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

Abstract 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 e...

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Main Authors: Bridie A. 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: Article
Language:English
Published: Wiley 2024-02-01
Series:Health Expectations
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Online Access:https://doi.org/10.1111/hex.13856
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author Bridie A. 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
author_facet Bridie A. 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
author_sort Bridie A. Evans
collection DOAJ
description Abstract 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 healthcare 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 the 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 to by police and were arrested for behaviour associated with their health needs. Those callers receiving case management did not know they were selected for this. Some respondents were concerned that 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 to inform design and delivery of accessible and effective services. Patient or Public Contribution People with relevant experience were involved in 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.
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spelling doaj-art-024a4fedde1b4ab6adb818ade10689522025-08-23T11:53:04ZengWileyHealth Expectations1369-65131369-76252024-02-01271n/an/a10.1111/hex.13856Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service usersBridie A. Evans0Ashra Khanom1Adrian Edwards2Bethan Edwards3Angela Farr4Theresa Foster5Rachael Fothergill6Penny Gripper7Imogen Gunson8Alison Porter9Nigel Rees10Jason Scott11Helen Snooks12Alan Watkins13Swansea University Medical School Swansea UKSwansea University Medical School Swansea UKSchool of Medicine, PRIME Centre Wales, Division of Population Medicine Cardiff University Cardiff UKPublic Contributor, c/o Swansea University Medical School Swansea UKSwansea Centre for Health Economics Swansea University Swansea UKEast of England Ambulance Service NHS Trust Melbourn UKLondon Ambulance NHS Trust Greater London UKPublic Contributor, c/o Swansea University Medical School Swansea UKWest Midlands Ambulance Service University NHS Foundation Trust West Midlands UKSwansea University Medical School Swansea UKWelsh Ambulance Services NHS Trust Cwmbran UKNorthumbria University Newcastle upon Tyne UKSwansea University Medical School Swansea UKSwansea University Medical School Swansea UKAbstract 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 healthcare 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 the 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 to by police and were arrested for behaviour associated with their health needs. Those callers receiving case management did not know they were selected for this. Some respondents were concerned that 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 to inform design and delivery of accessible and effective services. Patient or Public Contribution People with relevant experience were involved in 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.https://doi.org/10.1111/hex.13856calling frequentlyemergency careemergency health servicesprehospitalqualitative researchservice user experience
spellingShingle Bridie A. 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
Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users
Health Expectations
calling frequently
emergency care
emergency health services
prehospital
qualitative research
service user experience
title 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_short 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
topic calling frequently
emergency care
emergency health services
prehospital
qualitative research
service user experience
url https://doi.org/10.1111/hex.13856
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