Does Your Practice have a 999 Policy


Does your Practice have a protocol on calling 999?

What is your Practice policy if a patient telephones the surgery and it is identified that an ambulance is needed?

Why do you need to have such a policy?

You owe it to your staff to have the correct procedures in place. No one likes to get something wrong – and delaying in getting an ambulance to a patient can have dire consequences.

When I was a supervisor managing a team of Receptionists we did deal with calls that were a matter of urgency – and needed an ambulance. If a Doctor (or in the Doctors absence a nurse) was in the building they would deal with the call.

But there were times that a call would come through and there would be no healthcare professional on the premises. The Receptionist had to deal with the emergency call and quickly.

A good receptionist will pick up on the urgency of a call and in a split second know that an ambulance is needed.

But what happens in your Practice?

  1. Does the Doctor/Nurse/Receptionist ask the caller to call 999 and request an ambulance?

or

2.  Does the Doctor/Nurse/Receptionist call the ambulance?

I fought for our practice to have a protocol put in place for such calls. The Doctors at first did not see a need for it.

Until we had this in place and a patient called in an emergency it might be the Doctor that would call an ambulance or  the Doctor might phone out to Reception and ask a Receptionist to call an ambulance or the Doctor might ask the caller to call 999.

If a Receptionist took the call depending on who took the call and she identified that an ambulance needed to be called she might tell the caller she would phone for an ambulance or another Receptionists might advise the caller to phone 999 them self.

But one thing for sure was that there was no procedure whereby everyone was doing the same.

DOES THE DOCTOR/NURSE/RECEPTIONIST ASK THE PATIENT TO CALL 999?

When I brought this up at a Doctors Meeting they were very keen that we as Receptionists ask the caller/patient to call 999. They felt that this would be less pressure on the surgery staff – and they felt that the ambulance control could phone and speak to the caller/patient if needed.

I disagreed – I asked what if the patient was there on their own and we asked them to phone an ambulance and then they collapsed before making the call – we as a Surgery would have thought it was being dealt with and the patient would not have made the call therefore no ambulance being despatched – leaving the patient in danger.

They suggested that if the caller was on their own then we would make the call. If the patient had someone with them then we would ask them to make the call.

Again, I disagreed – this was not fair on the Receptionists – to ascertain if the patient had someone with them at the time of call – this would take up valuable time and that person might be needed to be at the aid of the patient.

DOES THE DOCTOR/NURSE/RECEPTIONIST CALL THE AMBULANCE?

Yes, I say – every single time.

What I did learn from taking such calls is people are often in a panic – if  a caller is calling on behalf of someone else they might not necessarily have all the patients’ information at hand ie medication they might be on. The caller might be a neighbour and might know very little about the patient.

They often will give you details and THEN you ask them to call 999 and they have to give the information all over again. This delays time when the caller can be with the patient – especially if the patient needs assistance.

Or, if the patient is on their own they are often in a panic. Elderly patients have been known when they put the phone done after being asked to call 999 that they don’t “think” it is necessary and the call has not been made. They often do not like causing a fuss.

You might have a mum with a young child that needs the mother to be with them – asking her to phone for an ambulance takes her away from the child for longer.

In my experience I felt that the caller/patient was happier when we at the surgery phoned 999 on their behalf – it gave the caller time to go back to the patient – or the patient to prepare for the ambulance calling.

The Doctors felt that Ambulance control would rather the call come from the patient – so I contacted them on behalf of the practice. I explained what had been discussed at our recent meeting and ambulance control agreed that they would prefer it if the Surgery was to call in the event of an ambulance being needed.

They felt the Surgery would have all the patients’ records that they needed such as

  • Name
  • Address
  • Date of Birth
  • Telephone number
  • Medical History / Medication
  • Any other relevant information they might require.

Not all of the above might be know to a caller if they are calling on behalf of the patient.

Ambulance control felt that they could get this information quickly from a Doctor or Receptionist, get the ambulance despatch quickly and if they needed to speak to the caller/patient for further information they needed to.

Also, to make a note on the patient records that an ambulance had been called, the date and time the call was made. This could be useful for any of the healthcare professionals when dealing with the patient in the future.

To get this protocol right was important – and for me I had an example of just how this can fail if there is not policy in place

“True Story”

I have a cousin – she and her partner were due to go on holiday the following morning. My cousin’s partner started feeling unwell that afternoon, by tea time he was decidedly a lot worse and seemed to be very unwell – my cousin started to panic as her partner was in a pretty bad state.

She got through to the Surgery, by this time she was really panicking as her partner was drifting in and out and not with it at all.

My cousin spoke to one of the Receptionists – she gave her the details – the Receptionist put her straight through to the Doctor, my cousin went through everything again with the Doctor, the Doctor asked her to phone an ambulance immediately – but what she thought he said was that HE would phone an ambulance for her. She said that her head was all over the place and she was certain that he said he would phone.

She waited over an hour – no ambulance arrived. She phoned the surgery again and it was closed. She was in a fit of panic by this point  – instead of phoning 999 she phoned the out of hours number on the answer machine and had to go through everything with them. She now blames herself that she did not phone 999 instead. The out of hours contacted ambulance control who confirmed that no ambulance had been requested earlier but despatched an ambulance immediately.

The ambulance arrived too late – my cousins partner had died of a heart attack.

 

Had her surgery had a 999 protocol the ambulance would have been called.

Discuss such events at your next Practice Meeting – get everyone following the same procedure.

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