31 March 2023

I’m an emergency medical dispatcher – I make life-or-death decisions daily

Working from the ambulance control room, I know that the resources just aren’t there to save everyone.

Ambulance staff have been on strike several times over pay, and are considering a 5 per cent offer. Photo by Carl Court/Getty Images

Every 999 call goes through three phases. We have the call handlers who receive the calls and ask all the questions. Once they’ve got all the relevant information, it’s passed through to me, the emergency dispatcher.

It’s my responsibility to manage the resources that go to the incident. These will depend on the situation – a “category one” emergency gets an ambulance, while a more complicated incident might get a double-crewed ambulance, or specialist resources.

In the ambulance service things change quickly. You can have a plan to do one thing and then a call will come in and that plan can literally go out the window. It’s hard because I can see all the calls coming in. It’s up to me to contact the crews to make sure that they’re OK if they’ve been on a scene for ages and ask whether they need more resources. I work on a shift basis, managing 20 to 30 individual crews a day.

It’s important to me that we’re helping people. For those of us in the control room that’s about getting the right people there on time to save lives. Sometimes the volume is overwhelming. I can walk into a shift at 6am and face 25 or 30 outstanding emergencies that are waiting for crews to be allocated, with only ten crews available.

When that happens, I know I’m not going to get through the “stack”. I’ll go home at 6pm and some of those jobs could still be on my screen. It’s not a nice feeling knowing that somebody’s been waiting for 12 hours, and you don’t know when they’re going to get an ambulance. You go home and wonder, “what happened to that patient?”

The problem is we’ve got hospitals that are short staffed, so there are massive delays, and crews get stuck waiting at the hospital. After having done full 12-hour shifts, crews will work for two or three hours extra, or even more. It puts a lot of pressure on people. You think: “When is it going to end?”

We’ve always had winter pressures, such as people getting ill or falling over due to the weather conditions, but now it is constant. You go into work wondering what you’re walking into. The other week I dealt with ten deaths in one shift. That was a really hard day.

We have a great network of colleagues. We chat to each other, and to the road crews, about the pressure, because it’s affecting all of us. The road crews see death every day, but they only deal with one call at a time, whereas I’m dealing with a full area’s worth of calls at once. At any given time, I’ve probably got 20 to 25 patients on the screen needing an ambulance.

Retention in the ambulance service is horrendous. In November last year we had about 14 call handlers leave in one month – that’s a full training class of people. This is putting pressure on the call handlers that stay. In my opinion it boils down to pay. I don’t think we’re paid enough for the responsibility that we have, along with the abuse and threats of violence that we get over the phone.

Ultimately, there is no way to fix the NHS without paying workers properly. Half of our problems are because hospitals are understaffed and have no beds. Our crews end up sat with patients in the back of ambulances for hours on end. But the patients who need to go home from hospital also can’t because there’s no social care for them. One thing leads to another, and unless the NHS is fixed and funded properly, it will carry on that way until it cannot anymore.

The government has buried their heads in the sand about this. Why did ministers wait three months, forcing us to strike several times, before doing what we asked for in the first place – just to come to the negotiating table. We are currently considering their 5 per cent pay offer.

I voted for strike action because I thought it was the right thing to do. We must have a voice. Because if we don’t stand up for what we think is right then nobody’s going to listen to us and nothing’s going to change.