Patient Story - November 2024

Meeting: Public Board

Date: 6 November 2024

Report Title: Patient Story – Leg Injury EOC Experience

Agenda Item: PUB24/11/1.4

Author: Victoria Boyce, Patient and Public Engagement Manager

Lead Director: Simon Chase, Chief Paramedic and Director of Quality

Purpose: Discussion/review

Link to Strategic Objective:

• Provide outstanding quality of care and performance

Link to CQC domain:

• Caring
• Responsive
• Effective
• Safe

Link to strategic risk(s):

• SR1a: If we do not ensure our people are safe and their wellbeing prioritised, there is a risk that we will be unable to attract, retain and keep all our people safe and well
• SR1b: If we do not ensure our leaders are developed and equipped, there is a risk that we will not be able to change our culture, and value, support, develop and grow our people
• SR4: If we do not resolve long standing organisational inefficiencies, we will be unable to deliver an effective, sustainable, value for money service to our public

Equality impact assessment: No negative impact identified

Previously considered by: The discovery interview has been reviewed by Richard Smith, Clinical Lead for Emergency Operations Centre (EOC), the Patient Experience team and Chief Paramedic and Director of Qualit

Recommendation: The Board is asked to receive, review and discuss the impact of call-handling difficulties within the EOC’s, and the work underway to address this to improve patient experience.

Purpose: To share the experience of a first aider who called the ambulance service for a young patient who had sustained a leg injury, and the difficulties the caller experienced with the handling of the 999 call.

Executive Summary:

This is the story of a first aider called Richard, who called 999 when a player at a youth rugby match was injured. The player sustained a compound (serious) fracture of the lower leg that had broken the skin.

When Richard called 999, his call was answered quickly and categorised as Category 3 and he was initially told there would be up to a 12-hour wait for an ambulance. Richard continued to make it clear that this was a serious injury. The Call Handler advised that an ambulance would not be sent at this point. Richard asked for clarification on what would happen next (eg. would he receive a phone call or an ambulance response)? He was advised by the Call Handler that they were unable to say but that his call was now being escalated. The Call Handler then stated that they had calls waiting and ended the call. Richard was left not knowing what was happening or what to say to the distressed patient. At the time of the incident, a doctor was on-scene who was a relative of another player. He then called 999 again and after approximately 10-minutes of conversation, he was advised that an ambulance would be dispatched. The call had then been upgraded to Category 2. The ambulance arrived on-scene a further 10-minutes later. The patient was conveyed to hospital and has since made a good recovery. Richard has been left feeling that, in future, if he has to ring 999, he will have to overplay the symptoms of the patient if he is to get a quicker response. Richard raised his experience with the Trust through a concern. The incident has been investigated and Richard felt initially that the Trust had not taken any learning from this, however he has now deemed the response appropriate.

Introduction / Background:

This patient story has been reviewed by Richard Smith, Clinical Lead for EOC, who has provided an overview of the key developments in the EOC since this incident, which will help with the response to callers like Richard in future.

This delayed response patient story has raised some key areas for actions and progress to be made.

The accompanying slides highlight the following key areas:

1. Increasing clinical navigation and validation in the EOC and Clinical Assessment Service

2. Access to additional patient pathways

3. Community response, advanced practice, hospital delays

Key Issues / Risks:

This patient story raises the following key issues/risks:

• In future, callers may overplay symptoms of the patient they are calling for in order to gain the Call Handler’s attention and, subsequently, an adequate response from the ambulance service.
• More emphasis to be given on the circumstances surrounding a call and focus on the patient (in order to prevent the patient’s health from becoming further compromised and the situation from getting worse).

Options:

N/A

Summary:

This patient story shares the experience of a first aider, Richard who raised his experience with the Trust as a concern. The incident has been investigated, but Richard feels the Trust had not taken any learning from this, although he has now deemed the response appropriate. This delayed response patient story has raised some key areas for actions and progress to be made and these are detailed within the slide deck attached.