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Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users

Bridie Evans Orcid Logo, Ashra Khanom Orcid Logo, Adrian Edwards, Bethan Edwards Orcid Logo, Angela Farr Orcid Logo, Theresa Foster, Rachael Fothergill, Penny Gripper, Imogen Gunson, Alison Porter Orcid Logo, Nigel Rees, Jason Scott, Helen Snooks Orcid Logo, Alan Watkins Orcid Logo

Health Expectations, Volume: 27, Issue: 1

Swansea University Authors: Bridie Evans Orcid Logo, Ashra Khanom Orcid Logo, Angela Farr Orcid Logo, Alison Porter Orcid Logo, Helen Snooks Orcid Logo, Alan Watkins Orcid Logo

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DOI (Published version): 10.1111/hex.13856

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Introduction: People who call emergency ambulances frequently are often vulnerable because of health and social circumstances, have unresolved problems or cannot access appropriate care. They have higher mortality rates. Case management by interdisciplinary teams can help reduce demand for emergency...

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Published in: Health Expectations
ISSN: 1369-6513 1369-7625
Published: Wiley 2024
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They have higher mortality rates. Case management by interdisciplinary teams can help reduce demand for emergency services and is available in some UK regions. We report results of interviews with people who use emergency ambulance services frequently to understand their experiences of calling and receiving treatment. Methods: We used a two-stage recruitment process. A UK ambulance service identified six people who were known to them as frequently calling emergency services. Through third sector organisations, we also recruited nine individuals with health care experiences reflecting the characteristics of people who call frequently. We gained informed consent to record and transcribe all telephone interviews. We used thematic analysis to explore results. Results: People said they make frequent calls to emergency ambulance services as a last resort, when they perceive their care needs are urgent and other routes to help have failed. Those with the most complex health needs generally felt their immediate requirements were not resolved and underlying mental and physical problems led them to call again. A third of respondents were also attended by police and arrested for behaviour associated with their health need. Those callers receiving case management did not know they were selected for this. Some respondents were concerned case management could label frequent callers as troublemakers. Conclusion: People who make frequent calls to emergency ambulance services feel their health and care needs are urgent and ongoing. They cannot see alternative ways to receive help and resolve problems. Communication between health professionals and service users appears inadequate. More research is needed to understand service users' motivations and requirements in order to inform design and delivery of accessible and effective services. Patient or Public contribution: People with relevant experience were involved throughout developing, undertaking and disseminating this research. Two public contributors helped design and deliver the study, including developing and analysing service user interviews and drafting this paper. Eight public members of a Lived Experience Advisory Panel contributed at key stages of study design, interpretation and dissemination. 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spelling v2 64181 2023-08-30 Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users 6098eddc58e31ac2f3e070cb839faa6a 0000-0003-0293-0888 Bridie Evans Bridie Evans true false 1f0f14742e3a36e8fd6d29f59374a009 0000-0002-5735-6601 Ashra Khanom Ashra Khanom true false ab00dbaa888f32b41b07ef223d0e2987 0000-0002-2087-9310 Angela Farr Angela Farr true false fcc861ec479a79f7fb9befb13192238b 0000-0002-3408-7007 Alison Porter Alison Porter true false ab23c5e0111b88427a155a1f495861d9 0000-0003-0173-8843 Helen Snooks Helen Snooks true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false 2023-08-30 MEDS Introduction: People who call emergency ambulances frequently are often vulnerable because of health and social circumstances, have unresolved problems or cannot access appropriate care. They have higher mortality rates. Case management by interdisciplinary teams can help reduce demand for emergency services and is available in some UK regions. We report results of interviews with people who use emergency ambulance services frequently to understand their experiences of calling and receiving treatment. Methods: We used a two-stage recruitment process. A UK ambulance service identified six people who were known to them as frequently calling emergency services. Through third sector organisations, we also recruited nine individuals with health care experiences reflecting the characteristics of people who call frequently. We gained informed consent to record and transcribe all telephone interviews. We used thematic analysis to explore results. Results: People said they make frequent calls to emergency ambulance services as a last resort, when they perceive their care needs are urgent and other routes to help have failed. Those with the most complex health needs generally felt their immediate requirements were not resolved and underlying mental and physical problems led them to call again. A third of respondents were also attended by police and arrested for behaviour associated with their health need. Those callers receiving case management did not know they were selected for this. Some respondents were concerned case management could label frequent callers as troublemakers. Conclusion: People who make frequent calls to emergency ambulance services feel their health and care needs are urgent and ongoing. They cannot see alternative ways to receive help and resolve problems. Communication between health professionals and service users appears inadequate. More research is needed to understand service users' motivations and requirements