All language subtitles for Ambulance S12E04_Subtitles01.ENG

This programme contains scenes
which some viewers may find
upsetting and some strong language.

Ambulance Service.
Is the patient breathing?

Across the UK, more than
14 million 999 calls

are made for an ambulance a year,

with the North West
Ambulance Service

receiving a new cry for help
every 20 seconds.

As the pressure builds...

There's absolutely no reason
to talk to me like that.

I'm trying to help you here.

..the control room has to decide
who will receive an ambulance...

17-year-old male, cardiac arrest.

..and who must wait.

We do have delays at the moment
of up to eight hours and 45 minutes.

On the ground, ambulance crews
race to save lives...

..and offer the best help they can.

Oh, it's been nice of you to come.

You're ever so nice to talk to.

Tell you what, Norman,
you're made of strong stuff.

Black pudding!
I love a bit of black pudding.

From the picket line...
CAR HORNS TOOT

Everyone's gone on strike
because no-one can afford to live.

..to the front line...

Are you going to be violent
towards our crew?

..this is the story of
some of the darkest days

in the history of our NHS.

He was quite happy to die
on the streets of Manchester.

It's going to probably get a little
bit worse before it gets better.

3276. Unexploded bomb.

To my hometown.

Beats Darwen. Nothing beats Darwen!

SIREN WAILS

PHONE BEEPS

Ambulance. Is the patient breathing?

Across the North West,
there are currently 74 patients

waiting for an ambulance,

including a man found critically
injured in the middle of the road.

So he's face down?

Working together in Dispatch tonight
are Vicky and Gary.

Alpha 196, you have been diverted
to a Category 1.

SIREN WAILS

Quebec X-ray 095.

PHONE BEEPS
Receiving.

This is a male
that's been found face down

in the middle of the carriageway.

Amy is one of only two
advanced paramedics on shift,

available to respond
to the most serious incidents

across a 586 square mile patch.

We have got a number of calls
for this,

looks like he's been hit by a car.

I will provide you any more
information as we get it.

Yeah, roger, no worries, thank you.

Amy will reach the Category 1
emergency in 13 minutes.

Also en route is a senior paramedic
and an ambulance.

Police are already on scene.

PHONE BEEPS

So are you able to ask anyone
on scene if the patient's breathing?

SIREN WAILS

095, Amy, it's Jack at Control.
Just info on this job.

It doesn't sound particularly good,
but no further details.

Yeah, roger, thanks.

So, Vick, that looks like a bad one
that's just come in.

Who have you got going? We have
three crews currently en route.

Is that SP, AP and your ambulance?
Yeah.

Oh, dear.

Can one of you come
and give me a hand?

Take that and that.

Ta.

Take that.

As the senior clinician,
advanced paramedic Amy

will direct the multiple teams
already on scene.

Hiya.

Do we know anything about him?

Let's just have a look at the rhythm
after this set, this round, OK?

Just stop there, guys, a minute.

We're in VF, all right?

The police have been performing CPR
for 20 minutes,

but the patient's heart
is still not beating normally.

We're in a shockable rhythm as well
so when you've finish that 30,

I just want you to both let go, is
that all right? Yeah, two minutes.

To try and restore a regular rhythm,
Amy delivers a shock to the patient.

Everybody clear? Yeah. Yeah.

Will one of you go and get
a stretcher with the police?

Will you get the drugs bag out?

And grab just a cardiac pouch,
all right? Yes.

Stop there for a rhythm check, guys,
a minute.

Right, we're in asystole,
can you carry on with CPR?

The patient's heart
has not responded to the shock

and is still beating irregularly.

First adrenaline going in now.

Yeah, let's get him on the stretcher
and then we'll move.

Lights are showing. Yeah, let's.

Right, let's take it easy.

095, go ahead.

PHONE BEEPS

Yeah, 095,
you all right to do a prelim?

Yeah, no problem,
go ahead with the details.

Unknown if the fall or a medical
event has caused the cardiac arrest.

He does have a significant
head injury, skull fracture,

and significant bleed on scene.

Initial rhythm was a VF,

he's had three lots of shocks
with an asystole in the middle.

He's currently in asystole.

Our ETA is about 12 minutes, over.

PHONE BEEPS

Yeah, all received.
I'll give them a shout now.

The adrenaline's ready to go.

Just double check his rhythm
before you give it.

Right, are we happy
that tube's in? Yes.

How far are we away?

Let's have another one.
We're pulling it now.

Raise him up a little bit.

Yeah.

Raise him up. Yeah.

The crew reach hospital
in 13 minutes,

but the patient
has not regained a pulse.

SHE SIGHS

PHONE BEEPS

95, just a welfare check
after that last one. Everything OK?

Yeah.

They have called it in here,
unfortunately.

PHONE BEEPS

Bless him.

