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GPs accused of ‘misusing’ ambulance calls

NHS managers have accused GPs in Wales of deliberately misusing emergency ambulances in a bid to speed up routine requests for patient transport.

A letter to health boards from NHS Wales, which has prompted a backlash from local GPs, claimed practices were upgrading patients to life-threatening emergency status without cause.
LMC leaders said the letter from Dr Chris Jones, medical director of NHS Wales, asked NHS managers to write to all practices and warn them about the issue. NHS Wales, which has refused to release the letter concerned, said it wanted to ensure ambulance calls were dealt with ‘in order of clinical priority'.
The GPC said NHS Wales had subsequently ‘rowed back' on the letter, and GP leaders will be meeting with the Welsh Ambulance Services Trust to discuss how ambulance response times can be improved.
The letter from Dr Jones, seen by Bro Taf LMC, refers to an ‘impression' that some GPs are misusing a protocol known as ‘Card 35' to expedite routine requests for ambulance transport and urges local health boards to take remedial action.
But Dr David Bailey, chair of GPC Wales, told Pulse it was ‘not the case' that GPs were misusing ambulances: ‘We have raised this issue with the deputy chief medical officer and, to be fair, they have rowed back on this position. We have advised the local health boards strongly that if they do not want a storm of protest from GPs, it would be better not to send this out.' 
A statement from Bro Taf LMC said there was an issue over response times, and that it was the ambulance service itself that often asked for calls to be upgraded: ‘GPs have a lot of problems getting timely emergency ambulance transport for their patients and this letter does not reflect that situation. 
‘GPs agree response times which are often not met, and at that point it is often the ambulance service itself that advises GPs to upgrade the patient to life-threatening emergency status in order to secure ambulance transport that is consistent with the patient's medical condition.'
Dr Dyfrig Davies, a GP in Wrexham, said: ‘GPs don't call out urgent ambulances unless there is a serious clinical need. We wouldn't dream of calling an emergency ambulance for a routine matter.'

How calls are categorised

• Ambulance requests in Wales are classified as A (life threatening) or C (serious but not life-threatening and/or neither serious nor life threatening).

• GPs can also use the Card 35 protocol to ensure an urgent call is categorised as an emergency.

Source: NHS Wales