As I've mentioned many times in the past us in the ambulance service, and our colleagues working in A&E are often used as a 'safety net' by other medical professionals, whether that is by the nursing home nurse who is concerned by a patient being 'off their food', or the GP who doesn't wish to come out an see a housebound patient.

Obviously there are a lot of people who don't use us as such, but it does seem increasingly common.

Here is an example, we were sent to a severely mentally and physically disabled young woman because she was suffering from thrush. She had been sent home from the day centre and her family had made a sensible decision to phone the GP surgery. This young woman has some complex problems and so she is better served being seen by someone who knows her and her medical history.

The GP had refused to visit, telling the family that 'I'm not examining her' and had told them that they should call an ambulance to have her taken to the local A&E.

We had arrived to find her, not distressed but obviously suffering from the infection, sitting naked on the bedroom floor. Her older sister was playing with her. Both myself and the family were reluctant to take her to A&E, it's an unusual setting full of strange noises, bright lights and strong smells. It's also not the right place to be dealing with a medical condition that is neither an accident or emergency. All in all it would be an immensely distressing experience for her. She'd been there before and had hated it her family told me.

We discussed with the family our best plan of action, they agreed with us that our Control should try the GP and see if they could come out to see the patient, we were aided in this because by this time most of the regular GPs would have changed shifts so we would be talking to a different doctor. The family agreed to this and after our Control spoke to the GP the doctor agreed to come and visit.

It must have been fine as I didn't see her in the A&E department during the duration of the shift.

I don't like leaving people at hospital, it's often the path of least resistance to load up the ambulance and drive them in. But sometimes it really is in the patient's best interest to stay at home and this was a classic example of this and in those cases I'm willing to take that job-threatening risk.