I'll leave you to it to finish
de-brief and everything.

If you need anything just give us
a shout before you clear.

Yeah, roger, thank you, will do, ta.

They've called that, Amy's job.

Have they called it? Oh, God.
Yeah, once they got him to A&E.

Oh, that's heartbreaking.

That was a hard one.

HE EXHALES

PHONE BEEPS

Ambulance Service.
Is the patient breathing?

He's just had a seizure?

And how old is he?

He's five.

30 minutes into the night shift,

and call handlers are already
answering 160 calls per hour.

PHONE BEEPS

Sir, if you need transport home,

you'll need to ask the hospital
to arrange a taxi.

No, we're the Ambulance Service.

Sir, we're the Ambulance Service.
We can't arrange you a taxi home.

PHONE BEEPS

Has he had a head injury
in the last seven days?

Due to severe pressures we have been
experiencing a high demand

but an ambulance will be provided
as soon as possible.

However it is likely at this could
be over one hour and 30 minutes.

PHONE BEEPS
OK, tell me exactly what's happened.

OK.

SIREN WAILS

Alpha 169, I've just had
a Category 2 come in.

It's a nine-year-old girl
and she's got abdo pain.

Just looking at the notes,

she does have a long-standing
chronic condition.

Alpha 169, Kiera and Cameron,

are ten minutes away
from the patient.

Patient has a bowel blockage.

Has lost weight, last few days has
had abdo pain and today is severe.

Child looks similar to a ragdoll.
Oh, right, OK. Nine years old.

Hiya, are you OK, love? I'm Kiera.
What's your name?

Ayesha.

This has been going on now
since September.

Er, she used to have very,
very large stools, like,

she had one in September
that split her bum

and she bled everywhere.
Oh! Aww, bless her.

Ever since then, she's lost control
of her bowels. OK.

Now, we've been to the doctors
eight times.

They tried to expedite... Yeah.

They basically said,
the paediatricians,

that they had no capacity for her.
Really?

So she's now been, it's now February
and she's had

no control of her bowel since then.
Oh, bless her heart.

So she's lost over a stone,
but lately she's refusing to eat

because it hurts her stomach. Yeah.
Me and her dad have had to carry her

to the toilet
because she can't move.

Has surgery been talked about or
considered? They've talked about it.

Basically she's got a scan on
Monday. Oh, bless you!

She's got a scan on Monday.
Sorry, can I just squeeze past?

I think it's reality, isn't it,

that you're just banging your head
against a brick wall.

22nd, she's got an appointment
with the consultant. Yeah.

But now I'm concerned that if this
blockage is as big as it is...

Yeah. ..and she's getting worse
day by day, so summat's going on

and summat needs...
This blockage needs to be...

She's tried. Absolutely. It's such
a sensitive age as well. Yeah.

She's a young lady now, isn't she,
she's not a little girl.

You can tell she's uncomfortable
just the way...

She's a bit washed out.
I mean, we've not met her before...

I mean, you can see the colours
of her arm,

and if you feel her hands,
her hands are freezing.

She keeps saying she's cold,
but she's freezing to touch. Yeah.

It's just going to go tight,
but it won't be for long, OK?

Any history of anything like this
in the family?

I've lost a few. Have you? Yeah. OK.

Bowel cancer and...
Yeah, yeah. Yeah.

She's not eating anything.
Not eating anything at all?

She says when she eats
her belly hurts. OK.

Her brother's getting married
in ten days. Aww!

We need to get you right, then,
don't we?

And you're going to walk down that
aisle in your posh expensive dress.

Wow! What colour's the dress?

Shall we show her? Show me the
dress? Please! We need to see this!

Please show me the dress!

Yeah.

Oh, my gosh! Look at that!

Wow.

That is beautiful.

They've had that made from material.

Well, I think let's get this sorted

because we've got a wedding
to get you ready for, haven't we?

Yes.

My heart's actually breaking
about everything that's going on.

Yeah. She's been like this for
months. That's what's not right.

We've heard stories, people waiting
months and months and months

and becoming someone so unwell
whilst waiting for the referrals,

you know,
and we need to build a log up,

we need to be making a point
of saying,

we're in hospital all the time,
we're at the GP all the time,

pain relief's not touching it,

she needs more than
what we can give her here. Mm.

Do you think you can get yourself
down the stairs, chicken?

Yeah? Chicken!

That's her nickname. Is it?

Yeah. It's like... It's like
somebody may have told me that,

I might have had someone
whispering in my ear.

Park your bum on there,
swing your legs up and get comfy.

So I'm not going to press
where it's sore first,

I'm going to press
where it's not sore.

And then as soon as it starts to be
sore I want you to tell me.

Here? No?

Here?

Yeah, starting
to get a bit tender here?

Here?

Yeah? Can I have some Calpol,
please? Course you can.

