Volunteers could be responding to urgent 999 calls in London within weeks, as the capital’s ambulance service tries to tackle mounting delays.
A pilot scheme, revealed in London ambulance service (LAS) board papers at the end of March, will focus on people who fall into “category three”, where they require a response within two hours, and need extra help because of mobility problems.
Category three calls can include late stages of labour, abdominal pains, and diabetes where patients can be treated in their own home.
The report said calls from patients who are in this category and have mobility issues “results in the dispatch of an emergency ambulance, reducing ambulance availability for higher priority incidents and longer waiting times for patients”.
It added: “Following a clinical assessment, the Volunteer Ambulance Car Project will dispatch a volunteer car to these patients, reducing waiting times and increasing ambulance availability.”
It comes with ambulance response times at the worst level ever recorded – prompting the president of the Royal College of Emergency Medicine, Dr Katherine Henderson, to say lives are being put at risk by delays.
She told the Guardian: “It’s not acceptable … it’s a very, very significant loss of that basic agreement with the public about the NHS, which is that if you dial 999 and you need an ambulance – which an old person who has fallen downstairs does need – you’ll get one in a timely way.
“And we’ve broken that contract with the public. It feels shaming to me that we’re in this situation. We’ve got elderly, vulnerable people at home who need an ambulance … and we can’t get them in.”
Nationally, category 2 emergencies – including cases such as heart attacks or strokes – faced an average wait of more than an hour, against a target of 18 minutes. In London, the average was slightly lower, at 51 minutes. Category 1 incidents are defined when the patient is in a life-threatening condition.
Volunteers are already used by hospitals and charities to take people to outpatient appointments, and taxis are used to take low-priority patients to hospital after being assessed.
The LAS said trained volunteers already respond to 999 calls in their own car alongside ambulances. But it confirmed that such volunteers would now be deployed for lower-category calls in some instances and take patients to hospital.
An LAS spokesperson said: “These fully trained volunteers, who already respond to 999 calls in their communities, will help patients who have been assessed not to need an ambulance but who may need more support than a taxi can provide.”
NHS England and NHS Improvement support the plan, the board meeting was told, and NHS England is considering it as the basis for a “national volunteer transport” system.
The pilot will use 22 volunteers, trained by St John Ambulance and termed “community first responders”. They will be based out of six ambulance stations across the capital.
Rachel Power, chief executive of the Patients Association, said she had concerns. She told the Telegraph: “Given the long waits patients are experiencing waiting to transfer from ambulances into A&E, we’d like to know more about how patients in volunteers’ cars can be adequately medically supported if they face a long delay before being admitted.”
She added: “The introduction of a permanent volunteer force transporting 999 patients cannot be a substitute for trained paramedic staff.”
An NHS England spokesperson said: “This is a locally run pilot which will see fully trained volunteers like St John Ambulance accompany lower-risk patients to hospital where patients do not need to be managed as an emergency but are required to attend hospital following a clinical assessment.
“There are no current plans to expand this scheme more widely.”
