999 Call handling

When should I call 999?

It can be difficult to assess whether or not an ambulance is required or whether there is a more suitable alternative.

We would urge you to call 999 in a life threatening emergency or if the person you are calling on behalf of:

• Is unconscious or unresponsive
• Has symptoms of a stroke (weakness in limbs, muddled speech, paralysis)
• Is struggling for breath or not breathing
• Is having an asthma attack and is unresponsive to medication
• Has severe chest pain
• Has suffered major blood loss or has uncontrolled bleeding
• Has had a severe allergic reaction
• Is fitting (first seizure, last more than 5 minutes, remains unconscious)
• Has been submerged in water for more than one minute
• Has suffered a traumatic or penetrating injury or fall

Further information can be found on our When should you call 999 page

What happens when you dial 999 for an ambulance?

When you call 999, an operator will ask you which emergency service you need. You should say, Ambulance.

Your 999 call will then be passed to one of our trained call handlers in one of our three Emergency Operations Centres (Bedford, Chelmsford or Norwich). You will be asked for details of where you are, for you to confirm the number you are calling from and for details of what has happened. You may be required to repeat this information to ensure we have the correct location for an ambulance response and a call back number should the line drop out.

Your call will be categorised depending on the information and answers given and an appropriate resource will be arranged. This may be in the form of a further telephone assessment by a clinician or an ambulance response.

When I called 999 why was I asked so many questions?

When you call 999, you will be asked a number of questions by the call handler. Some of these questions may seem irrelevant at the time, however the answers you provide to these questions will establish the type of help that is required by you. By asking these key questions we can ensure that all callers receive the most appropriate help for their needs as quickly as possible.

Please be assured that the questions being asked and answered are not delaying help being provided; however it is important that the assessment is completed to ensure that the patient receives the most appropriate response.

Who makes the decision to send an ambulance?

When you call 999 you will speak to a trained call handler. The call handler will ask a number of questions about your condition. This process is called triage and is used by Ambulance Services both nationally and internationally.

The triage software used by our Call Handlers attempts to quickly identify any immediately life-threatening symptoms which would require an immediate response.

If no immediately life-threatening symptoms are identified, the electronic triage system will code the call appropriately depending on the presenting condition of the patient. The assigned category will decide whether the patient will receive an ambulance response or secondary triage from a clinician.

Further information can be found on our When should you call 999 page

My GP said I needed to go to hospital in an ambulance - when should this arrive?

If a GP arranges for an ambulance to take you into hospital, these are booked as GP Urgent calls and can be requested for one hour, two hour or four hour responses. These calls are dealt with alongside our emergency 999 calls and the Call Handler will obtain the required information and advise of any ongoing potential delays.

We will always do our absolute best to arrive as quickly as possible, but there may be times when delays are beyond our control. When we know that a delay is likely to occur then we will endeavour to let you know as soon as possible so you can be prepared.

Why did it take so long for the ambulance to arrive?

Information regarding your clinical need is gathered during the 999 call; from there an assessment will be made as to what the most appropriate help is for you. All ambulance resources are prioritised so that patients that require emergency treatment are attended to first.

On occasions it might be necessary to divert an ambulance that is on its way to see you to another patient who has a more serious, life threatening, clinical need. That is not to say that you will not receive an ambulance. Our Emergency Operations Centre staff reassess each situation as it arises and if the ambulance was on its way to you is diverted to another patient they will ensure that the next most appropriate resource is sent to attend you.

Why did they ask to speak with the patient when they were feeling so unwell?

When you call the ambulance service on behalf of a patient you will speak to a call handler who may ask to speak directly to the patient. This helps us to gain a better understanding of the patients clinical need. This information then informs the type of help that will be provided to the patient.

Why didn't they send an ambulance?

The response you are given may be an emergency ambulance or alternatively you may receive clinical advice over the phone. We have clinicians that work within our Emergency Operations Centres that are qualified to provide medical advice over the phone to callers with less serious conditions.

During the call they aim to establish the best course of treatment for you. This could involve being cared for at home, being referred to your GP or local pharmacy, or it might be that you are advised to visit a local NHS walk in centre. They are also able to request an ambulance response if they feel this most appropriate for your presenting condition.

Please be assured that you will receive the most appropriate care to meet your medical need.

Why wasn't I told there was going to be a delay?

If we have arranged help to attend you, we will make every effort to reach you as soon as possible. However, on occasions where there is a high demand being made on our service, we might not be able to provide help to you as soon as we would like. Our call handlers will always aim to advise of delays to our service at the time of the initial call. When delays do occur, we will do our utmost to keep you informed of the situation and carry out welfare calls to check for any changes in the patients condition.

Will arriving in an ambulance mean I get treated more quickly in hospital?

No.

The emergency department staff will prioritise all patients based on their clinical condition no matter how they arrive at hospital. However, if your condition is life threatening or needing immediate attention the ambulance crew are able to make the hospital aware that they are on route using our pre-alert system.