Bit of a naive student question following a recent placement experience:
Our crew attended a care home for an elderly patient with an unwitnessed fall. An experienced and somewhat embarrassed carer explained that their new management rules now requires staff to call 999 for all unwitnessed falls, regardless of injury or anticoagulant status.
The patient was assessed and did not require conveyance. The carer was clearly frustrated with the policy, and the crew suggested feeding this back to management, warning that repeated low-acuity calls to their facility could risk de-prioritisation by our dispatchers.
From a care home management perspective, it feels like there’s little to lose by defaulting to ambulance attendance. Clinical escalation decisions are effectively handed over to the ambulance service, and lifting patients becomes the crew’s responsibility rather than the care home’s. I’m sure most of you have encountered patients being left on the floor in care homes for prolonged periods while awaiting a crew, even when the care homes have hoists and staff available (how that isn’t considered neglect is beyond me).
Would it be appropriate to fine organisations when policy-driven reliance on ambulance services replaces core care functions (like falls or organising OOH GP referrals)?
I appreciate that we’re the healthcare service of least resistance (especially outside of normal hours) but the cost and inefficiency associated with these calls has to be staggering (not to mention reduced coverage while responding to these calls). Is there any realistic mechanism to address this?