Last updated at 16:55, Monday, 04 March 2013

STANDING in the emergency medical dispatcher suite at the North West Ambulance Service’s Cumbria and Lancashire control centre, I listen to the call handler calmly asking questions.

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Based on the nature of the conversation, something tells me the woman on the other end of the phone is, understandably, not quite so calm.

Calling from Barrow, she fears her mum has had a stroke.

“Is she awake? Is she breathing? Is she completely alert?,” the NWAS employee asks, clicking and typing quickly as she goes.

She is using the medical priority dispatch system, a complex flow chart-style computer programme which categorises emergencies and their level of priority.

It is designed to pick out very quickly, in three or four questions, those immediately life-threatening cases.

But the call handler has already taken the most important piece of information, the first thing she does being to type in the location of the patient.

The minute she does this, her case has appeared on a screen in the dispatch suite next door, and an ambulance allocated.

Pete Ballan, emergency operations sector manager for the NWAS Cumbria and Lancashire control centre, says: “A lot of people think we don’t allocate until the end of the call, but as soon as that detail is in there, the dispatchers are working on which vehicle to send.”

While on the other side of the wall, an ambulance is organised, the call handler continues with her questions to determine the patient’s condition.

Control staff, who also organise planned ambulance transfers for GPs and other services, aren’t medically qualified – for good reason. “Clinicians like to ask a lot more questions,” Pete explains, “whereas here, it’s all about speed.

“The average 999 call is between 180 and 210 seconds.”

Describing his staff, he adds: “They need to be calm, they need to be people who can take control of a phone call, who can project their authority. But they also need to be people that care, people that listen.

“It’s probably one of the hardest jobs in the ambulance service. I’m not taking anything away from the paramedics and technicians there but, listening on the phone to the scream of a mother who’s found her child in cardiac arrest is very different to walking into her home, hearing that scream and knowing you’re there to do something about it.”

Over 24 hours, staff in this room will share around 1,000 calls, fielding emergencies predominantly from the Cumbria and Lancashire area, although some will come through from NWAS control centres in Manchester or Liverpool if their lines are full.

The same happens in reverse, Pete explains but, as soon as the call handler there types in an address in this area, it will appear on the screens of the dispatch suite in this building.

As we walk next door to see how that works, we pass through the major incident suite, a large area currently empty but used by additional staff during unprecedented emergencies like the Cockermouth floods or traditionally busy dates like New Year’s Eve.

In the dispatch suite, Pete explains how different staff members are responsible for organising air ambulances, rapid response vehicles, community first responder or mountain rescue teams and incidents where patients may need to be transferred long distances to specialist centres.

Dispatchers are then assigned to specific areas.

Today, Janet Mitchell is on the South Cumbria desk. She explains how the ambulance allocated to an incident when the address first drops into her system is not always the one that ends up getting there.

Some may be sent elsewhere, if another incident arises in the area which is more serious. Crews may also be called off if another ambulance, having finished a job within that time, is now available much closer to the scene.

Using the stroke patient as an example, Janet shows me on one of her screens a map of the area and the ambulances in it.

“The first vehicle was coming from Ulverston,” she explains, “and then another vehicle cleared at Furness General Hospital, so we stood the Ulverston one down.”

“Of a 12-hour shift,” Pete adds, “these guys spend about nine swapping over vehicles. That’s how ambulance dispatch works.”

An example of this team at their finest was provided in the most tragic of circumstances last week, when an eight-vehicle crash on the M6 claimed the lives of two people.

“We had four or five vehicles and two aircraft there,” Pete explains, “and, very quickly, you go from having very good ambulance cover in Cumbria to having very poor ambulance cover for the rest of the public.

“They’re constantly having to think about these things. They’ll move vehicles in from different areas, things will shift around. For example, during the Cockermouth floods we had vehicles up here from Manchester.

“It’s a big juggling act – it’s keeping plates spinning all the time – and they’re fantastic at doing that.”

That juggling act unfortunately means that, in some cases, people may wait longer than they would like for an ambulance.

Pete reiterates that, in every situation, an ambulance is allocated, and no one will ever go without. But he is frank about the fact that, if something else comes in that takes priority, a lower category of call will have to wait.

“We have a finite number of ambulances”, he admits, “we’d love to have an ambulance on every corner, but we don’t, so we have to prioritise.”

Rick Shaw, NWAS sector manager for Morecambe Bay, who has taken the tour with us adds: “We’re always working to get there as fast as we can, it’s not that we’re not going to go. It’s just that someone who is on the floor needing CPR needs us before the person who’s in excruciating pain. And I think anyone could understand that.

“We do the best we can with the resources we have and, at the end of the day everything is 100 per cent patient-focused.”

First published at 16:35, Monday, 04 March 2013
Published by http://www.nwemail.co.uk