Northern Ireland

Poots considers helpline number after 'abuse of 999 service'

Health Minister Edwin Poots is considering the introduction of a new helpline number which could reduce unnecessary referrals to Accident and Emergency departments.

Last year, one in five callers who dialled 999 in Northern Ireland did not need emergency help.

A new national helpline number - 111 - is currently being piloted in three areas of England.

It is for patients who need urgent help but whose lives are not at risk.

The helpline is staffed by fully-trained advisers and nurses who can assess patient symptoms, and advise on the appropriate services.

Mr Poots said he was keen to explore the potential of a single contact number, but would await the outcome of the health and social care sector review before making a decision.

"The use of a single contact number to assess requests for urgent assistance and match them with services in a patient's local area is an initiative successfully being applied by the NHS in Great Britain," he said.

"I am keen to explore how this approach might benefit users and services here, by reducing unnecessary referrals to A&E departments for example."

About 28,500 callers from Northern Ireland, identified in the latest records, wanted everything from assistance getting into bed to treatment for a toothache.

The director of operations at NI's Ambulance Service said people must stop using ambulances like taxis.

Brian McNeill said paramedics' valuable time was being wasted and it could be dangerous.

Records for last year show that 22% of 999 calls last year were not emergencies.

Mr McNeill said paramedics play an invaluable role and should be left alone to get on with their real job.

"Wasted calls, hoax calls, those people who call for an ambulance and then when paramedics turn up they decide they don't want to go," he said.

"That is all wasting resources. Those vehicles could all be on standby for the next life threatening call and if they are not available that could be very dangerous."

The BBC spent a morning with Belfast paramedic Eamon Ferguson.

Shortly after midday, at Belfast's Royal Victoria Hospital, his bleeper went off and within minutes he was on the M1 in the direction of south Belfast.

He had eight minutes to reach that call - when he arrived an elderly man was struggling to breathe.

"We are busy 24/7. There are enough emergency calls to keep all of us on our toes - we don't need the hoax calls or the ones where people simply think we are a taxi service," he said.

While this incident turned out to be serious, not all emergency calls are. In fact paramedics are increasingly finding that their time is being wasted, as the public are too quick to dial 999.

Eamon recalls one Christmas Eve and a call which had been reported as a Category A incident.

"It was ten minutes to midnight and I was due to come off shift. I received an emergency call to go to a woman who was unwell," he said.

"When I arrived she couldn't get a ring off her finger - that was her emergency.

"I have had other similar calls including a woman asking me to help her turn over her elderly husband, even a woman asking me to make her dinner as the home help hadn't turned up."

Around 28,500 of 999 calls made last year did not require the expertise of a paramedic when they arrived at the scene.

Nose bleeds

Among the calls were requests for crews to help stop nose bleeds, turn people over in bed, comfort someone who was concerned about a pet and to treat a toothache.

As the service receives around 130,000 calls per year, Mr McNeill said there is no room for abuse.

And with the imminent closure of the City Hospital's A&E expected to create additional pressure, he's calling for the public to act sensibly.

"We are expecting an increase in the number of emergency calls, people who just haven't listened to the advice about changes to the City Hospital and no doubt we'll have to taxi people about.

"But that will be initially, judging by past experience when there have been changes to acute services, in time it will peter out."

According to the Northern Ireland Ambulance Service, paramedics here bring a higher percentage of people back into hospital after attending a call, compared to anywhere else in the UK.

Mr McNeill argues there must be a change of mindset about what the health and the ambulance service is all about.

"I would plead with the public to ask themselves, do they really need an ambulance, or could they be treated by a GP or the out-of-hours service."

In less than two months, Belfast City Hospital's A&E will close. Management are describing it as temporary, triggered by safety rather than financial reasons.

While that move is focusing on how emergency care is delivered, it is happening against a backdrop where health professionals want fewer patients treated in hospital and out in the community instead.

Image caption Dr Brian Dunn said people are also confused when to use the GPs' out of hours service.

The chairman of the British Medical Association's GP committee, Dr Brian Dunn, said doctors want to help with that transition.

Based in Larne, he insists, people are just not confused about when to call for an ambulance but also when to use the GPs' out of hours service.

He warns treating more patients in the community comes at a cost.

"GPs want their patients seen in a timely manner, treated properly and in the most appropriate place," he said.

"But some people don't know what the difference is between accident and emergency and an out-of-hours service.

Education

"There needs to be change not only in patient behaviour but also in patient education.

"Doctors who work in out-of-hours are already under too much pressure - that will get worse as more are directed to the GP - and we would welcome more resources to do that."

Accident and emergency care, minor injuries, out of hours service, are all terms the public really know very little about.

What they need to know, simply and quickly, is where they should go to get help.

While some might argue that it is self-explanatory, in paramedics and GPs' experience, it is not.

Senior health managers, therefore, need to begin explaining the health care map to the public as soon as possible.

This will attempt to avoid any unnecessary confusion especially as winter looms ever closer.

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