East Midlands Ambulance Service NHS Trust

3. Mrs R complains the Trust failed to send an ambulance on 24 April 2022 after she fell. Mrs R believes an ambulance should have attended as she has type 1 diabetes and did not have her insulin pens with her.

4. As the Trust did not send an ambulance, Mrs R’s daughter had to pick up her mother with the help of a passer-by and move her to the car, which she believes has worsened her injury and caused unnecessary pain and suffering. Mrs R broke her leg, had a five-and-a-half-hour operation and stayed in hospital for over two weeks. Mrs R says she also experienced unnecessary pain as she had to be moved with no pain relief.

5. Mrs R wants service improvements so ambulances are sent when an injured person has illnesses that could be fatal, such as diabetes. She also seeks financial compensation.

6. After Mrs R fell, her daughter called 999 for an ambulance, stating her mother had broken her leg, was diabetic and did not have her insulin pens with her.

7. The Trust said it could not send an ambulance at that time as it was not a life-threatening injury and if it was not possible for Mrs R’s daughter to move her mother herself, she should call 111 for further assessment.

8. Mrs R’s daughter carried her mother to her car with the help of a bystander and drove her first to her house to pick up her insulin medication and then to the A&E department.

10. Before we decide whether we should do a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any signs something has gone wrong.

11. Mrs R believes due to her diabetes she should have been categorised as more urgent than category 3. The Trust says it is confident she was categorised correctly based on Advanced Medical Priority Dispatch System (AMPDS) triaging. The AMPDS is a unified triage tool used by many ambulance trusts in the UK to prioritise medical emergencies.

12. The NHS England information provides information on what types of conditions fall into which of the four available categories. Category 2, urgent calls, is for emergency conditions such as stroke or epilepsy. Category 3, which Mrs R was categorised as, includes non-life-threatening conditions and specifically includes diabetes.

13. Mrs R has pointed out diabetes can prove ‘fatal’, and we know this is true if a person’s blood sugar levels are not controlled. We have seen no sign Mrs R’s diabetes was causing any raised risk at the time of the call or afterwards while her leg was being treated. The reason for the 999 call was the broken leg, and the Trust considered Mrs R’s diabetes at the time of the call. Given the non-life-threatening nature of the injury, we have seen no sign the Trust incorrectly categorised the call, and it is clear the Trust was aware Mrs R had type 1 diabetes and considered this.

14. The Trust gave appropriate safety netting advice if Mrs R could not be moved or if she worsened. It said if she could not be moved Mrs R’s daughter should contact 111 for further assessment. Mrs R’s daughter was able to get her mother to the car with assistance, so she did not call 111 or 999 again.

15. The Trust’s response was also in line with the CSP level 3 it had implemented at that time. Mrs R was correctly categorised as a category 3 injury, and the Trust took her diabetes into account. We have seen no signs of failings in how the Trust categorised the call and how it responded.

16. We recognise this was an extremely distressing time for Mrs R and know her recovery is not over yet. We are grateful to her for taking the time and making the effort to bring this complaint to us.

1. The Parliamentary and Health Service Ombudsman has carefully considered Mrs R’s complaint about East Midlands Ambulance Service NHS Trust (the Trust) and we have seen no signs anything went wrong.

2. Mrs R told us because the Trust failed to send an ambulance for her broken leg she has suffered prolonged pain and suffering. We are sorry to hear about Mrs R’s difficult experience. We understand what happened has been a very upsetting and distressing time for her.