Non-urgent calls swamp ambulances

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THE 999 ambulance service is being overwhelmed by rising demand and may be unable to respond rapidly to emergencies in the future unless it weeds out non-urgent calls, an NHS watchdog reports.

Up to 12 per cent of calls are for minor ailments such as cuts and bruises, and in London it has been estimated that up to one-third of the 1,000 calls a month could be handled without taking the patient to a hospital accident and emergency department. Although most callers are genuinely worried, and there is little overt abuse of the service, the report by the Audit Commission suggests that some might be treated on the spot or by paramedics who would travel by motorcycle to 999 callers' homes.

It costs pounds 100 to call out an ambulance and, on average, a person does so once every 16 years. Last year, ambulances responded to 3.2 million emergencies and 1.2 million urgent calls from GPs wanting patients admitted - a 40 per cent rise since 1990.

Almost one in four of the 38 ambulance services in England and Wales failed to meet national 999 targets specifying they should respond to 95 per cent of calls within 14 minutes in urban areas and 19 minutes in rural areas. "If growth in demand continues, services will find further efficiency improvements harder and harder to make. So it is vital to consider whether some 999 calls could receive a different response," the report says.

A two-tier system is being tried in eight areas, to be extended nationally by 2001, where ambulance controllers are required to identify life-threatening incidents by questioning the caller and getting an ambulance to them within eight minutes. In these services, about one call in four was judged life- threatening. However, the ambulance services are not permitted to let other, less serious incidents slip beyond the 14/19-minute standard.

Andrew Foster, controller of the commission, said: "What people lack is somewhere to call in an emergency. They call 999 because they don't know where else to call. Having access to help is what counts."