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155
ambulance-train-ambulance, etc., have resulted in delays to less urgent cases and during
1958 four per cent. of the journeys undertaken by the general section of the service
were delayed for over an hour because of the pressure of total demand and the overriding
need to deal promptly with urgent removals. Hospital authorities, realising the
heavy and fluctuating demand upon the ambulance service, have been most co-operative
in accepting some delay in the conveyance of non-priority patients as being sometimes
inevitable. It is nevertheless disturbing that delays on this scale should occur to the
inconvenience and distress of patients and the disruption of hospital appointment
systems. The Council has accordingly authorised an expansion of the fleet by ten ambulances
and an extension of the radio-telephony control system,
General section—For every 100 patients transported by the general section of the service
in 1947, 531 were removed in 1958. Of the 966,877 patients conveyed in 1958, 810,867
(84 per cent.) were out-patients taken to and from hospitals, 148,213 (15 per cent.) were
admitted to or discharged from hospitals and the remaining 7,797 (1 per cent.) were
transported on other journeys.
The task of coping with the annual increases in the volume of work since 1948 has
called for careful planning to ensure the fullest use of available resources. During the
past ten years the average mileage per patient carried by the general section of the
service has been reduced from 7.74 to 4.12, the average mileage per journey from
10.05 to 8.25 and wasted journeys from 4.2 per cent. to 1.9 per cent.
The existence of many specialist hospitals in the London area has meant that a
considerable number of orders are received from other local health authorities for
patients to be met at railway termini and conveyed to these hospitals and it is estimated
that about 24,000 patients are now being taken by ambulances to and from the eleven
main London railway stations each year.
Accident section—The work of this section is fully surveyed on page 74. Since 1948 the
average daily number of patients conveyed and journeys without patients as a result of
emergency calls received has risen from 185 to 280, and the following table compares
the daily average number of emergency calls received in 1948 with similar figures for
1958:
1948 1958
Street accidents 26 53
Other accidents 32 54
Urgent illness in public places, etc. 30 57
Maternity removals 63 75
Assaults and attempted suicides 5 14
Miscellaneous emergencies 18 6
Ambulances not required 11 21
The general public were responsible for 69 per cent. of all emergency calls received
in 1958 as compared with 63 per cent. in 1948.
Consultations were held in 1955 with the metropolitan regional hospital boards
and with certain teaching hospitals and police and fire services to formulate schemes
for dealing with major accidents. Some features of these schemes were subsequently
modified and improved in the light of the experience gained on the occasion of the
railway disaster at Lewisham in December, 1957.
Relationship with other services
(a) Hospitals—A close liaison has been developed since 1948 with the London hospitals'
staffs at medical, administrative and operative levels. Efforts have been directed in
particular towards ensuring that transport is not ordered unnecessarily, that routine
reviews arc made at frequent intervals of all patients receiving regular transport, that
wasted journeys are reduced to a minimum and that there is a quick release of
ambulances from hospitals. Hospital staffs have responded well and it is encouraging
to note (table iii page 85) that during the last ten years the percentage of wasted