What milligram are we after?
The higher one. The higher one.

So we have got...

..orange flavour. Oh, it's orange!

But we'll finish it off
with a Mini-Egg.

Might as well get this nasty pain
away if we can, haven't we?

There you go, darling.
Can you do it yourself? Go on.

Go on. Go on!

Yay! There we go.

Right, I'll see you
on the other side. See you there.

Let's have a Mini Egg party.
Woo-woo!

You see?

The NHS isn't all bad. I know.

Ayesha will be taken 16 miles to the
Royal Blackburn Hospital.

She's too young
to be having these problems.

Yeah.

They're just like, "Oh, we can't."

Yeah, it's not good enough.

No, it's not good enough.

You did the right thing, definitely.

Do you not find that when you're
not well, all you want to be...

..you want to be in Mummy's bed,
don't you?

She doesn't snuggle,

and she's not a snuggly person.
Are you not a snuggler? No?

You're never too old
for a Mummy cuddle.

Embarrassing mum alert.

You know, one day, when you're all
grown up, you'll look back,

like I do, because I used to always
say that my mum was embarrassing,

and you realise
it's cos they love you.

Yes.

DISTANT SIREN BLARES

I've made a friend for life now.

High five?

Yeah!

SHE LAUGHS

Shall we wrap you up, snug as a bug?

Need to hug you up,
you're freezing cold.

You're in very capable hands here,
Ayesha.

I used to be a porter.
Oh, did you? Yeah.

There's major issues
with primary care services.

You know, people being referred
to specialist teams,

people waiting for surgeries,

people waiting for all
kinds of treatment

is being delayed
because of the backlog.

All the hospitals are struggling.

There simply aren't enough
GP surgeries, primary-care centres,

walk-in centres to manage the amount
of patients that there is now.

So, we're left to mop up
the remainder of what's there.

SIREN BLARES

PHONE BEEPS

Ambulance Service,
is the patient breathing?

Three hours into the night shift,

and pressure on the service
remains high.

Call handlers are now answering
156 calls an hour.

PHONE BEEPS

OK.

Yeah, we have got you some help
arranged with an ambulance,

however this could be up to an hour
and a half at the moment, OK?

I know that does sound
like a very long time,

but we do need to be there as...

Yeah.

Across the region, more than
a quarter of all crews

currently treating patients
are stuck waiting at hospitals.

And 46 patients still need
a resource.

How are you looking? Are you busy?

17 active, but I've just got delays
at the hospital. Yeah.

Longest 118 minutes
stuck at the hos...

Oh, no, 155.

We've got eight crews
at the hospital.

And I'm having to take crews
from other areas to cover my jobs.

They're all at breaking point,
aren't they? Yeah.

PHONE BEEPS

Ambulance Service,
is the patient breathing?

No, no-one has cancelled the help.

We will be with you as soon as
we do have an ambulance available.

I just can't give you a time
for that at the moment.

It will be as soon as we have enough
ambulance available

to come out to you.

The patient on the phone has called
the Ambulance Service 35 times

in the past year.

So, when you say you feel
like you're vibrating,

is it like you're tremoring?

HE IMITATES VIBRATING

Right, OK.

So, all I can advise is that you
just wait for the ambulance.

OVER PHONE:
Blub-blub-blub-blub-blub-blub.

There is absolutely no reason
to talk to me like that.

I'm trying to help you here.

And if that's how you feel,
that's absolutely fine.

Alex, can I borrow you?

He won't make a decision as to
whether he wants to cancel or not,

and he's just kind of
getting abusive.

My name is Alex. I'm a supervisor
in the Control Room.

You've been asked to make
a decision. You keep...

You don't need to use that language
with me. I'm asking you a question.

I'm a supervisor and I need you...
You need to make the decision now.

Would you like an ambulance to come
or not? Yes or no?

You don't use that lang...

First of all, first of all,
do not use that language to me.

Do not call me sweetheart.

I've asked you a question.

Do you want an ambulance or not?

Right, we're going to leave the
ambulance running.

We're going to clear the line now,
OK?

So, we're going to keep
this ambulance running for you.

If you do get worse in any way

just call us back on 999, all right?

So, we're going to clear the line
on you now, OK?

All right, thank you. Bye.

Thanks, Alex. Pleasure.

In Dispatch, Vicky and Gary are
seven hours into the night shift.

Hang on, I just got a Cat 1.

I've just got so many people
to deal with.

This is basically two normal desks.

Lou, can you get that Cat 1, please?

On it. Thank you.

You are kidding me.

Do you know what someone's
phoning up for?

Athlete's foot.

I just...yeah.

PHONE BEEPS

Ambulance, is the patient breathing?

All right, tell me exactly
what's happened.

His eyes are rolling?
SIREN BLARES

All right, OK, an emergency
ambulance is being arranged.

