When you call 999, our aim is to provide you with care that meets your clinical need, which is delivered by the most appropriate clinician and is provided at a location that is most suitable to you and the wider healthcare community.

At times, conveyance may often be the most appropriate care pathway (for example, if you have complex clinical or mental health needs). However, our current strategy aims to support referrals to the most appropriate care provider, whether this is to the patients GP, a minor injuries unit, a walk-in centre or mental health facility. Alternatively the provider of care may be brought to the patient through the use of specialist nursing teams like community matrons, district nurses, out of hours services or other specialist providers.

Our staff will always try to avoid obstructing other road users whether this is when parking a vehicle or during transit. If you discover that your vehicle has been blocked in this could be because the condition of the patient being attended requires immediate intervention; as soon as the patient’s condition allows the ambulance crew will move the vehicle. On these occasions we understand how frustrating this may be, but we ask you to please be patient and the vehicle will be on its way as soon as possible.

In any emergency situation the patient will always come first. If you have a guide or assistance dog a decision on whether they can travel with you will be made on a case by case scenario. Please be assured that ambulance staff will do all they can to ensure the safety of your assistance dog while they provide you with treatment.

We have several enquiries regarding lost personal items that are subsequently found. In the first instance, please could you check all your pockets, bags and other receptacles for your missing items?

If you travel in an ambulance, any items you have with you will usually be handed over to the staff at the receiving unit. We would recommend checking with the hospital department you attended whether they have found your items.

If you have a lost property enquiry for NWAS, please forward this to our Lost Property Team using the form in our Contact Us section.

Ambulances are allowed to park on white or yellow lines providing they are engaged on official duties, e.g. it was necessary to park at that point to carry out essential duties or to be as close as possible to the patient they are treating.

Our ambulance crews are trained to ensure that they park vehicles in such a way that will not cause a nuisance to other road users, but also ensure that there is no delay in attending the patient.

If a GP arranges for an ambulance to take you into hospital then the length of time you will wait will vary depending on on the arrangements made by the GP based on your condition.

There will be times when there may be a delay in an ambulance reaching you; we will always do our absolute best to arrive as quickly as possible, but there may be times when delays are beyond our control. When we know that a delay is likely to occur then we will endeavour to let you know as soon as possible so you can be prepared.

The ambulance environment is designed to take you safely to hospital. The ambulance crew are unable to carry anything that would create an unsafe working environment and this is particularly important if they may be required to drive at speed. We understand that it might be upsetting to travel without a piece of equipment that you rely on. However, if you require a mobility aid these can be provided at the hospital.

When you call 999, an operator will ask you which emergency service you need. You should say “ambulance”.

Your 999 call will then be passed to one of our trained emergency call handlers in an emergency operations centre. You will be asked for details of where you are, for details of what has happened, and some questions to determine the level of care you require. The reason for your call will determine which questions we ask and the response you need, so it is important to answer them as clearly as possible.

Some of these questions may seem irrelevant at the time. However, the answers you provide to these questions will establish the type of help that is provided to you. By asking these key questions we can ensure that emergency medical help is sent to life threatening incidents as quickly as possible. Please be assured that the questions being asked and answered are not delaying help being provided; however it is important that the assessment is completed to ensure that the patient receives the most appropriate response.

Our ambulance crews are trained to drive the vehicles under emergency conditions. They do drive with all due care and attention; however they do need your help to move through the traffic as quickly and safely as possible.
Here are some tips that will help you stay calm and safe and help our emergency vehicles get to their destination without delay.
• Look and listen – check your mirrors regularly and make sure your music is not too loud.
• Consider the route and size of the vehicle – you may need to move over even if the emergency vehicle is traveling in the opposite direction.
• Signal your intentions using your indicators – this will help the emergency vehicle and other road users know what action you are taking.
• Pull in or move over safely – you may not need to stop completely.
• Don’t stop opposite any obstructions – this will make the road narrower.
• Avoid mounting kerbs/pavements where possible – be aware of pedestrians, cyclists and other motorists.
• Signal when you are pulling away – motorists behind you may still be moving, be careful when re-joining the road.
• Stay alert – more emergency vehicles may be on the way.

Ambulance staff can activate the vehicle sirens at any time of day or night. However, they will only use the sirens when it is appropriate and necessary to make other road users, including those on foot, aware of the presence of an ambulance.

It is sometimes difficult to know whether or not you need an ambulance. We would urge you to dial 999 if you or the person you are calling on behalf of:
• Is unconscious or not breathing
• Has a penetrating injury to the neck, chest, abdomen or thigh
• Has had a severe allergic reaction
• Has uncontrolled bleeding
• Is having an asthma attack and is unresponsive to medication
• Has severe chest pain (heart attack)
• Is fitting (if this is unusual for the patient)
• Has taken an overdose
• Has been submerged in water for more than one minute
• Has fallen more than 10 feet
• Traumatic back/spinal/neck pain

During the Coronavirus pandemic, we have had to limit the instances of people escorting their loved ones to hospital. We will normally only transfer an escort for reasons such as the patient having a sensory loss or severe impairment, language barriers, or has diminished capacity. The privacy and clinical need of our patients is of paramount importance to us. There is limited space available in our vehicles to enable additional passengers to travel safely. It is for this reason that during normal times, escorts for patients are kept to a minimum, usually only one person, who is ordinarily a relative, carer or friend. However, this will depend on the circumstances of the event. The safety of the patient and ambulance crew will be considered prior to agreeing any additional escort.

