By ROSALIND GRIFFITHS
A MAN who suffered a near-fatal heart attack was taken to hospital more than an hour after his wife dialled 999 by a porter with no medical training who turned up in a car.
Alan Woodworth, 56, took ill at his home in Sandwick in the early hours of Sunday 19th of October. His wife Pat immediately called for help and was assured that an ambulance would be on its way.
But despite a second frantic 999 call, it became clear no ambulance was available and with Mrs Woodworth unable to drive they were left wondering what was happening.
When they finally arrived at the Gilbert Bain Hospital in Lerwick courtesy of the porter, an hour and a half after Mr Woodworth’s chest pains started, he was taken straight to the rescusitation unit. He was told he was lucky to be alive and several days later was flown to Aberdeen for further treatment.
Now recovering at home, the grandfather of five said: “The ambulance cover is atrocious, only one to cover the island. It couldn’t get to me and the emergency doctor couldn’t get to me. I’ve put in a complaint because I want better cover for us all.”
Mrs Woodworth is still traumatised by the ordeal and has not been able to return to work as a domestic assistant at the Gilbert Bain.
Sitting on their leather sofa and surrounded by photos of their grandchildren, the couple, who moved to Shetland from Manchester with their three children in 1980 when Mr Woodworth got a job at Sullom Voe, relived the events of that night.
Mrs Woodworth said her husband had started getting pains in the neck at around 1.20am, then he complained of heartburn, then pains in the chest. He was clammy, his arms were heavy and he told her he “couldn’t focus”.
When he became delirious, she phoned 999 at around 1.35am and was assured an ambulance would be on its way. Shortly afterwards, she received a phone call from a doctor providing out of hours cover. The doctor said the ambulance was at another incident in Scalloway and she herself was in Walls. As it would take her an hour to get to Sandwick, she had phoned NHS 24 on the Woodworths’ behalf in an effort to get them transport to hospital.
Mrs Woodworth waited anxiously as her husband’s condition worsened. Alone with him, she became alarmed as no ambulance appeared. The doctor’s phone call, she could see on the phone’s display, had been at 1.49am and she decided to phone back.
“I was getting worried. I thought ‘this is taking too long’. I pressed 1471 and phoned the doctor back. I said ‘no-one’s come and he’s getting worse.’” Her husband needed to be hospitalised, she was told, and could they get a lift? As Mrs Woodworth did not think this was possible, she was advised to phone 999 again.
“After I phoned 999 the second time I waited and waited. I had all the lights on like they told me. They said to keep the door open and keep pets away. I was trying to take all this in and see to Alan at the same time. His mouth had been dry and I’d given him sips of water, but it had made him sick. When I phoned the ambulance the second time they told me not to give him any fluids and to get him to lie down, but he kept sitting up.”
Mrs Woodworth said she was constantly running to the window hoping to see an ambulance appear, but instead the phone rang again. It was the hospital porter who said he could not find the house.
She watched in disbelief as a small car drove up and the porter, alone and with no medical equipment, got out.
“I was expecting a doctor to come out of the car, but no-one [no medical person] was there.”
The porter, who had been summoned from his bed, turned out to be an acquaintance of the Woodworths. He expected his friend Alan to be suffering from the chronic back pain which has plagued him due to his 30 years as a scaffolder – instead he saw an ashen patient, rambling about his grandchildren.
Mrs Woodworth said: “Neither of us knew what to do. I had thought of getting a taxi but a taxi driver wouldn’t have known what to do. I’d been thinking, it’s 20 minutes for a taxi to get here [from Lerwick] and 20 minutes back. That’s why I was waiting – I was expecting a doctor.
“I can’t understand why they didn’t send a doctor or even a nurse with the porter.”
Between them, the porter and Mrs Woodworth managed to bundle her 15-stone husband into the car’s passenger seat. Mrs Woodworth sat in the back with her arms on her husband’s shoulders, trying to comfort him as he struggled for breath and drifted in and out of consciousness.
The journey to hospital seemed interminable. “I remember looking at the clock in the car. All of a sudden the porter seemed to put his foot down.”
Mr Woodworth said: “He did his best to get us to hospital as quickly as possible – he was put in a hell of a position.” They found out later they had got there just in time. Mr Woodworth had been starved of oxygen and his blood pressure was dangerously low. Any further delay would have been would have damaged his heart – as it was damage was confined to an artery. So serious was his condition deemed to be that he was later flown to Aberdeen by air ambulance for a possible by-pass. In the event he had a stent fitted to keep his artery open.
Once stabilised in Lerwick, Mr Woodworth had chatted to the doctors and nurses about the events of that night. “They were all disgusted.” He said his GP at the Levenwick surgery was also “shocked” at the time taken to get Mr Woodworth the 20 minutes to hospital and the way the situation had been managed.
Mrs Woodworth said: “All I wanted was for an ambulance to come and get him and take him to hospital.”
Mr Woodworth had been on incapacity benefit for some time due to his chronic back pain but said the pain of the heart attack was much worse. “I’d never had anything like this before. There was no warning. I hurt my back with the lifting and carrying at work, I’d even lost a toe through an accident scaffolding, but it was nothing compared to the heart attack.”
Mr Woodworth’s complaint about the incident, which focuses on the fact that there is only one emergency ambulance for Mainland Shetland, has now been received.
NHS Shetland director of clinical services Simon Bokor-Ingram pointed out that ambulances are provided by the Scottish Ambulance Service, which is a separate health board, and NHS Shetland does not commission the service.
He said that a nurse or doctor could not have accompanied the hospital porter to the Woodworths’ without compromising the hospital’s A&E service. “Releasing clinical staff from the hospital would not be possible as they’ve got an existing workload and have to provide a fully functioning department.”
Regarding the situation which now exists of only one GP being available for out of hours calls in Shetland Mainland areas covered by the GP co-operative (that is, all areas except Hillswick), he said having one GP for fewer than 20,000 people compared well to the provision south. He described it as being “well within the limits of capacity”. Although the distances a GP would have to travel are greater than in an urban setting, those working south might have to see many patients in one night, whereas in Shetland there could be no call-outs at all.
Mr Bokor-Ingram said: “GPs working out of hours are not a 999 service. Of course they will provide any assistance they can when they are called out but they are not a replacement for the ambulance service.”
He agreed, however, that statistically an incident like the one involving the Woodworths was bound to happen from time to time, but the solution would have to come from the ambulance service.
A spokesman for the Scottish Ambulance Service said that a group is currently examining the “challenges” of providing remote and rural services. “We are looking at different models of care. The issues for us in Shetland are the low volume of calls and the high level of resources needed [to provide back-up], not least in recruiting staff. We are aware of and recognise the challenges and are looking at the alternatives.”
These could include retained ambulance staff (a system used by the fire service) and community first responders, which are volunteers trained in early intervention. Although community first responders are well-established in parts of Scotland, no time-scale has yet been thrashed out for the system to be set up in Shetland.
The Woodworths’ experience exactly illustrates the problem outlined in a letter from Duncan Thompson of Firth in The Shetland Times on 31st October, in which he said the emergency cover was “wholly inadequate”. If outlying areas can have fire and police stations, he argued that ambulance cover should be provided in these areas too, as the target of a 21 minute rural response time is impossible to meet with only one ambulance based in Lerwick.