The Ambulance Service

"UK ambulance services have experienced a revolution in working styles as a result of technology. ICT has been used extensively in command and control centres to make the service more efficient and responsive. New secure digital communications systems have replaced crackly broadcast systems. Satellite tracking of resources (such as ambulances, helicopters, paramedic cars and bikes) and geographical information systems allow the optimal resource to be deployed at all times by centre staff. Technology is used to analyse patterns of usage to roster (call in) the exact number of staff required. It uses geographical analysis to decide where it is best to position ambulances and other resources so that they can be deployed to nearby locations very quickly. Ambulances are placed at points that are closed in travel time to places of peak demand and are tracked at all times to show where they are."

"The Staffordshire ambulance service says of the impact of new technology: “The adopting of this modern approach has resulted in remarkable results in the Trust performance in recorded response times. This has given the Trust the lead position in national ambulance table’s fir the last seven years. It has also seen dramatic improvements in the cardiac survival figures.”
The introduction of this system in London in the 1990s, however, was extremely problematic, not least because of the working practices that were brought about by the introduction of these measures."

The London Ambulance Service:
I have carried out some research on the London Ambulance Service’s Computer Aided Dispatch (CAD) system which was implemented on 26October 1992 and have found that neither the CAD system itself, nor its users, were ready for full implementation. This was because the CAD software was not complete, not properly tuned, and not fully tested. The resilience of the hardware under a full load had not been tested. The fall back option to the second file server had certainly not been tested. There were outstanding problems with data transmission to and from the mobile data terminals. There was some scepticism over the accuracy record of the Automatic Vehicle Location System. In addition, staff, both within Central Ambulance Control and ambulance crews, had no confidence in the system and were not all fully trained. Also there were a number of physical changes to the layout of the control room on 26 which meant that Central Ambulance Control staff were working in unfamiliar positions, without paper backup, and were less able to work with colleagues with whom they had jointly solved problems before.

A number of ambulance workers have objected to being sited in their “resources” in the most efficient place rather than being sited in the ambulance station because they would rather use the technology in an ambulance station rather than in their ‘resources’. There are a number of drawback with the introduction of these new systems, but can be summarised: some staff at central control had no confidence with the system and were not all fully trained, the staff found themselves working in unfamiliar positions, and without paper backup, they found it harder to work with other colleagues they had previously worked with before. There have been a number of benefits to these new systems, for example response times have increased, which has made the system more efficient and reliable, which has led to dramatic improvements in the cardiac survival figures. In all the introductions of these new systems have improved the service provided and has saved time and a number of lives. I feel that whenever you introduce a new ICT system there are always teething problems which need to be addressed, and a lesson which could have been learned here is that on the first day of introducing a new system you need to have a back-up plan to refer to if necessary.