Misuse of Resources This blog could just as well be called, random acts of stupidity. I am not just talking about the patients. How long did it take to establish a presence and for the first ambulance unit to arrive on scene at the fatal stabbing? I agree with batsgirl, sometimes you just got to let it, fucking, rip! In these sort of circumstances a good long rip. Very good for maintaining optimum mental health! And I should know! You are going to make my dissertation on, The Real Response of the London Ambulance Service to Accidents and Emergencies; With Particular Emphasis on The London Borough of Newham very hard work. I do hope the local Members of Parliament and councillors start logging in for your current bird’s eye view of the underbelly of emergency care. Who do you blame for all these Fuck-ups and foo-bars? It is not really controls fault; the majority of controllers do good work. Of course even they can have a bad mental health day and mistakes are made. Mistakes that cost lives and limbs! It is the “system” that is at fault, a historical truism reinforced by the previous failures of the mark 99 model of the system of allocation and the 98th, 97th etc. The trouble is that the “bread and butter” work creates a kind of fog of war, and that coupled with the stress and strain of dealing with the dichotomy of who gets priority that leads to break-downs of logic. The London Ambulance Service along with all the other emergency services, right down to the Automobile Association, is usually at its best, when the shit really hits the fan. Within minutes of a major crisis all the services become fully-focussed on their primary function, the protection of property, maintenance of good order and the care and control of the victims of crisis, in all its forms. In these situations the Services response is always appropriate to the event. The LAS like all ambulance services is part of the strategic reserve. The Service always has to be on the lookout for situations which could be the spark of crisis, the first flicker of a major disaster and on a London wide basis. With this in mind there must always be a strategic reserve vehicle available, at virtually a moments notice to be dispatched to the scene of potential disaster. When the solo responder or Rapid Response Vehicle role was first instituted by the then Chief Executive of the LAS, Mr John Willby back in the early nineties, this was the main selling point presented by senior management to operational staff, as justification for introduction of the role. Additional funding was provided by government in order that this vital function would be initiated. There was some staff resistance to its introduction, but every occasion when the only available ambulance had to travel a considerable distance to the scene of potential disaster reinforced the usefulness of the rapid response unit. I have been in this situation all too often and on arriving on scene and witnessing that a solo was already there has gladdened my heart. Many of these incidents could have been described as turning out to be “minor“ emergencies, an every day convey to hospital kind of job, but all to often they had the potential for disaster. This is the primary role of the solo ambulance unit, to investigate and through establishing an on-scene presence to relay information and orders back to Ambulance Control. The person performing this function becomes the focal point and embodiment of the Emergency and Accident arm of the London Ambulance Service. Once the potential of any situation has been established, the appropriate action (operational order) can be initiated and followed. What ever the end product of such action, whether one or many patients have been treated then dispatched to hospital, the ideal solution would always leave the Rapid responder still on scene and in a position to provide a near instant response to the next, potentially disastrous situation. During my seventeen years service, I was regularly dispatched to distant and real emergencies and when I requested if the Rapid Response Unit had been dispatched, all too often the answer was in the negative. Later enquiries as to what the RRU had been responding to at the time of my real emergency and usually it was some piece of drivel. Childbirth is one of the most natural events and most babies deliver by the mother themselves. They do that by pushing and most are well equipped for the task. Although each and every one of them has a potential for disaster, once the level of potential has been established, a function which in most cases should be resolved on the telephone, the prospective mother or her carers should be directed to make their own way to the local maternity unit, either by use of their own transport or by licensed taxicab. If the patient has no money at the time of the incident the Service should provide a contract taxi at public expense and reclaim the money at a later and more appropriate date. That you were dealing with a bog standard maternity case at the time of the Stabbing event is culpable and a perfect example of inappropriate allocation of a precious recourse. To any family in the land, serious illness or accident to a member of their family automatically become a major incident and a potential disaster. If the Service does not respond properly to such an incident, whether as the person on the ground or the person in Control, then there is justifiable cause for complaint and such failure brings the reputation of the Service into disrepute. This is an offence under the Services code of conduct and its general moral and ethical responsibilities to the people of London.