Date: 01 January 2014
The patient had been visited by her GP who decided that she should go to hospital for further tests. An ambulance was arranged and when the Paramedic arrived, he expressed his opinion that the patient did not need to go to hospital. Concerns were raised as to why the Paramedic was questioning the GP’s decision. The Paramedic was dismissive and disrespectful of the information provided by the family about the patient’s dementia. The complainant was distressed and upset with the attitude of the Paramedic and wanted to know if ambulance crews are warned in advance of patients having dementia.
The crew member was not a Paramedic but an Emergency Care Assistant employed by an Independent Private Ambulance Service (IPAS) contracted to response to lower priority calls for the East of England Ambulance Service. IPAS crews are only used from the Trust’s accredited independent ambulance providers, who must be registered with the Care Quality Commission, with no conditions to practice. Each company is accredited and re-accredited every six months to ensure continual assurance to the standards required. Any issues around crew practise is reported on the Trust’s internal incident reporting system and investigated in the same way as with the Trust’s staff. The investigation manager interviewed the attending crew. The doctor did not leave any information or a letter to explain what the Doctor had found and the suggested treatment. The crew wanted to speak to the GP to ensure continued care on route and on arrival at hospital. The crew would not have been able to question the Doctor’s request for ambulance transport.
Crews are provided with information prior to arrival with the patient if this is provided at the time of the call. When the call was made the ambulance service were not notified of the patient’s dementia. When the crew were interviewed and asked about their reasoning for making a vulnerable persons referral for the patient, they felt that she may be vulnerable due to the way the carer was behaving with them. Crews are always expected to make referrals to protect patients if there is any doubt in their mind. If it is found that there is no case to answer to, then at least the patient’s welfare has been safeguarded. We will always support crews in making these referrals. Upon review, it is clear that there was a breakdown of communication and clash of personalities between the crew and the carer. The crew have apologised if they have caused any upset by this incident but felt that they had the patient’s best interests at heart throughout their attendance.
- Lesson learnt / action taken:
Further to this incident, memorandums have been sent to all of our independent ambulance providers to remind them that they must convey the patient to the receiving destination as requested. Delaying on scene can often cause frustration and the crew have apologised if it felt like it was the case. The investigating manager has asked that both crew members be retrained to address the issues of professionalism, communication and customer care.
- Date:01 January 2014