

A team a surgeons rushed in, taking bloods and feeling my daughter’s tummy. Three doctors stood with their heads together discussing next steps whilst my husband and I stood by watching our worst nightmares unfold.

My daughter was sent for an ultrasound scan where to our horror the sonographer found a 13cm mass attached to her ovaries. Not appendicitis. Something else. A growth larger than a grapefruit taking over her insides.

MRI

B would have to be transferred to a more senior team of surgeons. I felt sick to my stomach as doctors explained that the growth was too dense to be a cyst and more likely be a tumour. An MRI would help them to determine what kind.

I cried into a surgeon’s shoulder as she explained that B would need to be transferred to oncology at another hospital. Radiation has been mentioned as well as biopsies and surgeries. All words parents don’t want to hear.

It was clear that my daughter was seriously ill when she collapsed on Friday morning. And yet, she wasn’t entitled to an ambulance.

Calling 999 is not a casual thing for anyone to do. Callers do it in their darkest moments, in the grip of fear for loved ones or even strangers on the street who need urgent medical help.

People dialling 999 don’t need upbeat hold music whilst they watch their children cry out for help. They need urgent action from a trained paramedic.

Distressing

The Welsh Government’s new ambulance performance framework is cruel and distressing for families and good Samaritans who dial 999 to save people in desperate need of help.

The new response strategy puts too much responsibility on the person calling 999 to do the job of a trained professional. It wastes time and prolongs unnecessary pain.

My daughter’s sudden collapse and our call to 999 has left us both traumatised. What’s worse is that the experience has taught B that if she is in severe pain and needs urgent help – there’s no point calling 999.

I blame ministers in the Senedd for that.