"I just want to get an ambulance to them" - on the 999 night shift at the heart of BBC1's Ambulance
Radio Times joins the men and women answering desperate calls for help
At first glance, you could mistake this place for any customer services call centre. Deep in a nondescript industrial estate two miles east of the M6 in Stafford, on the first floor of an anonymous office building, is a big open-plan space filled with half-a-dozen hexagonal islands of interlocking desks, of the kind familiar in thousands of offices. But at 7pm on a Friday night at this workplace, far from going home for the weekend, Team Four has just clocked on for a gruelling 12-hour night shift.
At every desk, a staffer is gazing intently at two, sometimes three, screens, telephone headset in place, talking with a caller. In an atmosphere of absolute calm, the steady murmur of their voices fills the air. It’s only by leaning in close that the words that answer every call become audible: “Ambulance service. Is the patient breathing?”
These are the men and women at the nerve centre of BBC1’s Bafta-nominated observational documentary series Ambulance – the people we see coaching frightened callers through childbirth, calming people threatening suicide and instructing family members paralysed by fear on how best to save the life of a loved one. Richard, 49, is duty manager on this shift, in charge of everyone in the room – 17 assessors answering emergency calls, along with ten dispatchers and six controllers sending medical staff and vehicles out in response, along with the hundreds of ambulance paramedics giving treatment at the scene.
“I’ve done all those jobs in my time,” he says, gazing at a bank of screens where each call has been given a job number and assessed in detail. “Every call that’s on here, I can picture the exact scene because I’ve been in those situations. I just want to get an ambulance to them, now.”
The control room he commands is one of two Emergency Operations Centres (EOCs) for the West Midlands Ambulance Service, the other being in Dudley, 25 miles south. Up to 263 ambulances are available across the region throughout this shift, along with up to ten rapidresponse vehicles equipped for more specialist care. Ultimately on this Friday-night shift, the two EOCs will field 1,668 calls between them.
Portia, 45, has been call taker supervisor at Stafford for a decade and says that the number of calls has soared in the past five years. “Three thousand calls in 24 hours used to be a lot, but now we’re reaching 4,000,” she tells me. “People think it’s their right to phone about a finger injury, or to ask for a lift home. Then there are the regular callers with mental health issues or social problems, who are just lonely. We get to know them.
“And it’s changed in another way – there’s an awful lot of abuse, again through mental health difficulties, but also drugs and alcohol, or even people just waiting a long time for an ambulance.” She nods to her team with concern. “The new ones here really struggle with that."
Karen, 53, has been a call assessor at Stafford for a decade. Her job is to apply what’s known as the NHS Pathways system. After the initial response of “Ambulance service. Is the patient breathing?” she next asks, “Is the patient conscious?” Depending on the answer to each query, the computer algorithm provides the next in a series of questions, so that a patient can quickly be categorised from one to four (lifethreatening, emergency, urgent or less urgent). The patient survives in around 90 per cent of category-one (life-threatening) calls while, at the other end of the scale, around 20 per cent of calls require no more than a visit to a GP.
On a typical shift, Karen deals with 60 callers and I listen in. They include a boy who says his knuckle is hurting, a woman who is suicidal as the result of a rape two months previously, and a father whose 11-month-old baby has bronchitis and is having breathing difficulties. All receive the same kindly reassurance as the patient’s need is established (“Well done, my love, help is on the way”). “Bless you,” Karen says when I remark on her manner. “They can be calling in their deepest, darkest moment, and the last thing they need is to feel as if someone is reading off a script.”
Up to a point, calls follow a pattern. On a Friday night, alcohol-related incidents including fights are a certainty; Sunday lunchtime heralds football and rugby injuries from over-zealous part-timers; and every morning brings a rash of calls about older people who have fallen while trying to get out of bed. “Nan down” is the expression at such times; a “truck” (ambulance) is sent, although the speed of arrival hinges on “the knock” (the precise nature of apparent injury, if any) and whether Stafford is “stacking nines” (receiving many ambulance requests). But there is no slang for the worst of times, when the youngest lives cannot be saved.
Dan, a 33-year-old controller, can’t forget a call from several years ago when “a baby had died at home, with the baby’s parents on the line begging for help”. Richard, too, has his demons. “There are always jobs you take with you, but you have to box them off and put them away or you can’t function. When I was on the road [as a paramedic], we went out to a four-year-old kiddy who’d run round the back of her uncle’s car and he’d accidentally reversed over her. There was just nothing we could do for her. That’s 12 years ago, and I still remember her name.” He gazes at the screens on his desk bearing the evidence of tonight’s calls, clearly visualising what’s happening at each. “I just want to get an ambulance to them,” he says.
Ambulance begins on BBC1 on Thursday 26th April at 9pm
