Reforming areas of coverage for ambulance services in the UK

Sickle cell patients need care by healthcare providers familiar with the disease

Mary Shaniqua avatar

by Mary Shaniqua |

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Continuing the spirit of offering suggestions to make the healthcare experience more efficient for patients and the National Health Service (NHS) here in the U.K., I want to address the restrictions governing which hospitals ambulances can take patients to.

My previous two columns have detailed how the need for emergency access via ambulance can be reduced by having more day unit services and community nursing options. Presuming I had a magic wand and my suggestions were implemented tomorrow, unfortunately, there would still be instances when a sickle cell patient would need to go to a hospital by ambulance. I would implore the NHS to consider allowing ambulances some flexibility regarding which hospital they take patients to.

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A recent trip reminded me how unpredictable sickle cell can be

When I lived in London, I didn’t have any issues with ambulances. In 2019, I moved just outside the city. Anyone who keeps up with the U.K.’s financial situation understands that life in London is expensive. Thus, moving out of the city is an understandable decision, particularly for young people.

A person looking to relocate must consider many things, such as how close is it to the town center? How accessible is transportation? Are the schools good? What are the tax rates? But many people might not think about what the ambulance boundaries are.

When I moved, I did consider the distance to my regular hospital in London. While my previous home was located only five minutes from it, I made sure it was still the closest hospital to my new home just outside the city. Nevertheless, over the years, I’ve had to call an ambulance several times. But the paramedics told me they had to take me to a different hospital that was farther away. It is my understanding that these decisions are based on boundaries, bureaucracy, and budgets.

So what does this mean for patients?

For sickle cell patients, it can make for a bad hospital experience because it requires specialist care. Not all doctors and nurses are experienced in treating the disease. Treatment of acute and chronic pain caused by sickle cell disease often requires the use of controlled medications, such as opioid narcotics. A lack of knowledge about sickle cell disease can sometimes prevent patients from receiving these medications when they need them.

Over the years, I’ve tried to learn something from each hospitalization so that I can be better prepared in the future. I store my care plan on my phone to inform medical personnel about my needs. I have my medical team at my regular hospital on speed dial. I’ve memorized the guidelines established by the National Institute for Health and Care Excellence for managing and treating painful sickle cell episodes. I have a speech memorized to explain how fantastic my life is so that healthcare workers don’t think I’m just seeking narcotics.

Despite all of this, I’ve still had bad experiences. And the most frustrating part is that when I’m taken to a hospital where staff isn’t familiar with sickle cell, it prolongs the hospitalization. This affects my income, family, and life planning.

One thing would prevent all of this: Taking patients to their regular hospital, where staff is familiar with the condition.

In my healthcare utopia, patients would receive the same standard of care anywhere they go. Sadly, this is not the current reality in the U.K.

Note: Sickle Cell Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sickle Cell Disease News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to sickle cell disease.


Vivian Ngang avatar

Vivian Ngang

Great write up Ms. Mary Shaniqua. So true about the ambulance taking you to where you USUALLY get treated.


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