London Ambulance Service is being deluged with almost 350,000 emergency calls a year from “frequent callers”.
Almost one in six calls received by the LAS – the busiest emergency service in the country with 1.9 million 999 alerts a year – is from a repeat caller.
The number of repeated requests for help soared between 2014 and 2015 by almost 100,000 cases, often because patients believe they “have nowhere else to turn”. Some people call several hundred times a year.
Now the LAS has launched a pilot scheme to “manage” 425 patients who are responsible for almost 40,000 incidents a year. This could save the equivalent of 3,800 12-hour paramedic shifts a year by freeing-up front-line staff to attend other calls.
David Fletcher, a paramedic who received a Darzi fellowship to research the problem, said there was “no single patient profile” but “social isolation” was a major factor.
He found there were 50,034 Londoners who had called 999 five or more times in a month or 12 or more times in three months. This resulted in a total of 339,339 calls last year – almost twice as many as suspected to have been made by frequent callers.
Mr Fletcher said: “The number of calls attributable to frequent callers is growing every year. We have got to get on top of this problem.
“It’s not uncommon that a patient can call four or five times a day, for some of the most frequent callers. Frequent callers are complex patients.”
Mr Fletcher said frequent callers were typically patients with chronic co-morbidities – for example, someone with COPD lung disease who developed a winter infection – or mental health problems. Many calls were also received from the frail elderly, drug users and homeless people. Only about three per cent were hoax callers.
The pilot scheme will aim to identify frequent callers more quickly and investigate whether better care can be provided in the community or via social care to reduce their reliance on 999.
About 10 per cent of frequent callers are only given advice on the phone, while a third are attended by a medic but not taken to hospital. However more than half – 183,000 calls a year – result in the patient being taken to A&E.
Malcolm Alexander, chair of LAS Patients’ Forum, said: “Londoners who call the emergency ambulance service frequently, are being offered new ways of getting the care they need without dialling 999.
“Many ‘frequent callers’ are chronically ill and struggle to get the right service from their GP or community health team – dialling 999 can be a desperate call for help, but responding to these calls has a major impact on access to ambulances for people suffering from heart attacks, strokes and other serious illnesses.
“The innovative ‘frequent callers’ project, developed by the LAS paramedic David Fletcher, brings together a team of experienced staff who can negotiate new ways of providing appropriate care for frequent callers.
“Frequent callers often suffer severe anxiety problems and need carefully designed service that enable them to cope with their problems and live more safely – this leading edge LAS project is creating that much needed service.”
Separate research for LAS found that many patients with mental illness had begun calling an ambulance because of a “lack of community-based services”.
Researcher Jessie Cunnett said: “Where they didn’t want to go was to hospital. They just didn’t know what else to do. Being conveyed to a hospital or inpatient unit in that situation wasn’t what people wanted.”