– It can be at the expense of life and health when there are not enough ambulances to handle all the missions. Then someone has to wait. And then it may be that someone who has a serious problem does not get help in time. That’s what department union representative Hans Erik Ringnes says in the ambulance service in Østfold. They move out on more and more urgent missions with blue lights and sirens. CONCERNED: Departmental representative in the ambulance service in Østfold, Hans Erik Ringes believes there is a lack of preparedness. Photo: Caroline Bergli Tolfsen / news In the last two years, the number of “red trips” has increased a lot in Health South-East. Between 2020 and 2022, there was a 38 per cent increase in the number of urgent assignments in densely built-up areas and a 26 per cent increase in pig-infested areas. At the same time, the response time also increases. In 2020, 74.4 per cent of ambulances in densely built-up areas reached the right place within 12 minutes. In 2022, the number fell to 65.1 per cent, according to figures from the quality indicator of the Norwegian Directorate of Health. – The volume of assignments is far too large in relation to the access to resources, says Ringnes. Responds urgently to things that are not urgent The shop steward believes the AMK central has too little time to assess all incoming calls. – The staff is too small, the experience is too short and there is a complex problem with the entire sector. All the way back to the GP and emergency room, says Ringnes. – After all, we experience that we respond to conditions that are apparently serious, but which do not correspond to what we find when we arrive. When you call 113 from Østfold, Akershus, Oslo and the Kongsvinger region, you get to a switchboard at Oslo University Hospital. This exchange serves 1.7 million people. This is the AMK central office in Oslo. Here, they receive thousands of calls a week. Photo: SIV JOHANNE BJØRKLY SEGLEM / news Central in Oslo has had challenges. The requirement is that 90 percent of those who call in must receive an answer within ten seconds. The central office is still unable to do so. – I think this is a societal problem. The specialist health service is not sized to handle the increased workload that is. If the recommended response times are to be observed, preparedness must be increased and there must be more opportunity and time to assess the callers, says Ringnes. Wants the AMK central in Østfold back Previously, Østfold had its own AMK central. It was moved to Oslo in 2015. – Now we have got Østfold back as a county. Now it’s time for us to get AMK-Østfold back too, I think, says Rune Solmyr, first candidate for the Center Party in Fredrikstad. He himself has worked in the ambulance service. Rune Solmyr, first candidate for the Center Party in Fredrikstad, believes AMK must return to Østfold to ensure patient safety. Photo: Caroline Bergli Tolfsen / news Solmyr reacts to ambulances being sent out on missions that are not urgent. He fears for patient safety. – When the ambulances are out on assignment all the time, it sometimes happens that certain municipalities run out of ambulances. He explains that they then have to send ambulances from other places in the county. – When it comes to seconds, it really goes beyond patient safety. Concerned about the volume of assignments Head of Department Merete Storli Tveit at the pre-hospital department at Østfold Hospital says that they too are concerned about the increase in emergency assignments. – We see that there are many of these who do not end up in hospital or are in need of urgent help when we arrive. There can be many reasons for this, and there will be situations where it is still correct to send an ambulance on an emergency trip. Head of department Merete Storli Tveit at Østfold Hospital. Photo: Caroline Bergli Tolfsen / news She says that it seems that many incidents could have been solved with other help. – No health regions reach the recommended response time requirements and the increase in the number of emergency assignments also occurs nationally. Tveit says there is some flexibility and that they can get assistance from the ambulance service elsewhere if needed. Working with measures Clinic manager Stephen JM Sollid, at the pre-hospital clinic at Oslo University Hospital, replies in an e-mail that what they are working with is measures. – There is not a single measure that will make AMK Oslo better able to meet increasing activity and to answer 113 calls more quickly. AMK Oslo is strengthening staffing, but is also working on how working methods, working conditions and follow-up of the employees can be improved. Health South-East replies that they will start a review of the organization of the AMK centers this year. It is too early to say anything about the outcome of this work. Read the full response from Clinic Manager Stephen JM Sollid here: Response from the AMK central at Oslo University Hospital The AMK central in Oslo has been supervised by the State Administrator in Oslo and Viken, and still does not meet the requirements to respond quickly enough, among other things. Is it sufficient as it is today? – Prehospital clinic at Oslo University Hospital is not satisfied that AMK does not meet the emergency medicine regulations’ requirement for a response time of 90% within 10 seconds. As the state administrator points out in his supervision, the reason for this is complex. AMK Oslo is therefore working on several measures that will contribute to improving AMK Oslo’s ability to respond to 113 calls more quickly. Among the most important measures are to strengthen staffing, strengthen follow-up of employees, improve working conditions in the AMK central office. reorganization and review of working methods in AMK to identify opportunities for improvement. What does AMK think about the proposal to split up the exchange and have a separate exchange in Østfold again, as Solmyr proposes? – Prehospital clinic in OUS believes that the size of AMK Oslo is not a significant reason why AMK Oslo does not meet the requirements for response time. The collaboration with Sykehuset Østfold and especially the ambulance service in Østfold is very good and we feel that there is a mutual understanding of the challenges pre-hospital services in Helse Sør Øst are facing with increasing activity, and which measures make sense to take to meet these. An investigation is underway into how the pre-hospital services in Helse Sør Øst will be organized in the future. What must be done to ensure that the AMK center answers the phone in accordance with the requirement and that there is sufficient time to assess the patients who call in? – There is not a single measure that will make AMK Oslo better able to meet increasing activity and to answer 113 calls more quickly. AMK Oslo is strengthening staffing, but is also working on how working methods, working conditions and follow-up of the employees can be improved. It is no secret that AMK Oslo is housed in old and worn premises that are not suitable for running AMK. The ICT tools the employees work with are also outdated and cumbersome. The decision support tools the employees must rely on when assessing calls to 113 and what help the caller needs are also not suitable for today’s challenges. AMK Oslo is working on several measures that will give the employees in the AMK center better conditions and a better framework to answer 113 calls faster and have the right tools to be able to make good and correct assessments.
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The response time for the ambulances is increasing – news Oslo and Viken – Local news, TV and radio
