Keith Hopwood

1. 1. delays in ambulance service

   “The inquest heard that the delays in relation to the ambulance service were due to significant resource issues for all ambulance services not just North West Ambulance Service. The inquest was told that the shortages were due to staffing levels and demand. Steps had been taken to try to increase resources but the ambulance service was still struggling to meet the demand. In this case it was clear that had the initial ambulance not have been rerouted due to demand and pressure on services that he”

2. 2. missed symptom exploration

   “The inquest heard that in the initial call to the ambulance service he was told to call back if he got worse in any way. His response was to say that he couldn't feel any worse than he had in the last 10 minutes. The algorithm driving the conversation did not direct that this response should require exploration of symptoms and why he had made this comment. As a consequence an opportunity to explore his presentation further was lost”

3. 3. inadequate ambulance equipment

   “The ambulance that arrived was a private ambulance and not equipped to deal with a cardiac patient. If the second call had been correctly categorised it would not have been dispatched as private ambulances are deployed with less qualified staff to calls categorised as 3 and 4 due to a lack of NHS Ambulance resources. As a consequence a further ambulance had to be deployed to the scene when Mr [name redacted] was found to be unresponsive”

4. 4. lack of escalation on disconnection

   “The second call from Mr [name redacted] disconnected. Because he was alone a disconnection does not automatically result in an escalation of a call. Had he been with someone who said he had become unresponsive that would have generated a different approach”

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