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• What Price 90 Seconds; is "Call Connect" a disservice to 999 users?
  Jonathan Leach
  Published on: 25 October 2010

• Published on: 25 October 2010

  What Price 90 Seconds; is "Call Connect" a disservice to 999 users?

  • Jonathan Leach, Medical Director and Director of Primary Care

  Woollard et al reiterate the view that many of us have for some time, there is no evidence that an 8 minute response target is worthwhile in itself, that it should be replaced with more clinically orientated priorities and that it has had unfortunate consequences. It is interesting to reflect that most other health organisations (whether primary or secondary care) have significantly increased both the breadth and depth of...

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  Woollard et al reiterate the view that many of us have for some time, there is no evidence that an 8 minute response target is worthwhile in itself, that it should be replaced with more clinically orientated priorities and that it has had unfortunate consequences. It is interesting to reflect that most other health organisations (whether primary or secondary care) have significantly increased both the breadth and depth of the skill mix of clinical staff over recent years and that ambulance trust policies of employing large numbers of emergency care practitioners with three weeks clinical training runs counter to the approach of other parts of the health economy and most importantly makes little or no sense. By design such personnel are not in a position to be able to make an overall clinical assessment and take responsibility for decisions with the consequence that patients in virtually all cases are transported to a hospital emergency department. At a time when the NHS is struggling to meet demand and contain financial pressures and where the solution is to guide patients (where appropriate) to more suitable and cost effective community health services (including general practice), ambulance trusts need to be concentrating on increasing significantly the breadth and depth of clinical decision making (likely to include nursing and medical disciplines) rather than employing personnel with limited training and rushing to "stop the clock".

  As many colleagues have said to me (once they have understood the level of training of an emergency care assistant), if they became unwell, they would prefer to be seen by a health professional who had undergone significant training and who could undertake relevant treatments at 8 minutes and one second than an individual with a very limited skill mix at 7 minutes 59 seconds! Probably just as important is that those who develop policy, is to consider the effects upon the overall health economy as there are large interdependencies between organisations with the risk that there are unexpected and often expensive clinical and financial consequences.

  Conflict of Interest:

  NHS Worcestershire is involved with commissioning ambulance services in the West Midlands. The author responds in a voluntary capacity for West Midlands Ambulance Service

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  Conflict of Interest:
  None declared.

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