From October the first this year, local NHS organisations will have responsibility for managing how ambulance services respond to Category 'C' calls. These are the calls that are for cut fingers, simple bee stings, grazed knees and splinters in the hand. Ambulance service chiefs nationwide welcomed the changes, because they think it will mean more ambulances for actual emergency calls, which means that response times should go down. This will make the chiefs happy, because it makes the government happy.

But I have bad news for them - The London Ambulance Service was selected to trial this idea, so we instituted a 'No Send' policy. This meant that the call takers in Control could redirect crap calls to NHS Direct or the patients own GP. This was going to reduce our workload, increase response times and generally make life a lot better for all concerned (including the A&E departments who would have less crap brought to them by ambulance).

We have approximately 3300 calls a day across London. Our 'No send' policy filtered out, on average, 30 of those calls.

That is 0.9% lowering of our workload.

The reasons for this are many, primarily we are scared of getting sued - if someone phones up and asks for an ambulance, we refuse and they drop dead later in the day (from something completely unrelated) then the lawsuits, suspensions and bad press will be massive.
Then there are the callers who know how to work the system. When you call up 999 and ask for an ambulance, the call-taker asks a number of questions about the patient - one of these being 'Are they having difficulty breathing?'. If they answer yes to this question an ambulance gets sent as a Category 'A' emergency call. This is fine until you realise that most people will answer yes to this question in order to get an ambulance. Sometimes they will just agree with everything the call-taker asks, and other times if the patient is crying (because, for example their boyfriend left them), then they will think that this is 'difficulty in breathing'.

Sometimes a cough, that the patient has had for a week, equates to' difficulty in breathing', in the callers mind.

This is without getting into the thorny subject of people who call for an ambulance that can't speak English.

I think I've mentioned before that I spent a shift up in Control, listening to calls being taken. I couldn't do their job - at least I can see the idiots and decide there is nothing wrong with them, call-takers just have some nutter shouting down the phone at them in barely decipherable gibberish.

So, in closing, congratulations for extending the 'No send' policy across the country - but don't expect it to do wonders for your numbers.

Thanks to *anon* who pointed this out to me - I'd forgotten all about it