999 Ambulance or Blue-Light Taxi Service?: The South Glasgow Experience

Abstract

Objectives: To determine whether patients brought to the Accident and Emergency (A&E) Department by 999 ambulance genuinely need to attend hospital. Methods: Prospective cohort study of 314 patients transported to the A&E department of the Southern General Hospital by 999 ambulances during a 3-week study period. Additional information was gathered from A&E and in-patient case records. Results: Complete data was available for 290/314 (92.4%) patients. 126 (40.1%) of 999 ambulances arrived between 9am and 5pm, 127 (40.4%) between 5pm and 1am and 61 (19.4%) between 1am and 9am. 202 patients (73.1%) had one or more investigations carried out in the A&E department. 32 (11.0%) had a dressing, 118 (40.7%) had drugs prescribed, 27 (9.3%) had sutures and 4 (1.4%) had a plaster cast applied. 179 (57%) patients were referred to inpatient specialties and 95 (30.3%) were discharged without follow up, 23 (7.9%) of these having required no investigations or treatment. 16 (5.1%) were discharged to outpatient follow up, 6 (1.9%) were transferred to another hospital and 2 patients (0.6%) died. 16 patients (5.1%) discharged themselves against medical advice. Conclusions: The majority of patients currently brought to hospital by 999 ambulance attend appropriately. Over 90% of patients receive investigations or treatment or are admitted. The introduction of prioritisation and telephone advice is unlikely to reduce the number of patients requiring transport to hospital.