in order to inform design and delivery of accessible and effective services. Patient or Public contribution: People with relevant experience were involved throughout developing, undertaking and disseminating this research. Two public contributors helped design and deliver the study, including developing and analysing service user interviews and drafting this paper. Eight public members of a Lived Experience Advisory Panel contributed at key stages of study design, interpretation and dissemination. Two more public contributors were members of an independent Study Steering Committee. Journal Article Health Expectations 27 1 Wiley 1369-6513 1369-7625 Calling frequently, Emergency care, Emergency health services, Prehospital, Qualitative research, Service user experience 1 2 2024 2024-02-01 10.1111/hex.13856 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University SU Library paid the OA fee (TA Institutional Deal) National Institute for Health Research, Health Services & Delivery Research (HS&DR) programme: reference number 18/03/02. 2024-09-17T15:38:21.0301820 2023-08-30T15:18:09.7769119 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Bridie Evans 0000-0003-0293-0888 1 Ashra Khanom 0000-0002-5735-6601 2 Adrian Edwards 3 Bethan Edwards 0000-0001-7413-056x 4 Angela Farr 0000-0002-2087-9310 5 Theresa Foster 6 Rachael Fothergill 7 Penny Gripper 8 Imogen Gunson 9 Alison Porter 0000-0002-3408-7007 10 Nigel Rees 11 Jason Scott 12 Helen Snooks 0000-0003-0173-8843 13 Alan Watkins 0000-0003-3804-1943 14 64181__28632__1fd8466d1a1c4550a4518e7aaef163ba.pdf 64181.VOR.pdf 2023-09-25T17:20:13.8435138 Output 494662 application/pdf Version of Record true © 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd. Distributed under the terms of a Creative Commons Attribution 4.0 License (CC BY 4.0). true eng https://creativecommons.org/licenses/by/4.0/
title Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users
spellingShingle Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users
Bridie Evans
Ashra Khanom
Angela Farr
Alison Porter
Helen Snooks
Alan Watkins
title_short Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users
title_full Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users
title_fullStr Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users
title_full_unstemmed Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users
title_sort Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users
author_id_str_mv 6098eddc58e31ac2f3e070cb839faa6a
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fcc861ec479a79f7fb9befb13192238b
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author_id_fullname_str_mv 6098eddc58e31ac2f3e070cb839faa6a_***_Bridie Evans
1f0f14742e3a36e8fd6d29f59374a009_***_Ashra Khanom
ab00dbaa888f32b41b07ef223d0e2987_***_Angela Farr
fcc861ec479a79f7fb9befb13192238b_***_Alison Porter
ab23c5e0111b88427a155a1f495861d9_***_Helen Snooks
81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins
author Bridie Evans
Ashra Khanom
Angela Farr
Alison Porter
Helen Snooks
Alan Watkins
author2 Bridie Evans
Ashra Khanom
Adrian Edwards
Bethan Edwards
Angela Farr
Theresa Foster
Rachael Fothergill
Penny Gripper
Imogen Gunson
Alison Porter
Nigel Rees
Jason Scott
Helen Snooks
Alan Watkins
format Journal article
container_title Health Expectations
container_volume 27
container_issue 1
publishDate 2024
institution Swansea University
issn 1369-6513
1369-7625
doi_str_mv 10.1111/hex.13856
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description Introduction: People who call emergency ambulances frequently are often vulnerable because of health and social circumstances, have unresolved problems or cannot access appropriate care. They have higher mortality rates. Case management by interdisciplinary teams can help reduce demand for emergency services and is available in some UK regions. We report results of interviews with people who use emergency ambulance services frequently to understand their experiences of calling and receiving treatment. Methods: We used a two-stage recruitment process. A UK ambulance service identified six people who were known to them as frequently calling emergency services. Through third sector organisations, we also recruited nine individuals with health care experiences reflecting the characteristics of people who call frequently. We gained informed consent to record and transcribe all telephone interviews. We used thematic analysis to explore results. Results: People said they make frequent calls to emergency ambulance services as a last resort, when they perceive their care needs are urgent and other routes to help have failed. Those with the most complex health needs generally felt their immediate requirements were not resolved and underlying mental and physical problems led them to call again. A third of respondents were also attended by police and arrested for behaviour associated with their health need. Those callers receiving case management did not know they were selected for this. Some respondents were concerned case management could label frequent callers as troublemakers. Conclusion: People who make frequent calls to emergency ambulance services feel their health and care needs are urgent and ongoing. They cannot see alternative ways to receive help and resolve problems. Communication between health professionals and service users appears inadequate. More research is needed to understand service users' motivations and requirements in order to inform design and delivery of accessible and effective services. Patient or Public contribution: People with relevant experience were involved throughout developing, undertaking and disseminating this research. Two public contributors helped design and deliver the study, including developing and analysing service user interviews and drafting this paper. Eight public members of a Lived Experience Advisory Panel contributed at key stages of study design, interpretation and dissemination. Two more public contributors were members of an independent Study Steering Committee.
published_date 2024-02-01T15:38:19Z
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