Understanding the Cause and Effect of Failed Responses to Ambulance 999 Calls in London - Essay Example

Introduction

London is one of the largest metropolises in the world and at the same time one of the most technologically developed cities regarding infrastructure and also in the health care system. London firefighters and ambulances have been ranked to having the best response rates to emergencies in the city. However, since the establishment of London ambulance service, there have been some catastrophic failures in their emergency response systems which have led to the loss of life as well as financially loses (Wankhade, 2015). In this case, for the London ambulance services, it’s a big blow to their reputation when there is death as a result of their failed responses to emergencies. LAS has an enormous duty of serving the largest city in the world. It has experienced problems of software failures which has led to delayed responses or no response at all to emergencies (TAB, 2015). Many are the times the 999 emergency response number is offline because of system failures. In this paper we are going to look at London ambulance services and what are the causes and effects of delayed ambulance response. The paper shall also look how it affects the operations of the company and finally recommendations

London Ambulance Service (LAS)

LAS was formed in 1930, and so far it is the biggest ambulance service in the world. It has become the biggest ambulance service because it has to serve a large number of people at one across London and Great Britain. LAS responds to between 2000 to 2500 calls per day all involving emergency responses across London (Edwards, 2014). It has a fleet of over 750 vehicles which are distributed across London. Each vehicle is strategically located across the city ready to respond to any emergency services. With the assistance of the London fire service department and the metropolitan police, LAS covers an area of 600 square miles. Because of its excellent work and contribution to saving lives since 1974, the LAS has been incorporated, and it is part of the National Health services, NHS, in the United Kingdom hence getting the chance to be funded by the government (O'Shea, 2015). LAS is comprised of two sectors which serve different cases of emergencies which include the patient transport service and accident and emergency services.

LAS has had several projects in which most of the projects the systems collapsed leading to casualties across London. Going back in history, LAS changed its manual dispatch system in the 1990s. At this time, other departments like the fire and police departments also wanted to computerize their systems to make operations easier for them. However, For the Ambulance services, the manual system was hectic and time wasting. It involved three steps. First, the employees would take the calls and write down the details and location of the incident. The location is identified on a map, and the preprinted paper is placed on a conveyer belt to the next step resource allocation. Next, the form is checked by another staff and details reviewed. He hands the forms to three resource allocators subject to whether the incident occurred in the North West, northeast or south of London. The resource allocators had files of every ambulance, its location, and its current state. According to the location, the resource allocator decides which ambulance to send to the call. In resource mobilization, the dispatcher would call the relevant ambulance and give it all the details it required to respond to the calls. The manual process was a long one and in most case, it would arrive at the scene too late to save the patient (Souza, 2013).

LAS then introduced the use of CAD system which comprised of a CAD software and hardware, a mapping software, radio system and communication software. The CAD system was meant to make the response of calls and emergency faster and efficient. The systems expectations were that it would save more lives than before hence improving the state of health in London. The government was ready to fund the projects, so the LAS had no barriers to stop them from implementing the systems. The ambulances were also fitted with vehicle location systems that were electronic and mobile data terminals. With these gadgets installed the communication between the central station and the ambulance would be quicker and efficient. The system was meant to pick emergency calls automatically and allocate resources automatically (Perkins, 2012). Then communication of the incident details to the ambulance that is available and nearest to the location of the incident. Management and allocation of the ambulances to enhance their service capabilities and finally production of reports which would help in the future upgrading of the system. However, the system no longer meets these expectations but has become a failure in the 999 response time (Souza, 2013).

Causes and failures

Design

The first system was abandoned in 1989 after it was found that it would not be able to cope with the load. The number of calls and allocations that are done per day could not be handled by the system which leads to its abandonment (Peters, 2015). However immediately, they started the design of another system that they were sure would handle all the necessary requirements and at the same time meet the objectives of the company. The system was finally implemented in 1992. However, over the years, the system has had many upgrades because of the many situations that have led to the death of patients. One of the causes of failure of the London 999 emergency systems is ignorance. For instance, in the development and implementations of the first CAD system, it had many flaws, but the LAS management and the government went ahead to implement it not knowing the repercussions that follow suit. The system had over ten identified problems and flaws with the software, but they had not been addressed. The system was also incomplete since all the data regarding the ambulances had not been fed into the system. This made it tough for the system to allocate ambulances whose state was free and ready (Anderson, 2016). To make matters worse, the system interface was not clear. The interface had black spots which made it impossible for the operator to see all the details on the screen. Such errors brought the operations of the LAS down. However, it was until they started using the system that they realized how problematic it was to become.

