Surge in single-crew ambulances 'putting lives at risk'

Ambulances queued up outside hospital in Aberdeen.

A surge in the number of ambulances being sent with only one crew member is putting patients’ lives at risk in every area of Scotland, experts have warned.

Clinicians say the practice risks wasting precious time in emergency cases because paramedics working alone are unable to provide some important medicines or transport very ill people to hospital.

But last night, the Scottish Ambulance Service signalled a major shift in policy away from trying to eliminate the use of single-person crews as it hailed the practice as an “invaluable” part of the service.

Bosses noted single-person crews were now “often” being used for cardiac arrests – a decision paramedics told us could leave patients facing the “potential for disaster”.

Clinicians arriving on their own are unable to manage the patient’s airways, administer adrenaline or provide other potentially life-saving treatment, they warned.

‘Staggering admission’

Highlands and Islands Tory MSP Tim Eagle called the ambulance service’s statement a “staggering admission that reflects how much life-saving services are toiling on the SNP’s watch”.

Official data shows the number of single-person shifts increased from 2,823 in 2023 to 3,121 last year.

The situation deteriorated across Scotland but was worst in the north region – covering Grampian, the Highlands and islands – with the number increasing from 1,081 to 1,116.

Single-person shifts made up 2.62% of total ambulance shifts in the north last year – significantly higher than the 1.7% nationally.

Eagle said: “Nicola Sturgeon promised single crewing would become a measure of last resort just two years ago.

“But numbers are going up, not down. People will be alarmed to know that, if their loved one has a heart attack, the person who arrives to help them may not be able to provide the life-saving care they need until back-up arrives.

“That places patients and ambulance workers in an intolerable situation.”

Ambulance workers who spoke to The Sunday Post said single-person crews were increasingly being used because of absences linked to staff burnout and long delays outside hospitals.

While bosses strive to send single-person vehicles to less urgent cases, those with knowledge of the service say it frequently leads to dangerous situations.

‘Potential for disaster’

One worker said it was not uncommon for paramedics to be sent on their own to a scene and then have to wait for hours in the patients’ home after they realise the person needs to be taken to hospital for treatment.

He said: “There is a potential for disaster when people are not being given the full chance of advanced life support, which cannot be done by one person on their own.

“If I’m called out to a person with chest pains that turns into a cardiac arrest, either before or after I arrive, all I can do as a single operator is hand-on-chest compressions.

“You can’t manage the airways, you can’t offer adrenaline or any drugs that might help that person.

“That will have a very detrimental outcome to the patient and it’s very distressing for the individual because you feel helpless.

“You feel that it’s a postcode lottery and that if this man, this woman or this child had a two-man crew, the outcome could have been different and you have to live with that.”

Broken promises

The dangers of single crewing were highlighted in November 2020 after care home manager Pam Anderson died on her way to hospital in Aberdeen.

It emerged the 74-year-old had to wait 40 minutes for a two-person crew from Tomintoul to transport her for treatment as the first ambulance to arrive had only one crew member, so was not allowed to take her.

Pam Anderson died in an ambulance on the way to Aberdeen.

Nicola Sturgeon also warned against single-person call-outs while she was health secretary more than a decade ago and promised “action to eliminate rostered single-manning” would be taken.

She said at the time: “The policy of the Scottish Government is clear – traditional A&E ambulances should be double crewed, with at least one member being a paramedic, unless in exceptional circumstances.”

Karen Leonard, GMB Scotland union organiser in the SAS, said the latest increase was concerning and demanded action.

She said: “There are many routine calls when sending a single crew member is appropriate but the apparent failure to reduce the number of paramedics sent to emergencies alone must be addressed.

“It risks the care of patients and the wellbeing of our members as they are placed in impossible situations under unacceptable and needless levels of stress.”

What does the ambulance service say?

The SAS said that, with the expansion of key initiatives aimed at supporting patients to access alternative care, the use of single crews “can be invaluable”.

It said single crews can provide a valuable initial assessment, instigate treatment for patients and assist in targeting resources.

Bosses added: “We, like other public services, experience short-notice, unplanned staff absences and every effort is made to fill gaps through rostered and relief staff, overtime or our bank staff.

“When this isn’t possible, we would rather use the crew’s expertise for the patient’s benefit than not deploy them.”