When you call 999, you will speak to a trained Emergency Medical Dispatcher or Call Handler. They will ask a number of questions about your condition in a process called triage. The electronic triage system that the Emergency Medical Dispatchers/Call Handlers use takes the answers you give to the questions, and will make the decision regarding what help you require from the ambulance service; this response will meet your clinical need. Sometimes this will be an ambulance, but sometimes you may be called back by a highly skilled Health Care Professional from our service. They may recommend that you visit an NHS Walk-in centre, a GP or another NHS provider. During periods of high demand, if your condition is less urgent and doesn’t require an emergency response, you may be asked if you can make your own way. Its fine if you can’t, and we can still get to you, but you may be waiting much longer than expected.

Frontline ambulances are very specialist and very complex vehicles. They carry essential items of clinical and diagnostic equipment that can provide life-saving treatment to patients and also transmit ‘real time’ information to the hospitals regarding a patient’s condition. Vehicles also require advanced tracking and mobile data technologies to ensure ambulances can be on scene within minutes of a 999 call. All this equipment requires significant power from the batteries on board. Failure to keep these batteries fully charged can result in equipment not working correctly or at worst shutting down which may pose a significant threat to lives. In order to keep the battery charged the vehicle must be left running during some periods of rest.

Ambulance engines may also be left running to ensure the patient compartment, medications and equipment remain at a regulated temperature. In many cases patients are on board requiring urgent medical attention. During this time regulated power supply to all medical and diagnostic equipment is critical. Turning the engine off may result in a break to the real-time diagnostic information feed into the hospital or vital patient life support systems failing.

Vehicles can often be seen idling on the roadside or at a scene for the reasons identified above. If a power supply is not available regular charging is required by keeping the engine running. Idling also allows for a rapid departure from a scene. Lastly, in cold weather, leaving an ambulance running allows the diesel engine to operate more efficiently. When vehicle are on station, vehicles do not need to run their engines as they are plugged into charging units that ensure the vehicle maintains a state of readiness.
North West Ambulance Service is committed to continuously reducing its carbon footprint and regularly reviews systems and practices to ensure this happens.

Information regarding your clinical need is gathered during the 999 call; from there an assessment will be made as to what the most appropriate help is for you. All ambulance resources are prioritised so that patients that require emergency treatment are attended to first.

On occasions it might be necessary to divert an ambulance that is on its way to see you to another patient who has a more serious, life threatening, clinical need. That is not to say that you will not receive an ambulance. Our Clinical Hub staff within the Emergency Operations Centre reassess incidents which have waited longer than we’d expect, and if there is any clinical concern, they will ensure that the next most appropriate resource is sent to attend you.

Unfortunately, due to the very nature of the service, we cannot give an estimated time of arrival. This is because of the way we dispatch in order of priority. If an ambulance is on its way to you, but a higher category of call comes in, we may have to divert the ambulance to the other incident. This would then increase the estimated time of arrival. It is important to note that we can never give an estimated time of arrival, so you should be mindful of this when thinking about calling us back on 999. Please only call us back if the condition of the patient worsens or changes and you feel you need further advice on what to do, or to cancel the ambulance.

Not all ambulances are staffed all the time. Sometimes this may be down to staffing, but the majority of the time, the vehicles which are kept on station are for resilience. This is so that should there be an issue with an ambulance which is active, such as a breakdown or if it requires scheduled maintenance, there is another ambulance for our crews to use.

The decision on which hospital you go to is based on multiple factors, including (but not limited to) your current condition, your current location or the pressures faced by the local hospitals. There are many specialist hospitals which deal with very specific conditions, so if you meet the criteria for these hospitals, you will be taken there to ensure you receive the best possible care for your condition. If your condition does not require specialist care, but you are in need of life saving emergency treatment, you will always be taken to your nearest emergency department. If your local hospital is experiencing an increase in demand and you need hospital treatment for a condition which is not immediately life threatening, you may be taken to an alternative hospital to ensure you are seen as quickly as possible.

In line with the NHS Standard Contract, North West Ambulance Service has adopted the new national Patient Safety Incident Response Framework (PSIRF). The framework sets out how we will learn from patient safety events to provide better and safer outcomes for our staff and patients.

The framework is made up of two elements – national guidance which sets priorities that must be investigated in depth, and a local plan, which has been developed by our trust. Our plan details our top priorities, how we should respond to incidents, and how investigations should be carried out.

You can download a copy of our new Patient Safety Incident Response Plan (PSIRP) via publications.