“Is the patient breathing?” - Ambulance control room staff celebrated during International Control Room Week

EEAST is celebrating throughout the week with stories about the staff working in the three Emergency Operations Centres that cover the six counties of our region.

The emergency call centres take 1.4 million calls a year – that's 4,000 a day, every day. Around 1,000 of those calls will be from doctors, nurses and other health care professionals arranging care or transport for their patients. The other 3,000 calls will be members of the public who have dialled 999.

Let’s follow the progress of one 999 call.

In the control room in Norwich, a 999 call comes in and is immediately answered by one of the call handlers – the first point of contact for someone needing help.

The call handler asks “Is the patient breathing?” This is the first of a series of questions which flash up on the call handler’s screen. These questions are used by ambulance services throughout England and they change dynamically in relation to the answers received. These questions will determine the problem – and how urgent the patient is – within a few seconds.

The call handler follows the questions that pop up on their screen, establishing that this is a person who has been taken ill at home.

They are in a lot of pain, but they are assessed as a Category 2 patient – the second most serious category of medical emergencies. This category is for emergency calls that are not immediately life-threatening. This is one of nearly half a million Category 2 calls EEAST takes each year.

The call handler assigns the call as needing an ambulance response. It's Friday night and she looks up at the room’s large display screen. It shows the levels of demand the service is currently under and provides essential information such as current waiting times and how many calls are waiting to be assigned to an ambulance.

She advises the caller that an ambulance will be sent, but the service is very busy at that time, so there could be a delay in responding. The person with the patient is advised to call back if the patient’s condition deteriorates.

The call is passed to a dispatcher – they have a number of screens on their desk showing maps, how many callers are waiting for an ambulance and, critically, it also shows available ambulance resources. The dispatcher looks at the location of the patient on their interactive map and can see the ambulance resources nearby. They are all either with patients, or responding to more serious emergencies. The dispatcher can look at other resources further away, but that can add travel time.

The map is constantly updating with new information. An ambulance crew 20 minutes away becomes free, and the dispatcher assigns them to that patient – a crew is on their way.

Then another call is assigned to the dispatcher. It is a Category 1 call – the most serious type of medical emergency. A patient is in cardiac arrest, and the crew dispatched to our first patient is closest. The dispatcher makes the decision to divert that ambulance to the Category 1 call as that could make the difference between life and death. One in ten calls taken by EEAST’s call handlers are classed as Category 1.

The dispatcher looks for another crew to send to our Category 2 patient. Meanwhile, because that patient has been some minutes without a response, a paramedic from the Clinical Assessment Service (CAS) calls the patient back to check on them, and see if an ambulance is the most appropriate response for their needs. As well as asking if their symptoms have got worse, they will also try and find out more about the patient and their history.

CAS’ questions have two functions - firstly to check that the Category 2 assessment is still appropriate and escalate to a higher priority if the patient’s condition is worsening, and secondly to provide help and advice to patients who can be effectively treated without being taken to hospital.

While critically ill patients will always take priority, non-urgent patients also need to have their conditions assessed and treated as quickly as possible. For many minor injuries and illnesses, it can be quicker for patients to make their own way to A&E – they won’t be seen quicker if they are taken by ambulance.

For lower categories of callers, seeing their GP or going to a pharmacist might mean they get help quicker than waiting for an ambulance crew free to attend patients in the lower urgency categories. Last year 11% of callers were helped by CAS without the need for an ambulance – freeing up those ambulances to attend to more serious emergencies. EEAST has an ambition of successfully treating 16% of all 999 calls over the phone.

Back with our Category 2 patient: the CAS team have checked that the patient’s condition has not worsened in the minutes during the first call, and by asking further questions about the patient’s medical history, have established that the initial Category 2 assessment is the correct one. Another ambulance is now available – just three minutes away.

The dispatcher assigns the crew to our caller, and this time there is not another more urgent case to divert to. The ambulance arrives at the patient’s address, and the dispatcher can see that the crew have updated their status to ‘busy with patient’.

The ambulance will remain unavailable until the crew has assessed their patient, transported them to hospital, handed the patient over, and then prepared their ambulance for the next patient.

This patient’s story has concluded - but is just one of the 4,000 calls dealt with every day in our Emergency Operations Centres.

Could you be part of our team? Do you want a career that makes a difference? Do you want to find out more? Our virtual recruitment event on Thursday 30 October is focusing on careers in our Emergency Operations Centres! You can speak to our recruitment specialists, hear first-hand from people who work in our call centres and ask any questions you might have about the different jobs available. Register at: EOC virtual recruitment event: Expression of interest | EEAST