Queen's Hospital in Romford is closed

King Georges Hospital, a bit closer to my station is closed.

Whipps Cross hospital remains open for more of the day, but then closes.

Newham, Homerton and the Royal London are now the only hospitals in East London accepting patients.

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Queen's and King Georges being closed in the east means that ambulances local to them are bringing patients to Newham.

Crews local to Newham (i.e. me) are being told to take patients to either the Homerton or to the Royal London.

I don't know what crews local to the Homerton or Royal London are being to to do.

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I pick up a patient a stone's throw from Newham hospital, he has chest pain that could be cardiac in nature. I have a bit of job persuading him to come to hospital, but he finally agrees that the only definitive test is some blood tests.

As directed I contact Control to see where I should take him. They tell me to go to the Royal London hospital.

I tell the patient - he gets off the trolley and walks out of the ambulance, he doesn't want to go to that hospital and I had a hard enough time getting him to agree to go to the local hospital.

I complete my paperwork and then fill out a clinical incident form. If he drops dead it'll be me in front o the coroner, not my bosses.

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I spoke to one of the crews that is local to Queens hospital, they tell me that the A&E department is full of patients from last night. They are still waiting to go up to the wards to get the treatment that they need.

But there aren't enough beds.

Queen's hospital was only built in the last two years - you'd assume that it would have been designed and funded to meet the needs of the local people.

I can understand why the A&E closes, it's a clinical risk to be so overcrowded.

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But it's also a clinical risk to be driving patients across London, it's a clinical risk to have patients decide that they want to stay at work rather than be driven miles to a strange hospital.

It's a clinical risk that I can't take a patient who has multiple problems that the local hospital knows all about to that hospital (although in that case I successfully argue my case with Control, at least I think I do, they don't reply after I tell them why I'm going to the local hospital instead of one unfamiliar with my patient).

I'd say that it's a clinical risk that ambulances are tied up with longer than normal transports - this means it takes us longer to go clear at hospital to get to our next patient. And it's normal for us to be holding calls for ambulances to come clear - how many more calls were we holding today?

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Once more, a lack of capacity means that those of us on the bottom of the pile get the most crap - and in this case it's not the ambulance service, it's the patients.

The answer is simple, but it costs money. Money 'better' spent on keeping bankers in jobs and fighting wars that don't concern us.

But of course, I'm just a stretcher monkey, what do I know?

Good News

Patients suffering an out of hospital cardiac arrest in London now have more chance than ever before of being resuscitated by staff, according the latest Service figures.

The report, published by the Clinical Audit & Research Unit (CARU), also shows the Utstein* survival rate is up to 15.2 per cent from 12 per cent the previous year.

So, if you have a cardiac arrest in London (for certain values of cardiac arrest), you have a 15.2% chance of survival. Which is great but won't result in us getting any more funding. Well done everyone involved, and well done to the new CPR protocols - I've personally noticed a difference with the 30:2 compressions.

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Bad News

For the first time in its history the Service has responded to one million incidents in a single calendar year.

The Service has already attended over three per cent more incidents than in the whole of last year (968,952), with the busy New Year's Eve period still to come.

Chief Executive Peter Bradley said: “To attend one million incidents in a single year is an amazing milestone and one that no other ambulance service has ever reached.

“Every member of staff can be proud of the contribution they have made towards helping us to reach more patients more quickly than ever before.

“Demand on our Service has risen steadily over the years , and this is something experienced by ambulance services nationwide. We continue to work to find innovative ways of offering more appropriate care pathways for our patients. The ability to offer some of our callers telephone advice or to transfer them to NHS Direct is allowing us to save thousands of traditional ambulance responses each year."

The millionth incident was to a patient suffering chest pain in Tower Hamlets. A Poplar ambulance crew and a HART single responder attended. The patient was taken to hospital.

This is what I meant when I previously mentioned that our chief executive sounded proud that we go to more than a million calls. Is that something we should be proud of, or rather something that we should be worried by? And these are the calls that ambulances are sent on, not the ones where telephone advice refuses an ambulance.

Someone please explain to me how this is a good thing, especially if we aren't increasing the number of ambulances and staff on the road?

As an aside, half of my workload is 'chest pain in Tower Hamlets', I'm willing to bet that it was a cough or bellyache, or maybe a bit of 'flu'.