Whether you call 999 or 112, your call will initially be answered by the switchboard to find out which service you require (Ambulance, Fire or Police). You will then be put through to the ambulance call centre; if you’re in Wiltshire, it will usually be the South West Ambulance Service call centre in Bristol, if you’re in Hampshire it will be the South Central Ambulance Service in Winchester.
The call handlers are highly skilled at using the very detailed and complex software which will help them to ascertain the problem, provide you with advice and guidance, and ensure an appropriate resource is allocated to help. In the call centre there is also a team of despatchers who look at each incoming incident and allocate an ambulance, rapid response vehicle, first responder or other available resource, or for lower level calls, they may put the incident in the ‘stack’ awaiting an available resource. There are also clinicians on hand to assist with trickier calls or to offer guidance to crews and responders where necessary.
The first question is always, ‘Is the patient breathing?’
If you answer ‘no’, the system automatically categorises the call as a Category 1 (highest level) and the incident appears on the despatcher’s screen for allocation. The despatcher decides which resources to allocate, whilst the call handler instructs the caller in how to do CPR.
If you answer ‘yes’, the call handler will ask you to tell them what has happened, and as you start talking, they start typing the information into the computer. The algorithm assesses the information and either puts the next question prompt on the screen to elicit further details, or provides advice which the call handler reads out. In the meantime, the computer uses the information to categorise the call, which then appears on the despatcher’s system for resource allocation whilst the call handler continues to question and advise the caller.
The call handler will often ask for confirmation of your location and any information which may help the ambulance service attend the call, for example if there is a key press to enable access to a home, or a landmark which may help identify the location. They will have a rough idea as to your location from either the location of the landline used or mobile phone data masts, but any further information you can provide is always useful.
If the call is immediately life threatening (Category or Cat 1), such as an arterial bleed, a cardiac or respiratory arrest, or anaphylaxis, the call handler will usually remain on the line to instruct the caller in how to help the patient and offer guidance in the event that anything changes. They will not usually end the call until the ambulance service arrives at the incident. This would also usually be the case in the event that the caller was a young child or perhaps someone with substantial learning disabilities, even if the call was a lower category level.
If the call is a lower category and the patient is stable enough, the call handler will usually give advice for what to do if the situation changes or the casualty gets worse, and then clear the line to take the next call whilst the patient waits for the ambulance service to arrive. Don’t be afraid to call back if the situation changes at all, as this may change the advice you are given and may also change the category of the call. However, please don’t call back just because you’ve been waiting a long time, or to find out how long the ambulance is going to be. If you’re waiting, it’s because the service is busy and calling back takes up the time a call handler could be spending giving advice to a new caller. They are unlikely to be able to give you an estimated arrival time, because even if you have been allocated an ambulance and it’s on its way, if a call comes in with a higher priority the ambulance may be diverted. The call handler will advise you during the initial call whether to seek alternative transport to the hospital, e.g. a taxi if your casualty is a lower level call and could reasonably make their own way to A&E.
Please carefully consider whether the situation requires an emergency response. The ambulance service is there to respond to emergency situations but is often unable to arrive as quickly as they would like because resources are being used attending calls for which an alternative pathway such as a GP, walk-in centre or minor injuries unit may be suitable. By being considerate of the way in which we use our emergency services, we can help the resources attend the right locations at the right time, and achieve better outcomes for our communities.
Carolyn Port is a qualified teacher and first aid trainer and a volunteer Community First Responder with the South West Ambulance Service Trust.