Hansard

I welcome the opportunity to make a statement to Parliament on the telephony problems that the Scottish Ambulance Service experienced on Wednesday 21 July. I will cover the cause of the problem, what happened on the day to ensure that calls were answered, the steps that have already been taken to prevent a recurrence and the audit that the Scottish Ambulance Service is undertaking to provide assurance that patient outcomes were not affected.

First, I will give some background. The 999 calls to the Scottish Ambulance Service are answered by one of our three emergency medical dispatch centres, which are in Inverness, Glasgow and South Queensferry. A call handler answers the calls and obtains the necessary details to allow the appropriate ambulance response to be dispatched. The systems that are in place make that a seamless process. The Glasgow telephone system is the main hub for the three centres in Scotland and it manages the local telephone systems at the other sites.

At just after 1 in the morning on Wednesday 21 July, the EMDC in Inverness started to experience disruption due to a fault in its telephony system. That fault in Inverness caused the corruption of the processor memory at the Glasgow hub, and that subsequently affected the telephony systems across the EMDCs. Throughout the day, the ambulance service and BT worked to resolve the situation, and all centres were back in full operation by 3.30 that afternoon. Contingency arrangements were activated at all three centres, and those arrangements allowed calls relating to more than 90 per cent of the incidents that the ambulance service dealt with that day to be handled in Scotland.

The Inverness centre was unable to take calls in the usual way between 1.05 am and 2.55 pm. The South Queensferry centre was unable to take calls between 9.42 am and 3.30 pm. At both those centres, BT was able to route 999 calls to mobile telephones as part of the contingency arrangements. The Glasgow centre experienced disruption between 9.56 am and 2 pm. During most of that time, four call takers were able to continue using the normal system and the remaining five call takers had to use mobile phones. However, between 1.10 pm and 2 pm, the Glasgow centre undertook a controlled closedown and restart of the system to clear all faults. During those 50 minutes, all call takers in the Glasgow centre used mobile phones.

In short, although the whole incident lasted from 1.05 am until 3.30 pm, it was only between 9.56 am and 2 pm that all three centres were affected and it was for only 50 minutes—between 1.10 pm and 2 pm—that the normal system was completely disabled. Scottish Government officials were advised of the telephony problems at about 12.25 pm and ministers’ offices were informed about 15 minutes later. The Scottish Ambulance Service has advised that the 999 calls that were answered in Scotland, either in the normal way or by mobile phone, experienced no delays between the information being received from the caller and the details being logged on the ambulance dispatch system. In addition, there was no impact on ambulance response times.

As I said, calls answered in Scotland accounted for more than 90 per cent of the total number of incidents that the Scottish Ambulance Service dealt with that day. A small number of calls were, however, routed to other ambulance services through what are known as buddy arrangements. Those arrangements form part of the contingency arrangements for a scenario such as the one that the Scottish Ambulance Service experienced on that day, and are established across all emergency services in the UK. The arrangements involve information being taken by call handlers in the buddy organisations and then passed back to the SAS for an ambulance response to be dispatched.

As a result of utilising the buddy system, a total of 149 calls were answered outside Scotland and then passed back to the Scottish Ambulance Service—121 by the Northern Ireland Ambulance Service and 28 by the North West Ambulance Service. Although those calls represent less than 10 per cent of the 1,609 incidents that the Scottish Ambulance Service dealt with that day, I want to take this opportunity to record my thanks to the services in Northern Ireland and north-west England for the invaluable support that they gave us during this period.

The Scottish Ambulance Service is undertaking a thorough review of the events of 21 July and I will return to the output of that review at the end of my statement. However, it is already clear that most aspects of the contingency arrangements worked well. For example, BT has confirmed that all 999 ambulance calls were answered during the period of disruption and I can also confirm that, once the patient information was logged on the ambulance dispatch system, ambulance response times were unaffected.

However, it is also clear that, as with any incident of this nature, we must take the opportunity to learn lessons. First and most obvious, we must work to prevent any recurrence of the situation. Immediately following the problem, BT was instructed to undertake a full review of system resilience. All the findings of that technical and complex review will be acted on and factored in to future contingency arrangements. Already, upgrades have been installed across the telephony system and analogue phones have been installed to support future resilience.

The second area in which we must learn lessons is use of the buddy system. The buddy system is an essential part of ensuring the resilience of the 999 service. However, because details are first taken by a call handler in the buddy service before being passed back to the SAS for an ambulance to be dispatched, there is an inevitable delay compared with the normal process, in which there is a seamless transfer of information from the call taker to the dispatcher. Use of the buddy system also means that, at virtually no notice, staff in another ambulance service are dealing with demand over and above the levels that they are resourced to manage.

The ambulance service has thoroughly reviewed each of the 149 calls that were passed from the Northern Ireland Ambulance Service and the North West Ambulance Service. Of them, 24 were duplicate calls, which means that 125 patients had their calls dealt with through the buddy arrangements. Of the 44 that were category A calls, the delay in the information being passed back to the Scottish Ambulance Service was less than 10 minutes in 55 per cent of cases, the average delay was 13 minutes and the longest was 57 minutes. For the 53 patients who were category B patients, the average delay was 32 minutes. The remaining 28 patients had non-emergency clinical needs.

I am very aware that these delays will have been distressing to the individuals concerned, including one of Jackie Baillie’s constituents who wrote to me about the delay that she experienced. I would like to convey to all of them my apologies and those of the chair of the Scottish Ambulance Service.

Making changes to the operation of the buddy system to address such delays will be one of the key action points from the on-going investigation. However, at this stage, I again acknowledge the hard work of all staff on duty that day, including all the staff in the buddy services.

Of course, what matter most are clinical outcomes for patients, which is why, as part of its investigation, the Scottish Ambulance Service has undertaken a clinical audit of every 999 call received on the day. The audit has focused particularly closely on the 125 patients who were routed through the buddy system. Dr George Crooks, who is the medical director of the Scottish Ambulance Service, is now in a position to assure me that the clinical case mix and outcomes that were achieved on 21 July reflected those that are experienced when the service works as normal. As is the case every day, it is not possible to achieve a positive outcome for every patient who requires an emergency ambulance. However, the service has informed me that no adverse outcomes were attributable to the delays associated with the buddy system.

I emphasise to members that the Scottish Ambulance Service investigation is still on-going. I believe that it is important for the Scottish Ambulance Service to complete its thorough and detailed investigation into the incident and for the public to be reassured about the service’s resilience, so I have asked the Scottish Ambulance Service to provide me with a detailed report on all aspects of the incident. To allow the SAS’s audit and clinical governance committees to consider the report fully, I have asked for it to be submitted to me by the end of November. I will then make it available to members through the Scottish Parliament information centre.

Of course, that does not mean that no actions will be taken until that report is published. In fact, many of the telephony actions that are required to ensure resilience in the system are already complete and the service will continue to act quickly in response to the lessons that emerge from its investigations.

As I said, the Scottish Ambulance Service’s detailed investigations remain on-going, but I hope that members are assured that the difficulties that the service experienced on 21 July are being responded to with the thoroughness that they deserve.