One of my great irritations with my job is the abuse we get from people when it comes to Ambulance transport. And G.P.s need to take some of the blame.

There is an old fashioned term used within the medical profession since the discovery of the telephone…”off legs!” 

This term, on the face of it, should refer to someone who is unable to make use of their legs. Someone who is unable to propel themselves forward in a bi-ped manner. A person who, either through sickness, trauma or poor mobility in general, cannot walk.

Unfortunately “off legs!” can, and is, frequently applied to persons who can mobilise, who can walk, and who sometimes are fitter than the crew calling for them! 

“Off legs!” is usually mentioned to Ambulance control when a G.P. is arranging for a patient to be admitted to a hospital ward. Therefore the Ambulance dispatcher will assign a crew to the detail which is 99% of the time as an urgent. (Low priority detail not requiring “Blues & Twos”.)

Recently I seem to have been assigned to many such calls which takes away a crew and emergency vehicle. As I said earlier if the patient is truly “off legs!” then no problem. But when we are being used as taxi service then that grates.

Typical example…called to a lady “off legs!” numbness in both legs, unable to walk!

On arrival at the address we are greeted by the family who show us into the house where we find our patient…walking from room to room collecting her things to take into hospital with her! Her legs appear to be in fine working order, both facing the right way, moving in a coordinated manner, transferring her body through space by using equal footfall therefore enabling her to get from point A to point B in good time!

She has been waiting for us to take her to hospital for three and a half hours (remember these are urgent not emergency details). Her family have a car so I ask if they are following? Usually if they are I ask them to take the patient…just so long as I am satisfied that the patient will not need any kind of interventions or monitoring by us.

On this occasion the family said that they could not take her as they had to be at work in two hours time! They could have taken her at least two hours earlier but the G.P. insisted on calling us!

As an Ambulance service we should be looking at some kind of payment for these jobs either by the G.P. or the patients family for unneccessary transport. That might stem the tide of calls we receive to take people to hospital who could get there easily themselves.

It is some kind of law of physics that states that:

“…every person who is off legs will live in a house with at least two cars on the drive!”


8 Responses to “Taxi…!!!”

  1. ecparamedic says:

    Couldn’t agree more, if the practices were billed for taking an emergency vehicle off the road I think we’d see a shift from our seemingly default position of cheap taxi.


  2. Ellis James says:

    The only problem I can see with charging patients for unneccessary transport is that it may well deter elderly patients from calling an ambulance.
    Most elderly people are apologetic when we turn up even when it’s obvious they need help, so if they thought that there was a possibility that they may be charged….

  3. Lee says:

    The money is more or less in the same pot, no matter who you give the budget to. The surgeries should have there own ambulances funded by themselves, and when not in use should be on standby to cover emergency situations. My dad was in the fire brigade for 35 years and now there is talk of putting paramedics on the fire engines i think that would help emergency situations.

  4. Emma says:

    Unfortunately the people who you are targeting would probably be exempt for some reason, see today’s Times in relation to GB trying to get the GP’s to offer OOH and NHS Blog Doctor’s reply about ingrowing toenails etc.,

    I did reply that if he doesn’t get them the ambulance service will…

  5. traineeparamedic says:

    I agree with both the charging and the elderly points, although generally from what I’ve seen so far, elderly people don’t dial 999 for no reason. However I have seen a few people that could make their own way to A&E. I would think that for charging to be introduced, at least the crew and a doctor or sister at A&E would have to sign off that it was unnecessary.

  6. ecparamedic says:

    I’m not suggesting charging the patient direct, not under these circumstances at least, though there are certain circumstances where they should be fined. However that isn’t the point of this post.

    As the much publicised GP targets have shown, if you attach a financial incentive to meeting a target the GPs will make damn sure they hit the target, likewise if you attach a financial penalty……….. work it out.

    You could achieve all sorts within the NHS if all staff had a material incentive to deliver the goods… sadly this would never happen as it’s cheaper to throw threats around and spin failure into success.


  7. kingmagic says:

    Thanks SD.

    The gist of the post was not about charging per se, but about the many jobs that crews up and down the country go to where an ambulance has been ordered by a G.P. or the family wont transport due to “other commitments”.

    A crew will transport a patient who needs monitoring/treating due to an illness or injury or simply if the patient cannot walk.

    Its just one of the many examples where the Ambulance Service is used inappropriately.

    However I do accept that in most cases its just down to a case of not thinking it through and lack of education.

    I know of lots of G.P.s who will always ask the patient if they can get to the hospital under their own steam…obviously only if their condition allows.

    The other side of the coin, and lots of colleagues will back me up on this with their own examples, are the times when we see severely ill or injured people being brought by private car into A/E. When asked why they invariably say that they did not think it was serious enough to get an ambulance!

    Again its due to a lack of education. A recent case in point was one that I witnessed whilst working in A/E on secondment: a woman drove herself to A/E after suffering partial thickness burns to her entire left arm. She was in agony and how she never crashed the car is a miracle!

    Just to reiterate, we get called to lots of jobs where we are just being used as a transport medium. The phrase “off legs!” rarely matches up to the patients condition.

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