“Fuel to the fire” – Survey of ambulance service shows alcohol placing a huge demand on frontline workers
Alcohol related call outs are placing an avoidable demand on nine out of ten ambulance service staff. And more than three-quarters have been physically or verbally assaulted in the line of duty.
Those are the findings of a new survey of frontline staff at the North East Ambulance Service – the service featured in the recent BBC documentary series Ambulance.
It has resulted in calls from campaigners nationally for action on cheap strong alcohol and day and night availability from countless outlets to protect emergency crews.
There have been warnings nationally that millions of people are causing themselves harm by drinking at risky levels at home. The North East saw the worst death rates from alcohol in 2020 during the height of the pandemic and alcohol has been a recurring theme in the TV series.
Health campaigners are now calling for more action nationally to protect both communities and 999 workers from alcohol harm, with an independent review and a new alcohol strategy urgent priorities.
In the run up to December – one of the busiest times of year for 999 control rooms – Balance the North East alcohol programme has released the findings of a new survey of nearly 150 frontline staff from the North East Ambulance Service (NEAS) to show the effect alcohol has on the service.
The survey of NEAS ambulance employees found:
- 93% say dealing with intoxicated patients wastes valuable capacity and places avoidable demand on time and resources.
- Nearly 1 in 3 say HALF or more of the incidences they dealt with over the Christmas period involved alcohol
- Almost half of NEAS employees (47%) say that over 75% of call-outs for assaults were related to alcohol.
- 68% say over half of call-outs for domestic violence were related to alcohol
- 40% have received threat of injury from patients or members of the public at least SIX times, and 1 in 3 have received an actual injury or verbal abuse on as many occasions.
- 38% have received sexual harassment / assault whilst on duty from people under the influence of alcohol
- Only 1 in 10 (12%) say that they have never been threatened by an intoxicated patient or member of the public whilst on duty
The findings mirror a previous survey from 2015 but cover a period in which alcohol consumption and the associated health harms rose among heavier drinkers during the pandemic .
Whilst alcohol-related call-outs were clearly common during the first winter lockdown in 2020, ambulance crews noticed an increase in the number of call-outs involving alcohol once lockdown restrictions had been lifted.
Call handlers as well as front line crews face pressures, with time too often taken up dealing with intoxicated patients and many emergency operation centre members reflecting on the difficulty this can cause when triaging patients.
Alice Wiseman, Alcohol Policy Lead for the Association of Directors of Public Health and Director of Public Health for Gateshead, said: “The bulk of alcohol harm including deaths and disease falls on the most deprived people in our communities and Covid has made this worse.
“As alcohol has got cheaper, the harm to individuals and communities has got worse. It is a scandal that people can drink a week’s worth of alcohol for the price of a coffee and during the pandemic alcohol companies and supermarkets bombarded vulnerable people with advertising, encouraging us to drink to cope. We need action at national level to protect health, our NHS and our emergency services.”
Sexual harassment and abuse is also common for both ambulance crew member and EOC staff. Female respondents in particular are subject to abuse of this nature, with almost half (46%) reporting an incidence of sexual harassment, compared with 28% of male respondents.
It is worth highlighting that whilst patients themselves can be the cause of abuse or disruption, crews also find themselves subject to threatening behaviour and harm from family members and friends of the patient, making it difficult to provide appropriate care.
Susan Taylor, Head of Alcohol Policy for Balance, said: “The increased risky drinking we saw on the back of the pandemic is likely to lead to thousands of extra cases of disease and premature death. And for 999 crews it has created additional pressure on already stretched services.
She added: “We carried out this survey to measure the impact on crews. But while many will blame individuals who drink too much for this, we need to remember that alcohol can be an addiction, which some people are struggling with. Heavier drinking since the pandemic is spilling over into more incidents impacting on our emergency services.”
Stephen Segasby, chief operating officer at North East Ambulance Service, said: “The amount of assaults, both physical and verbal, we continue to see is worrying. The effects of alcohol and behaviours of people under the influence can have a huge impact on all of our staff and services.
“There is an emotional cost and a financial one for if staff are assaulted or abused. To do their best for patients in an emergency, our people need to be well and able to work safely. Working under such conditions can take its toll on the mental and physical health of our people. This can have a direct impact on the availability of the trained professionals we all rely upon in an emergency. Nobody comes to work in an emergency service like ours to be put at risk.”
