How quickly ambulance crews respond to an alert is often a matter of life or death. In Germany, the response time – from answering an emergency call to actually reaching the patients – has been increasing for years, but the UK is struggling with similar delays.

Ambulance staff is overwhelmed

In Bavaria, ambulance crews must arrive at the scene within 12 minutes of an alert, a target they have failed to achieve more and more frequently of late. Bavaria’s interior ministry prescribes that this response target must be observed in 80 per cent of the alerts in the so-called areas of provision. While in 2012, this target was met in 92 per cent of the cases in Bavaria, the figure dropped to 87 per cent in 2021. Keeping response time is especially difficult in rural areas in Bavaria.

While timely response targets are met in 95 per cent of the cases in large cities with populations over 100 thousand, this figure is 76 per cent in rural settlements with less than 5 thousand residents, meaning that the target is not achieved.

Ambulance stations being situated very far from each other is one of the main reasons, meaning that crews are responsible for an area that is too large to cover. However, long distances in rural areas are not the only problem, as is shown by BR Data’s analysis. Figures provided by Germany’s different states reveal the same trend: ambulance response times are increasingly below target. It is difficult to tell how much of this delay is due to each state determining the starting of response times. In Bavaria, response time is measured from the moment the vehicle leaves. In Berlin, crews should reach patients in ten minutes, and the clock starts ticking right when the emergency call centre answers the phone.

Berlin registers the worst figures. The problem in the capital is not with the long distances, but with too many alerts to locations where there is no real need for the ambulance services. Ambulance are often alerted unnecessarily, when – for instance – someone has cut a finger. Ambulance doctor Heiko Luther and his colleague told one of Germany’s public media outlets that they often feel more like taxi drivers than ambulance officers.

Several trade unions and associations have warned that in the near future, someone urgently needing care will call the ambulance in vain as the services will be unable to dispatch a vehicle. They believe the situation has become so critical that the system is nearing the brink of collapse.

„The pressure is so huge that action must be taken. It is occurring more and more often that we are unable to perform our missions,” Frank Flake from the German Association of Emergency Medical Services (DBRD) told the press.

This situation is mainly due to severe staff shortages and overloaded emergency departments. Mr Flake noted that

„Just a few years ago it was unthinkable that you would treat a patient in an ambulance for an hour outside the emergency department, because the clinics are so overloaded. And now, sometimes there are huge traffic jams”.

Meanwhile, available vehicles not being dispatched because of staff shortages has become a regular occurrence. A recent tragedy in Berlin is a clear demonstration of reality. A 15-year-old girl died in a traffic accident because it took the ambulance twice as long to arrive at the scene as it should have. According to the association of paramedics, their workload is extreme, so they demand that their weekly working hours be reduced from the current 48 or more, and that more ambulance vehicles are deployed in order to reduce their workload.

Another problem is that this type of career – offering long working hours and low wages – is not very attractive, so many who start out in the profession will switch jobs rather than stay paramedics. The firefighters’ union also complains that ambulances often fail to arrive at the scene.

The situation is worse in the UK

Similar problems exist in the UK, where the health system is on the verge of collapse.

In the event of a heart attack or stroke, the ambulance must reach the patient within 18 minutes. However, figures published by the NHS, the UK’s public health service, show that it currently takes an average of 40 minutes for an ambulance to arrive at the scene of an emergency.

In a survey by the GMB Union, which also represents ambulance staff, 85 per cent of respondents said they had witnessed delays that had a negative impact on patients, including the death of those patients in some cases.

„When an elderly person is lying on the floor all night and we have to tell them that it will take hours to get to them, you wonder: they could be your own grandparents. You hear them fainting, their breathing getting worse. This is really bad,”

says an emergency call centre staffer in a documentary. The NHS itself has authorised the film to explain the reasons for its own overload. The shortage of health professionals has other consequences: currently, around 6.6 million people across the country are waiting for an intervention because there is simply no doctor, no nurse, and in many cases no hospital bed available. Paramedics, however, cannot leave the patients until they have handed them over to staff at a hospital, so there is a long queue of ambulance vehicles just outside the ward’s entrance, often with a significant backlog of new cases.

Brexit has had many consequences that the British did not necessarily expect. Exiting the EU has, for instance, made it more difficult for people from EU member states to work in the UK as either doctors, or nurses.

A recent study has found that Brexit has exacerbated the acute shortage of doctors in the UK more than expected. There are now over 4,000 fewer European doctors working in the UK health system than was expected before Brexit, a study by the Nuffield Trust revealed.

Anaesthesia, paediatrics, cardiac surgery and psychiatry wards are particularly affected. But it’s not just specialist doctors, as the number of nurses has also decreased in the UK because of Brexit. There are currently 30,000 nurses, but without Brexit, the study estimates that there would be almost 90,000 nurses working in the health sector. In the 2021/22 financial year, the UK received only around one fourteenth of the EU workers it received in 2015/16 from other member states.

As the UK is no longer part of the EU, professionals now need work visas, which are costly and involve complex and lengthy bureaucratic procedures. The shortage of professionals is also compounded by a significant deterioration in working conditions. In England alone, over 10,000 doctors are still needed.