Untrained staff

London ambulance services had no trained staff to handle the new systems. This is a trend that has been there since the begging when it first implemented its CAD system. The workers were poorly trained which led to the slow absorption of the system in the NHS (Wankhade, 2015). The staff who were to handle the system has to be literate in IT and computer operations. However, they took the existing staff and had to train them on how to operate the system having in mind they have no background information on computers. The problem is still eminent in the LAS operations as most of its staff operating the systems are under trained such that they cannot handle problems arising out of small system failures. They are not aware of the risks in every call they handle (Edwards, 2014).

Failing systems

The systems have been upgraded several times due to the many times it has failed. In one incidence, the system began to show duplicate calls during the rush hours of the early morning in 1995. The calls coming in were many such that the system could not accommodate all the calls hence it ended up losing some of the calls. Currently, the systems have a problem of being overloaded by the many emergency calls per day making the system slower and incompetent. For instance, some people are left to wait for the next operator for up to thirty minutes. Hence, delays are created in dispatching the ambulances. At some point, some calls would disappear from the screen or will not be received. The operators will not identify These scenarios since the CAD system has hidden some of the calls and kept them in waiting. The LAS 999 emergency system is at the edge of melting down because it can no longer handle the increasing number of calls every day (Barrett, 2015). The delay in the system has even made the dispatch systems to send ambulances in areas where there are no emergencies. The systems have become inadequate and unreliable. To make matters worse, the operators on the receiving end are not well trained and less risk averse, they end up sending ambulances to the least emergency areas leaving no free ambulance to respond to heart attacks and other more crucial medical conditions.

The management

LAS management has relaxed in their duty hence making the operation of the ambulance services slower and inefficient (Newton, 2015). They no longer care for their tired paramedics who have been on duty all day. They should also work on improving the systems and making sure that they are operational. Incentives should be given to the staff to motivate them. The LAS management has the responsibility of creating a good working environment for its staff.

Effects

The failure the systems has led to the loss of lives. For instance, in 2014 when they tried to upgrade the system, the system integration failed which led to a system crash and at the same time emergency calls were streaming in. It resulted in the death of several patients. Due to the failure, some calls diapered from the screens, but some were answered late. For instance, in 1992 when the system failed and locked up, it was reported that up to 20 people died (Hackett, 2013). The response rate for emergency calls is slowing down. For instance, last year, only half of the ambulances managed to get to the scene in 8 minutes. The others were late or responding to alcohol-related responses which are minor. The bosses now fear a meltdown of the 999 services due to the weak state of the London ambulance services. Many public inquiries have been formed to look into the problems, but as time goes by, the same problems reoccur (Edwards, 2014). Furthermore, even the change of management is not working because the service provided by the ambulances are becoming slower and slower. At this day and age, the LAS is still using the pen and paper system after several failures of the systems in the past years.

Recommendations

The LAS management systems should seek an upgrade of the system from the CAD system which was installed in 1992. Even though they have been upgrading it, it has led to the loss of lives due to its failure. The management should engage experts and come up with a new system that will be able to handle the traffic and dispatch systems. Since the current systems are failing, they should learn from that and design a new system that will handle and solve the current issues (Mackway-Jones, 2015). Completely overhauling the system is the right step to take. However, it could be costly, but the government will be ready to fund the system if it improves the state of emergency ambulance responses in London. Secondly, all its staff should be well trained to ensure that they are aware of imminent risks in each call. They should also be trained in emergency response and management of the ambulances. The LAS management should motivate their employees by providing the excellent working environment and payments (Turner, 2015).

Conclusion

The essay has clearly explained the problems that are faced by the current LAS systems and what the systems are expected to do. Also, the paper has looked at the causes of such system failures which have been attributed to poor management, ignorance by designers and poorly trained staff. The effects of such failures lead to the death of patients and a bad reputation on the company. Finally, the paper has also mentioned on the few recommendations that should be implemented by the LAS management to improve on the 999 response time in London.