David Nicholson (Chief Executive NHS)

"The ambulance service is not close to breaking point. It's tough, there is pressure on them, but I think they are responding fantastically well. Staff are absolutely responding to provide a fantastic service to our patients"

Peter Bradley (Chief of the London Ambulance Service)

"The increase that has come this winter has been far more dramatic than normal. It has been the most difficult ten days I have seen in the last ten years. It is absolutely horrendous. Hospitals are full and A&E departments are struggling. We have got ambulances having to wait longer to offload patients and that is causing difficulties."

Who do you think has the better idea of the state of the ambulance service at the moment? I know who my money is on and it's not on Nicholson.

On Monday the London ambulance service went to REAP 4. The REAP system runs from REAP 1 (no problems with the service) to REAP 5 (the sort of problems you get after all the power stations blow up and there are plague rats running on the streets of London).

We have never been at REAP 4, and if you ask the road crews in London they would probably say that we should have been at REAP 4 a couple of months ago.

From the official London Ambulance website

"Ambulance staff responded to 20,939 emergency incidents across the capital in the seven days up to last Sunday (14 December) – an increase of nearly eight per cent on the average of the previous four weeks. The pressure has been compounded by high percentages of calls initially treated as being Category A (immediately life threatening), and delays caused to staff at hospitals while waiting to hand over patients.
As a result of these ongoing issues, the Service today raised the declared pressure level at which it is operating from ‘severe pressure’ to ‘critical’ – the first time that it has reached this level since the capacity levels were introduced in late 2005."

The national news has been full of this story and there has been constant coverage that the 999 service is to be used for only 'genuine' emergencies...

...and obviously it has worked because five out of my nine calls today were to simple chest infections that could have been treated at home, seen a GP, or just sit and wait for it to go on it's own. None of them were sick enough to need an ambulance - but they called and we responded. I suspect it will be a similar story tomorrow.

We also had two hoax calls.

But I'm preaching to the choir.

It doesn't help that we had an outbreak of Norovirus at one of our local nursing homes, something that has led to a local hospital opening an isolation ward in order to safely cope with the influx. I'll tell you the full story of that night in a later posting.

Today, like many others of late, there were multiple calls being held waiting for ambulances - some of these calls would have been covered were it not for people picking up a phone and using the same number you dial if someone has dropped dead in front of you for their case of a 'nasty cough for the past three days'.

There are too many patients, 80% of whom don't require an ambulance, and not enough ambulances.

What doesn't help is that the politicians are ignoring the problem and trying to pretend that it hasn't all gone to the dogs. The politicians are being dishonest (yet again) and so, it would seem, are the executives of the NHS. Rather than admit a problem and make some sort of plan to improve it they lie and spin and lie some more. Just notice how they call a massive (30%) increase in calls a 'pressure' rather than a bloody disaster that we have seen coming from twelve months away - it's not like Winter just sneaks up on us does it?

And on Friday it's 'office piss-up' day.

Bloody great.

The only good thing about today has been a group of us stretcher monkeys getting a good result from a cardiac arrest. If this post reads a little weird it's because I haven't slept a wink in the last 36 hours and have just completed a 12 hour shift. At least the hallucinations haven't started yet...