Emergency dispatch algorithm flaws (medication)

Emergency dispatch algorithms failing to account for blood-thinning medication in head injury cases, delaying appropriate response.

94 items 6 sources 1 inquiry
Strongest theme matches

Mixed across source types and ranked by classifier confidence plus text match strength.

Indicative ranking
PFD report
99match
Roy Middleton
Nov 2022 · South Yorkshire West
The emergency dispatch algorithm fails to account for anticoagulant medication in head injury cases, risking delayed appropriate responses and future deaths.
Matched on terms: algorithm, dispatch, emergency, medication
PFD report
77match
Kenneth Adams
Mar 2023 · Dorset
The ambulance dispatch protocol (MPDS) inadequately prioritizes scalp lacerations in patients on antiplatelet/anticoagulant medication, failing to account for persistent bleeding or medication effects, leading to dangerous treatment delays.
Matched on terms: dispatch, medication
PFD report
77match
John England
May 2025 · Cornwall and Isles of Scilly
The ambulance service's dispatch system lacks nuance for specific abdominal complaints, leading to an inappropriately low emergency category and delaying critical care for a potential surgical emergency.
Matched on terms: dispatch, emergency
Inquiry recommendation
74match
MAI-104 - Review Advanced Medical Priority Dispatch System
Manchester Arena Inquiry
The Department of Health and Social Care and the National Ambulance Resilience Unit should consider whether the Advanced Medical Priority Dispatch System is fit for purpose and, if it is, whether it can be improved. Particular consideration should be given to how the system prioritises emergency calls.
Matched on terms: dispatch, emergency
PFD report
73match
James Sutton
Feb 2014 · London (North)
The London Ambulance Service failed to automatically link multiple risk factors—a 5-foot fall, patient age over 50, and anti-clotting medication—to trigger an 8-minute emergency response.
Matched on terms: emergency, medication
PFD report
73match
Christopher Fields
May 2016 · Manchester South
Police left a vulnerable, injured person in an unsafe situation without awaiting an ambulance, leading to further assault. Ambulance dispatch algorithms are inaccurate, causing critical delays in response times for seriously injured patients.
Matched on terms: algorithm, dispatch
PFD report
73match
Martin Sullivan
Mar 2021 · Manchester South
The emergency medical dispatch protocol inadequately recognised life-threatening asthma symptoms, and the ambulance service consistently failed to meet Category 2 response time targets.
Matched on terms: dispatch, emergency
PFD report
69match
Yusuf Abdismad
May 2015 · London Inner (North)
Emergency medical dispatchers use confusing questioning to ascertain consciousness, leading to misinterpretation of patient status and missing critical symptoms like a rash or obscured pupils.
Matched on terms: dispatch, emergency
PFD report
69match
Elizabeth Lester
May 2015 · Manchester (South)
The ambulance service's call-handler script for 'breathing difficulties' critically omits questions about chest pain, potentially delaying appropriate emergency response for cardiac-related issues.
Matched on terms: emergency
PFD report
69match
Keith Hopwood
Jun 2022 · Manchester South
Ambulance service delays due to resource shortages caused rerouting and late arrival. The call algorithm failed to properly assess patient distress, and an unequipped private ambulance was dispatched due to miscategorization, leading to further delays.
Matched on terms: algorithm, dispatch
PFD report
69match
Margaret Huntley
Aug 2024 · Teesside and Hartlepool
Ambulance staff lack understanding of steroid medication importance and Addison's Crisis, with no NHS Pathways guidance for triaging. Awareness and GP use of Steroid Emergency Cards and system alerts are inadequate.
Matched on terms: emergency, medication
PFD report
65match
Marie Millward-Winter
Jan 2019 · Manchester (City)
Administration of anticoagulation medication after a head injury, advised by ambulance technicians, likely worsened an internal bleed and contributed to death.
Matched on terms: medication
PFD report
65match
Lucas Pollard
Feb 2024 · Bedfordshire and Luton
A Critical Care Team was not immediately dispatched, and an End Of Shift Policy was inappropriately applied, preventing a rapid response vehicle deployment, despite clear evidence of patient deterioration.
Matched on terms: dispatch
PFD report
61match
Toni Skillington
Jul 2014 · London North (Inner)
The dispatch system inadequately captured methadone overdoses and patient solitude. Welfare checks were not actioned, resulting in a three-hour delay in paramedic response to an overdose.
Matched on terms: dispatch
PFD report
61match
Sharon Butcher
Mar 2015 · County Durham & Darlington
There was a delay in calling for an ambulance after an emergency medical code was broadcast, and a recurring issue of lack of clarity in response to medical emergencies at HMP Frankland and HMP Durham.
Matched on terms: emergency
PFD report
61match
Hayden Norton
Apr 2015 · Exeter & Greater Devon
After the deceased arrived at HMP Dartmoor, there was no record that his blood pressure was monitored, or that he had been informed of a screening test for aortic aneurysm; furthermore, there was a delay in calling an emergency ambulance because HMP Dartmoor lacked an emergency code protocol.
