Day in the life - GP rideout with the Service

Marilyn Plant GP By GP Marilyn Plant - PEC Chair, NHS Richmond

Riding in a speeding vehicle on the wrong side of the road in rush hour is pretty cool, but it is not the main reason why commissioners need to know about the work of ambulance crews.

I was very lucky to join a shift with paramedics Christian Johnson and Sue Elias. It was quite a revelation to appreciate at first hand the challenge of the Category A eight minute target, and the frustration of delayed hospital handovers (the time taken for a hospital to take the patient from the ambulance crews). In another case we were hurrying to a call only to be stood down as another closer vehicle became available and had to turn right round and hurry back in the direction we just came from. It was also an eye opener to see the family whose children had been taken to A&E dozens of times in their short lives with minor illnesses that should have been sorted out by a GP, to collect a patient from a GP surgery with a lot of anxiety and not much confidence about providing urgent care, and where a passer by who had punched a wall and broken his hand casually knocked on the ambulance window to get advice.

I also saw the team in action at a multi-agency road traffic collision where a vehicle was overturned and was impressed how calmly and professionally the situation was assessed. It was also good to see the positive relationships with teams in hospital and the commitment of the crew to give a good handover and support the patient and their relatives.

I feel I understand better the difficulties that crews have in decisions not to take people to hospital. There seem to be grey areas which need the exercise of judgement and the need to manage risk. I came away with a lot of ideas about what commissioners might want to consider in years to come as we struggle to transform the public’s relationship with urgent care into a more cost effective position.

There are a lot of challenges to come and it is always a good idea to walk a mile or two in each others shoes if you are going to work together to make improvements. I would certainly recommend this to GP colleagues as essential training for the job of commissioning the London Ambulance Service in the future.

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