Diana Gudgeon

1. 1. Delayed escalation of neurological symptoms

   “Triaging by '111' and EMAS call handling systems, including in relation to sepsis. In the present case, Mrs [name redacted] had collapsed, passed out, been confused and had been vomiting. These are signs of central nervous system/neurological problems but were not regarded as urgent. Despite EMAS being told that Mrs [name redacted] may have a urinary tract infection, no escalation occurred.”

2. 2. Inconsistent priority allocation across triage systems

   “It was suggested in evidence that if the same facts are inputted into the '999' AMPDS triaging system they are likely to allocate a higher priority to the call than the '111' Pathway triaging system would.”

3. 3. Insufficient ambulance resources

   “The shortage of double crewed ambulances and fast response vehicles in the Northampton Division.”

4. 4. Capacity Management Plan thresholds and overrides delay response

   “The effectiveness of the EMAS Capacity Management & Escalation Plan (CMP) including, inter alia, the fact that:‐ a) CMP status 1 - 3 does not trigger the deployment of additional 2 vehicular resources. b) CMP 4 is only triggered when 200 calls are holding (this was previously 150) - this is a high threshold. c) A Technical Commander can overrule a CMP status e.g. even if 200 calls are holding (CMP 4), this can simply be downgraded to CMP 3 by the Technical Commander”

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