AMBULANCE staff have seen a massive spike in the number of 999 calls in Lancashire this summer, leaving them struggling to reach patients with the most critical conditions.

Despite daily warnings about the financial problems facing the NHS, we hear very little about what hospitals, mental health units and ambulance trusts are doing to avert the looming crisis.

This is partly due to a lack of ideas and action – change has been slow in many areas – but also because the changes are often complex and do not lend themselves to easy headlines.

But one organisation that has already made a fundamental shift to the way it works is North West Ambulance Service (NWAS), by scrapping its traditional blanket response to those who dial 999.

The problem facing NWAS is that the number of people requiring help continues to increase – last year the trust responded to almost a million calls, up 15,000 on the previous year – while its £215 million budget has remained flat.

This has already forced the trust to make huge efficiency savings, and a further £48 million will have to be found in the next four years.

NWAS bosses admit it will be tough, but they also recognise there is slack in the system, due to the high number of calls which are not life-threatening, with many not even requiring an ambulance at all.

Pete Mulcahy, who oversees the service in Lancashire, explained there are now several different options for call handlers and paramedics when a patient calls for help.

He said: “I used to be out on the road and you’d go to a lot of houses where the patient would answer the door with their coat on and say ‘I’m ready to go to hospital’. We didn’t used to have much of an option – if they wanted to go we’d have to take them, even though it was a waste of resources. So what we’ve done is invested quite heavily in our triage process (about £500,000), to identify calls where the patient might not need an ambulance, or might not need to go to hospital.

“One option is what we call ‘hear and treat’, where the call will be transferred to a clinician who can give advice over the phone and help them explore other options such as a chemist.

“There will be plenty of cases where we’re not sure, so the call might then move to the next stage where a crew will visit a patient at home to assess them in person, which is called ‘see and treat’. They might decide the patient needs to go to hospital, but could also refer them to their GP.”

The new model puts more emphasis and pressure on the call centre staff based in Broughton, such as Jade Kenny, who had been training to become a paramedic when she applied to be a call handler last year instead.

The 23-year-old from Rawtenstall said: “You do get people calling up with really minor things – I remember one person saying they had toothache, but the next minute it could be someone in cardiac arrest.

“Often people call us when they don’t know where to turn, so we have to go through a series of check and questions to work out the best response.”