Matched on terms: emergency
PFD report
61match
Terrence Smith
Feb 2019 · Surrey
The ambulance call handling system failed to recognize Excitatory Delirium, conflicting guidance for call handlers caused confusion, and training packages contained potentially misleading information, impacting emergency response.
Matched on terms: emergency
PFD report
61match
Christopher Williams
May 2019 · Norfolk
The report highlights an ambulance arriving outside of Trust guidelines, a call handler's failure to escalate the patient's worsening condition and incorrect algorithm use, and a communication breakdown about an arranged hospital bed, potentially delaying treatment.
Matched on terms: algorithm
PFD report
61match
Amanda Gainford
Oct 2024 · Liverpool and Wirral
Unawareness among clinicians that they can challenge ambulance call categorisations by untrained handlers, or request a clinical review, can lead to critical delays in dispatch for severe cases.
Matched on terms: dispatch
PFD report
61match
Lee Armstrong
Oct 2024 · Cumbria
Emergency call systems fail to solicit or share existing medical conditions with ambulance call handlers, who also lack access to patient records, risking inadequate responses for patients, particularly those with conditions causing confusion.
Matched on terms: emergency
PFD report
57match
Barbara Patterson
May 2015 · Northumberland (North)
The Pathways system has a fault preventing timely CPR advice for agonal breathing, and ambulance dispatch was delayed due to paramedic shortages and handover issues at hospitals.
Matched on terms: dispatch
PFD report
57match
Barry Hodges
Apr 2017 · South Yorkshire (East)
Ambulance dispatch protocols were not followed, leading to unused resources and breached timescales without escalation. There was also a lack of staff knowledge and a "safety net" system for monitoring dispatches.
Matched on terms: dispatch
PFD report
57match
Susan Longden
Dec 2018 · Avon
The NHS Pathways algorithm fails to prompt questions about recent surgery for severe abdominal pain, and NHS 111 advisors don't adequately prioritise speaking to patients directly. These systemic issues have been repeatedly raised.
Matched on terms: algorithm
PFD report
57match
Anna Hedman
Sep 2019 · London Inner (West)
A police call handler's inadequate training led to a gross failure to prioritize preservation of life and call an ambulance, even when prompted, in an emergency situation.
Matched on terms: emergency
PFD report
57match
Esma Guzel
Jun 2022 · Hull and East Riding of Yorkshire
The 111 algorithm failed to prompt urgent paediatric referral for a critically ill child, inadequately considering parental concern, prior GP review, and timing of advice, leading to delayed optimal care.
Matched on terms: algorithm
PFD report
57match
Rashdah Bhatti
Sep 2023 · North Wales East and Central
Human error led to critical first aid advice for a varicose vein bleed not being given during emergency calls, highlighting a risk of future deaths from handlers not following MPDS protocols.
Matched on terms: emergency
PFD report
57match
Jeffrey Tyler
Feb 2025 · Gwent
Ambulance call handlers failed to clinically override the dispatch system's categorization, maintaining a low priority despite clear evidence of the patient's severe, deteriorating, and unmonitored condition.
Matched on terms: dispatch
PFD report
57match
Oscar Keenan
Jun 2025 · Oxfordshire
Inadequate algorithms for assessing ill newborns/infants, particularly for respiratory problems, and over-reliance on these tools lead to delays in obtaining early clinical assessment.
Matched on terms: algorithm
LGO / SPSO decision
54match
202000766 - Scottish Ambulance Service
SPSO (Scottish Public Services Ombudsman)
C complained about the treatment of their spouse (A) by the Scottish Ambulance Service (SAS). A became unwell at home and whilst on route to hospital in an ambulance they experienced a cardiac arrest and later died in hospital. C complained that the ambulance took a long time to arrive; that the care and treatment A received in...
Matched on terms: dispatch, emergency
PFD report
53match
Winston Llewellyn Johns
Oct 2013 · Powys Bridgend and Glamorgan Valleys
Critical low blood sugar information was disregarded by the ambulance operator, and the computer system's inability to process clinical details led to inappropriate CPR advice.
Matched on classifier match
PFD report
53match
Allan Davies
Jul 2019 · Birmingham and Solihull
The NHS Pathways triage system for overdose patients is too generic, failing to assess specific drug risks for sudden collapse, potentially categorizing high-risk cases incorrectly and endangering lives.
Matched on classifier match
PFD report
53match
Hannah Royle
Oct 2021 · West Sussex
The 111 service failed to appropriately handle a complex case involving a disabled child due to non-compliant call handlers and an inadequate system for disabilities. The public is also misled about the service's diagnostic capabilities.
Matched on classifier match
PFD report
53match
Aran Bradbury
Oct 2024 · Norfolk
The ambulance triage system incorrectly prioritised a patient with both substance ingestion and mental illness, assigning a lower category response because mental health history overshadowed drug ingestion, delaying critical aid.
