Paramedics left ‘suicidal’ amid equipment failures and crushing demand, ambulance whistleblower warns

In an explosive interview with LBC, paramedic James - whose name we have changed - has detailed the consistent “New Year’s Eve-style demand” facing paramedics, ambulance drivers and emergency medical technicians working for the London Ambulance Service.

James says his decision to speak out is motivated by a desire to protect his colleagues from harm.

His testimony raises significant concerns about the pressures facing workers across the NHS during the five-day strike by resident doctors (previously known as junior doctors), which entered its final day today.

While James explains that much of the extra strain on crews is owing to increased levels of public demand for emergency care, he believes that a series of changes being introduced by LAS have exacerbated the pressures.

In an alarming and frank interview, James revealed:

• Emergency workers are arriving at stabbings without necessary equipment - including trolley beds.
• A contentious restructuring will save just £22,055, as the trust is believed to have spent over £100,000 on carry chairs that are too big for use in many London homes.
• James also claims some crew have faced “borderline harassment” with senior staff monitoring toilet their breaks.

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New year’s eve-style demand driving staff to the point of ‘suicide’

New Year’s Eve is usually the busiest night of the year for London’s paramedics, with call handlers typically taking a colossal 7,000 calls.

However, on several occasions over the last six weeks, that figure of 7,000 calls has been hit.

“That is monumental,” James laments, “and this is in summer - not [even] a Bank Holiday or anything like that - so you can imagine what winter is potentially going to look like.”

Even when demand does not reach these extraordinary levels, James says it is “pretty routine” for there to be over 6,000 calls per day, around 10% higher than what the trust has described as a “typically busy day”.

James describes how the mounting pressure has caused a number of his colleagues to leave for jobs elsewhere, including going to Australia. In the most severe circumstances, however, he fears that some colleagues could take their own lives.

“The concern is that there's going to be a worsening in people's mental health to a point of where it sort of implodes.

“Suicide in our organisation and our type of role is not unheard of. And I think the concern is that if this goes further and further, people are going to feel like they have no other option.”

When presented with the whistleblower's concerns, the LAS’s Director of Operations, Darren Farmer, recognised that staff were in a “high pressure job”, pledging that the trust would do what it could “to support the wellbeing of our people… [offering] in-house therapists, peer support networks and occupational health referrals.”

LAS has ‘not seen a penny’ of extra NHS money

Earlier this year, the Chancellor announced an additional £29bn of spending for the NHS each year.

James, though, is skeptical about how much of this extra cash is finding its way to frontline services, which he says is evidenced by paramedics having to forgo critical equipment.

“Labour talked about bringing in loads of money into the NHS, but to be honest, we haven't seen a penny of it… And, to be honest, it seems like things are only getting worse.

“Staff [have] been to stabbings and things like that where they've had no trolley beds put their patient on… You're still waiting on scene for a patient who's been stabbed to get them onto a trolley bed for another ambulance to turn up.”

LAS confirmed that crews are forced, at times, to attend scenes including life-threatening injuries without trolleys.

This, they add, is largely a knock-on effect of ambulance handover delays, and therefore likely to reflect the significant pressure facing the capital’s emergency departments.

Ambulances crews across the country have been battling bottlenecks at A&E which have resulted in paramedics being unable to deposit patients at hospitals. An investigation by LBC in April found that 1,000 patients per week are being put in potentially serious harm as a result of such delays.

In an effort to get crews back on the road, LAS implemented a policy which sees paramedics leave a patient at A&E after 45 minutes - even if that means leaving important equipment like trolley beds in hospital corridors.

“We recognised hospitals are incredibly stressed as well,” Farmer told LBC in an interview arranged to discuss James’s account.

“There are times where they simply cannot offload an ambulance patient onto one of their beds within 45 minutes,” he conceded.

“If [an ambulance with a trolley bed] happens to be incredibly close to a time-critical patients, I think Londoners would expect us to send that ambulance and backfill with another ambulance immediately.”

Staff facing “borderline harassment” having toilet breaks monitored

A key objective shared by ambulance trusts across the country is to reduce the amount of time that crews are unavailable for dispatch.

Reasons for this can include being stuck outside A&E, a problem with the vehicle, or damage to essential kit.

Ambulances can also be categorised as out of service when crew members require a comfort break.

Recently, however, senior staff at the LAS reportedly conducted checks on whether paramedics are actually using the toilet, a development which James has branded “borderline harassment”.

These checks, he says, have been carried out by the trust’s Incident Response Officers [IROs], whose role, according to LAS’ website, involves ‘respon[ing] to and oversee[ing] complex incidents or situations involving multiple patients’.

“We've seen these IROs start coming out to crews that are taking facilities just to check they are actually using the bathroom,” James claims.

“We're all adults, and a lot of us are paramedics that are carrying Midazolam and morphine on us - these really sort of really high-potent drugs.”

“You know, we're trusted enough to carry around those drugs on our persons, but we're not trusted enough to go to the toilet. And I think that's what's really getting us.”

LAS insisted that they are not instructing IROs to check employees’ toilet breaks. Farmer was unequivocal in an interview with LBC that he “did not condone” such activity, and would encourage any staff who believed this had happened to report the conduct to the service’s complaint teams.

Cost-cutting restructuring

Like many other ambulance trusts, the London Ambulance Service is also facing budgetary pressures.

James believes that this has led executives at the trust to draw up a restructuring plan.

Currently, the trust divides its service in London into 21 groups, each covering a particular area, in a similar structure to how London is divided into 32 boroughs.

The consultation reduces this number to 19 groups, merging together Fulham and Westminster and as well as Ilford and Whipps Cross, which James fears could result in extra pressure on crews already facing unprecedented demand.

Farmer’s memo, which has been circulated to paramedics across the capital, argues that changes are necessary owing to the financial situation for the trust - and, indeed, the NHS more broadly - ‘becoming increasingly tight’.

Farmer said the restructure “has been designed with staff and piloted at local sites to help ensure it could improve the working lives of our teams”, but committed to “work[ing] closely with our people to hear feedback and resolve any emerging issues”.

The savings, however, are only due to raise around £22,000 in their first first year.

To put that into context, this figure is less than a quarter of what has been spent on automatic patient carry chairs which have been too big for London’s homes.

Internal documents seen by LBC show that at least 25 Stryker Xpedition chairs, which can carry patients and loads up to 227kg, have been purchased by LAS this year, each one costing “many thousands of pounds”. It is believed that at least £100,000 has been spent on these chairs, which have been marketed for over £10,000 each online.

LAS did not comment on the amount spent on the chairs, citing commercial sensitivities. The service also argued that the decision to pursue a restructuring was not motivated by a desire to save money, and that the inclusion of the line on budgetary pressures was simply to demonstrate that the changes would not increase the costs faced by the service.

LBC also contacted the Department of Health to address James’s concerns about some of his colleagues feeling suicidal and staff not feeling the benefits of the extra investment in NHS services.

Those feeling distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK