Isn’t this a sensible response to the problem? Few people in London have access to private cars so sending a taxi is a fast way of getting someone to hospital. Better than a four hour wait. I would be interested in another graphic: do those with highest use of taxis have longer or shorter waits for ambulances?
The main challenge is that of who bears the risk. Triaging over the telephone is difficult, both because the clinician isn’t seeing the person who is calling and because they can only go by what that person is telling them. Whilst the article recognised that some people overplay their symptoms to get a quicker response, quite a few people underplay their symptoms, whereas others may not be able to accurately describe them over the telephone (e.g. if English is their second language).
The problem of using taxis for acute situations (as opposed to elective cases) is what happens in a situation where a person is triaged based on the info provided over the phone, a taxi is dispatched, but then something happens on the journey to A&E because the severity of the condition was higher than expected? What should the taxi driver do? Who holds the risk and the responsibility? Very tricky medico-legal situation…
Not related to this edition but one of London Centric's long running stories - I was on a bus that was stuck in traffic yesterday because it couldn't use the bus land on Westminster Bridge, as it was blocked by ice cream vans and an enormous fleet of cycling rickshaws.
It's jaw-dropping how powerless the authorities are to do anything about this. For me, it rivals the phone-snatching epidemic when it comes to torpedoing confidence in the Met police.
It is interesting that the areas of London with the least use of taxis in this circumstance are the wealthiest areas.
Is there any idea of how many journeys as a percentage of total ambulance journeys are now using taxis? The cost saving in using a taxi is probably huge and this seems sensible, I just wonder how big of an impact this is having.
I would guess that this correlates to either higher private car ownership and someone who can drive the patient, or easier ability to pay for a taxi themselves. I live in Newham and fewer than half of the residents, and in some wards, fewer than 2/3 of the residents, have access to a car.
I would also guess that if you live in poverty and deprivation, health issues are less likely to be addressed at an early stage before they become an acute crisis.
I had an Addison Lee sent to me in 2023 when suffering a bad asthma attack. Luckily I only live a few minutes from a hospital. It does worry me a bit that someone might die in one of these cabs - as another commenter has pointed out, triage over the phone depends on what the caller is telling the person at the other end, and it’s possible something serious could be missed. And as well, we shouldn’t expect taxi drivers to be able to handle it if someone gets much worse or goes unconscious in their cab!
It makes sense on the surface of it that the walking wounded might not need an full emergency ambulance. Would a larger fleet of these make sense for offering ambulant emergency transport? Oxygen, ECG and single crew member - I'm no expert but a middle ground seems attainable. They could even offer Uber rides on the side...
Isn’t this a sensible response to the problem? Few people in London have access to private cars so sending a taxi is a fast way of getting someone to hospital. Better than a four hour wait. I would be interested in another graphic: do those with highest use of taxis have longer or shorter waits for ambulances?
The main challenge is that of who bears the risk. Triaging over the telephone is difficult, both because the clinician isn’t seeing the person who is calling and because they can only go by what that person is telling them. Whilst the article recognised that some people overplay their symptoms to get a quicker response, quite a few people underplay their symptoms, whereas others may not be able to accurately describe them over the telephone (e.g. if English is their second language).
The problem of using taxis for acute situations (as opposed to elective cases) is what happens in a situation where a person is triaged based on the info provided over the phone, a taxi is dispatched, but then something happens on the journey to A&E because the severity of the condition was higher than expected? What should the taxi driver do? Who holds the risk and the responsibility? Very tricky medico-legal situation…
I am tired of seeing the words 'run by criminal gangs' when it comes to a lot of London's issues.
Not related to this edition but one of London Centric's long running stories - I was on a bus that was stuck in traffic yesterday because it couldn't use the bus land on Westminster Bridge, as it was blocked by ice cream vans and an enormous fleet of cycling rickshaws.
It's jaw-dropping how powerless the authorities are to do anything about this. For me, it rivals the phone-snatching epidemic when it comes to torpedoing confidence in the Met police.
It is interesting that the areas of London with the least use of taxis in this circumstance are the wealthiest areas.
Is there any idea of how many journeys as a percentage of total ambulance journeys are now using taxis? The cost saving in using a taxi is probably huge and this seems sensible, I just wonder how big of an impact this is having.
I would guess that this correlates to either higher private car ownership and someone who can drive the patient, or easier ability to pay for a taxi themselves. I live in Newham and fewer than half of the residents, and in some wards, fewer than 2/3 of the residents, have access to a car.
I would also guess that if you live in poverty and deprivation, health issues are less likely to be addressed at an early stage before they become an acute crisis.
I had an Addison Lee sent to me in 2023 when suffering a bad asthma attack. Luckily I only live a few minutes from a hospital. It does worry me a bit that someone might die in one of these cabs - as another commenter has pointed out, triage over the phone depends on what the caller is telling the person at the other end, and it’s possible something serious could be missed. And as well, we shouldn’t expect taxi drivers to be able to handle it if someone gets much worse or goes unconscious in their cab!
Guy's & St Thomas' have been using 'Electric cabs' to transport elective patients.
https://www.guysandstthomas.nhs.uk/news/black-cab-white-taxi-ambulance-nhs-trust-launches-greener-patient-transport
It makes sense on the surface of it that the walking wounded might not need an full emergency ambulance. Would a larger fleet of these make sense for offering ambulant emergency transport? Oxygen, ECG and single crew member - I'm no expert but a middle ground seems attainable. They could even offer Uber rides on the side...
Needs must...
@Jim waterson Thanks for the kind comment at the start of this article!
Very much appreciated!
That opening line is damn perfect.