The 'pre-arrival instructions' given by 999 (emergency services) call handlers to pregnant women/people experiencing maternity emergencies is a 'postcode lottery', with potentially harmful advice being given in some cases, the Healthcare Safety Investigation Branch (HSIB) has warned.
A national investigation by the HSIB examined the factors influencing the pre-arrival instructions given to pregnant women/people awaiting an ambulance because of an issue with their pregnancy. The instructions given by 999 call handlers are generated by a clinical decision support system (CDSS), with two CDSSs in use by ambulance services in England: an international system and a UK-based system.
The investigation reference case involved a 30-year-old woman who received advice from a 999 call handler that was in conflict with maternity clinical guidance. Similar concerns were identified in 15 HSIB maternity investigations, which all involved pre-arrival instructions generated by a CDSS that had the potential to cause harm to the woman or pregnant person and/or their baby.
The investigation found no evidence of a regulatory mechanism for 999 call handler pre-arrival instructions, and stakeholders acknowledged a gap in maternity emergency guidance relating to the non-visual, non-clinician-attended environment.
Source: Medscape UK, 18 February 2022
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