Wayne McKay, NEAS Clinical Team leader, said: “Alcohol has a massive impact on the service. People think the busy time are Friday and Saturday nights but it’s not – it’s 24/7. There’s not an hour in the day when there is not someone suffering from the effects of alcohol waiting on an ambulance. That impacts severely on resources.
“Treating the patient is the easy bit but managing the scene can be more difficult. People rarely drink alone so often not just one person there, sometimes several. We spend time having to manage the scene safely, making sure we have an exit route and making sure we don’t get assaulted.
“It can very quickly turn from a bit of a laugh to somebody getting assaulted, and it can be scary at times – you’ve always got to have your wits about you. We have body cams and panic buttons on our radio. Some of my role is ensuring the welfare of staff and some of my day is making sure staff are OK after they have been verbally or physically assaulted.”
The Institute of Alcohol Studies carried out a major survey across all emergency services in 2015 and estimated that alcohol takes up as much as half of emergency service time.
Dr Alison Giles, Interim Chief Executive, Institute of Alcohol Studies, said: “These shocking statistics reveal just how much of our ambulance service time is taken up with alcohol-related incidents: time that is desperately needed to reach and treat people with life-threatening illnesses.
“With public budgets so stretched, we can’t afford this wasteful and entirely avoidable situation. It’s time for the Government to put in place measures to reduce alcohol consumption across the population and save lives.”
Professor Sir Ian Gilmore, Chair of the Alcohol Health Alliance UK, said: “With alcohol costing the NHS at least £3.5 billion every year, this survey sheds light on just how alcohol harm is impacting our already overstretched health services.
“We urgently need preventative measures to limit the affordability and availability of alcohol and protect our frontline workers from these shockingly high numbers of alcohol-related assaults and violence.”
What ambulance staff said:
‘I have attended various assaults, injuries, self-harm, suicide attempts due to alcohol mainly during night shifts. I have attended alcohol dependant regular callers numerous times who are unable to say why they called when the crew arrives.’ – Female emergency ambulance crew member with 0-4 years of service.
‘Alcohol has contributed to most situations where I have felt unsafe at work’ – Female emergency ambulance crew member with 5-9 years of service
‘I have been threatened, verbally assaulted and had to deal with degrading inappropriate sexual comments. When dealing with people in licensed premises it’s often seen as a joke to people that their friend has become so intoxicated that an ambulance has been called.’ – Female emergency ambulance crew member with 0-4 years of service
‘It takes so much longer to complete tasks due to intoxicated patients’ behaviours, including aggression and verbal abuse.’ – Female emergency ambulance crew member with 0-4 years of service
‘On a recent shift I spent nearly two hours on scene with a patient who was incapacitated due to alcohol. She was not suitable for hospital admission as she had no acute medical problems, however she was vulnerable due to her intoxication.’ – Male emergency ambulance crew member with 0-4 years of service
‘Drunk taxi’ is the first thing that comes to mind, lots of drunk ‘do gooders’ trying to be helpful… It’s so much bigger than just the patient, it’s the surroundings. There’s also other aspects, usually the patient vomits in the ambulance so we’re off the road for a clean.’ – Female emergency ambulance crew member with 0-4 years of service
‘Alcohol adds fuel to the fire when it comes to any situation that gets out of control, as a student paramedic I have seen both sides of the story, working in the EOC and on an emergency ambulance.’ – Male emergency operations centre member with 5-9 years of service.
‘Work becomes much busier by a certain time in the day/night relative to alcohol intoxication. Calls can become emotionally charged very quickly when alcohol is involved.’ – Female emergency operations centre member with 0-4 years of experience
‘I’ve been subject to an unprovoked attack by a bystander leading to several weeks of physio while unable to attend normal duties. Also needing counselling due to the emotional effects.’ – Male emergency ambulance crew member with 20+ years of service
‘A drunk patient being verbally and physically abusive has caused me time off work, I had to go for counselling in my own time, has made me anxious around intoxicated patients.’ – Male emergency ambulance crew member with 5-9 years of service
‘I feel drugs and alcohol are the biggest contributors to my assaults I’ve had (inclusive of sexual) in the workplace. I’ve been at cardiac arrests where I’ve have intoxicated family members pulling me off them, trying to punch and threaten as I’m trying to manage a resus.’ – Female emergency ambulance crew member with 0-4 years of service
‘I had a patient’s highly intoxicated boyfriend towering over me screaming obscenities and threatening me because he wasn’t allowed into the hospital so he decided to direct his anger at me.’ – Female emergency ambulance crew member with 0-4 years of service