Matched on classifier match
PFD report
49match
Linda Lloyd
Aug 2014 · Blackpool & Fylde
Prior to review, concerns existed regarding triage being performed by non-senior nurses without adequate training, and departmental policy failing to consistently consider the effects of warfarin on patients.
Matched on classifier match
PFD report
49match
Glyn Ackerley
Nov 2023 · Cheshire
The NHS Pathways system fails to differentiate between high and low-risk overdoses, potentially delaying urgent treatment for fatal opiate overdoses, and the implementation of proposed changes is unclear.
Matched on classifier match
PFD report
49match
Jane Walker
Mar 2024 · North West Wales
Paramedics are unable to administer rapid-acting analgesics like mucosal fentanyl lozenge due to controlled drug legislation, potentially delaying critical pain relief and extrication.
Matched on classifier match
PFD report
49match
Joel Colk
Nov 2024 · West Sussex, Brighton & Hove
NHS Pathways' overdose categorization system fails to differentiate severity, leading to delayed responses. Ambulances also lack the necessary antidote for certain ingestions, causing critical treatment delays.
Matched on classifier match
PFD report
49match
Miles Robinson
Jul 2025 · South London
The ambulance triage system's rigidity incorrectly categorised a heart attack call as less urgent, lacking specific determinants for heart attack symptoms and risking delayed response if a cardiac arrest occurs.
Matched on classifier match
PHSO casework decision
48match
P-003096 - NHS England
Closed After Initial Enquiries
Mrs H complains the NHS Pathways triage system used for all NHS 111 calls is flawed, as it fails to recognise the possibility of sepsis for a caller who reports recent surgery and chemotherapy.
Matched on terms: flaw
LGO / SPSO decision
46match
201705035 - Scottish Ambulance Service
SPSO (Scottish Public Services Ombudsman)
Mr C complained on behalf of his wife (Mrs A) that the ambulance service unreasonably failed to dispatch an ambulance following an emergency call and that they did not handle his complaint reasonably. Mrs A had been diagnosed with a tumour at the rear of her brain and was waiting for an operation. Mr C said that Mrs...
Matched on terms: dispatch, emergency
LGO / SPSO decision
46match
201707301 - Scottish Ambulance Service
SPSO (Scottish Public Services Ombudsman)
Mr C complained that the ambulance service failed to send an ambulance to him when he phoned to report that he had suffered a collapse at home. When he received a call back from an ambulance service clinical adviser, Mr C reported that he had suffered flashing lights, neck stiffness, headaches for the past three weeks, and that...
Matched on terms: dispatch, emergency
LGO / SPSO decision
46match
201708212 - Scottish Ambulance Service
SPSO (Scottish Public Services Ombudsman)
Mrs C complained about the length of time that her mother (Mrs A) had to wait for an ambulance. We listened to the audio recordings of the relevant phone calls, and we took independent advice from a paramedic adviser. We found that Mrs A's GP surgery had requested that Mrs A be transported to hospital within two hours,...
Matched on terms: dispatch, emergency
PFD report
45match
Refat Hussain
Feb 2014 · London Inner (West)
Out-of-hours GPs working for Harmoni lack access to patients' full medical records, compromising their ability to make accurate diagnoses.
Matched on classifier match
PFD report
45match
Clare Bain
Aug 2014
Paramedics lacked awareness that Naloxone's antagonism duration might be shorter than Methadone's respiratory depressant effects, risking patient deaths due to inadequate repeat treatment.
Matched on classifier match
PFD report
45match
Monica Lewis-Hinds
Apr 2016 · London (South)
The ambulance service's call triage protocol is inadequate as call handlers do not proactively ask about the "type of fit," potentially missing critical information for patient care.
Matched on classifier match
PFD report
45match
Caragh Melling
Apr 2016 · London Inner North
The current NHS Pathways triage system lacks a crucial breathing analysis tool for identifying agonal breathing, a concern raised nationally since 2014 with no apparent action.
Matched on classifier match
PFD report
45match
Alexander Davidson
May 2019 · Nottinghamshire
NHS 111 pathways use unsuitable language for children and cause confusion, while GP surgeries experience delays in uploading 111 notes. There is also a lack of standardized lipase/amylase testing for children and inconsistent ED return patient reviews.
Matched on classifier match
PFD report
45match
Alf Rewin
Oct 2019 · Buckinghamshire
No specific safety concerns were identifiable from the provided administrative text.
Matched on classifier match
PFD report
45match
Ashley Walker
Jan 2020 · Warwickshire
A communication error confused ingestion with a spillage, and an effective antidote (methylene blue) for toxicity was not available on the ambulance.
Matched on classifier match
PFD report
45match
Mitica Marin
Mar 2020 · London East
A significant delay in defibrillation occurred because the paramedic was distracted and the device defaulted to manual mode; this is a recurring issue, reducing survival prospects.
Matched on classifier match