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‘An ambulance is NOT a taxi to A&E’, report says

Paramedics should treat more patients at the scene and not just automatically whisk them away to A&E, a report claims.

Lord Carter of Coles, who led the review, estimated the move could save the cash-strapped health service around £300 million each year.

The Labour peer also argued treating patients roadside would alleviate pressure on over-stretched casualty departments and hospitals across the UK.

In a scathing attack on the standard practice in the NHS, he said: ‘An ambulance is not a taxi to A&E’.

Lord Carter of Coles, who led the review, estimated the move could save the cash-strapped health service around £300 million each year

Lord Carter added: ‘Too many patients are being unnecessarily taken to A&E by ambulances, putting further pressure on hospital services already on the back foot.

‘Not only is this financially costly, but it takes up staff’s time and means patients are having to spend time waiting in A&E when they should be recovering at home.

‘Modern technology means that patients can often be treated at the scene. But an ageing ambulance fleet means that this is not always possible.’

The report calls for ministers to invest in up to 3,300 new ambulances in the next five years to ensure staff can care for patients at the scene.

Lord Carter’s recommendation was based on examinations of 10 ambulance trusts in England, highlighting where they could save money.

He claimed the NHS could save a further £200 million a year until 2021 by improving the infrastructure of ambulance trusts and staff productivity.

And the non-executive director at NHS Improvement said the NHS fleet should be updated to allow paramedics better access to patient records and the best technology.

Frontline staff should also be given better information about other health services they can refer patients to – rather than A&E.


Advanced paramedics can now prescribe medications to people who do not require hospital treatment, MailOnline reported in April.

Under UK laws, paramedics who have or are working towards a master’s in their specialty, are now able to issue drugs without delay or such patients being required to visit their GP.

Up to seven in 10 people seen by advanced care paramedics require assistance but not hospital treatment.

Around 700 paramedics were due to be trained to make them qualified to issue prescriptions.

Previous Nice recommendations to train more staff to become advanced paramedics claimed such a move could reduce hospital admissions by 13 per cent.

It was hoped the development would free up A&E doctors to treat more needy patients.

Most staff currently unable to find out valuable medical information to make informed decisions about care, the report said.

Lord Carter’s report also suggested improvements in assessing patients over the phone during 999 calls would ease the strain on ambulance crews.

The 72-year-old said: ‘Paramedics and other staff have worked incredibly hard as demand for ambulances has soared.

‘It is now vital that improvements are made in the infrastructure of the wider NHS to help frontline staff work as efficiently as possible.’

The time an ambulance spends at hospital has increased from 27 minutes on average per patient to 35 minutes over the last decade.

Delays during the NHS winter crisis, when ambulances were seen queuing outside A&Es with patients, cost trusts nearly £50 million.

Miriam Deakin, deputy director of policy and strategy at NHS Providers, urged chiefs to invest money into other areas of the health service.

Commenting on the report, she said: ‘We must recognise the role ambulance services often play as the ‘front door’ for patients.

‘To be able to realise the levels of savings identified, we must address pressures in other parts of the health and care system.

‘Reducing unnecessary trips to hospitals in ambulances could save money, but it will require investment in other areas.’

The ambulance service has the highest sickness absence rate in the NHS, at an average of 20 days per person per year, the report also found.

Ms Deakin said the workforce is at ‘full stretch’ and that the significant shortage of paramedics must be tackled urgently.

Martin Flaherty, managing director of the Association of Ambulance Chief Executives, said the body welcomed Lord Carter’s report.

NHS Improvement is set to consider the recommendations in a public board meeting today.