Gary, I've got another Cat 1.

Er, 196, please.

Alpha 196.

Alpha 196, go ahead.

We've popped you into a Cat 1
for a 40-year-old male,

not conscious and not breathing.

Bleeding from the head.

Alpha 196, Kelsea, and newly
qualified paramedic Bushra,

are five minutes
away from the patient.

You have also got Romeo 180
assigned, no ETA at present.

Also dispatched is senior
paramedic Debbie.

Romeo 180.

180, go ahead.

So, this is a 40-year-old male,
he's bleeding from the head,

unconscious with noisy breathing.

Had a seizure in the last hour,
over.

Yeah, roger, no worries, ETA
is going to be about five minutes.

Is he responding at all to you?

We're going to get you some help,
OK?

Happy to take your stuff in? Yeah.

DOG BARKS

So, where are we going,
and who is it?

What's your name, love,
can you tell me your name?

Shall we get something just to
stem the bleed?

Keep your head still for me.

David, just try
and keep awake for me.

We're actively bleeding,
it's just leaking out.

David, do you know where you are?

Where are you?

You're home?

OK.

It's all right.

Do you remember anything?

Is he known epileptic?

Can you take your hand off a minute,
Bushra?

I'll just have a quick look...

DOG BARKS

It's just there, bleeding. Yeah.

We're here to help
and we've got you, all right?

All right doing it like that? Yeah.
All these...

You're bleeding from your head,

so we're just going to put
a dressing on your head.

Did you say you couldn't feel
any skull or bone? No. OK.

No, so...

DOG BARKS
I've had a feel of it.

It doesn't feel like there's
an obvious skull fracture

or anything like that.

I'm just trying to ascertain
kind of what's happened

and what's led to
the seizure activity.

So, it's whether he's had a
seizure and then he's fallen

and banged his head... Yeah.

..or whether he's fallen,
banged his head

and that's caused him
to have a seizure. Yeah.

So, either way we need to go
to hospital

because he probably needs a CT scan

to have a look
and see what's going on.

We'll take you.

Aw.

It's the best place to be right now.

If you don't go, you're going
to get more poorly.

Honestly, I wouldn't take you to
hospital if I didn't have to,

but I'm going concerned about you,
I'm not going to lie.

I know you might not feel it,

but you look confused, OK?

Your heart rate's up,
your blood pressure's up.

You're showing signs of
a head injury, internal.

You need a head scan.

David, do you understand
the extent of your head injury?

You've had a full-blown seizure,
David.

And that's not normal for you.

If there is a small bleed
on your brain,

there's a chance that if you go to
bed now, you won't wake up again.

You've got small kids up there.

And as a parent I think sometimes

we need to make decisions for them,
as well.

Because they need their dad.

Can I get your shoes?

And your charger. Listen...

Get your charger, get your jacket,
and we're sorted.

Listen, I'm going to
get off because I'm on the car.

You take care,
look after yourself, all right?

Get your head sorted, all right? OK.

Right, one sec, sit yourself there.

DOG BARKS
Pop this back on. Right.

Can you swing your legs up for us?
Push your bum...

..further up that way little bit,

and then get your legs up.
That's it.

There you go.
Oh, it is a good one, that.

I know, a bit lumpy.

Can I put a cannula in you now?
Thank you.

Let's have a good look at your hand.

Just a little sharp scratch,
all right? Yeah.

And we're ready to go.

Do you know that you were refusing
to go before?

Do you remember that?

That's all right,
don't worry about it.

SIREN SOUNDS

I knew it was because of
your head injury.

I was 21 when I qualified,
about seven months ago.

To be honest,
it's not what I expected.

I didn't think there would be
this much responsibility.

I think you're constantly thinking,
"Oh, am I doing the right thing?"

Sometimes that can become
quite overwhelming.

But you've just got to just
trust yourself

and just hope that you've done
the best for them.

We've just reached hospital.

David will be handed over to
staff at Royal Blackburn Hospital,

where he will be scanned
and receive further treatment.

It's the start of another
12-hour shift

for the North West
Ambulance Service.

Morning. Are you OK?

Caring for the 1.5 million people
of Lancashire

are dispatchers Vicky and Gary.

Morning, Gary. Morning, you OK?

It's a good start to the day,
to be honest,

considering it's Monday.

The GP surgeries have
only just opened,

so I'm sure we'll start getting...

Start getting... ..a few more calls.

We'll push on through.

I'm sure the manic Monday
will start in a couple of hours.

On the road are Alpha 196,
Bushra and Kelsea.

Fish finger pie.

That sounds banging, actually.

Fish finger pie?

Yeah. I've never... Fish fingers...

No. ..beans, potato -

cheesy potato...

What, all in a pie? In a pie, yeah.

Oh, my God, that looks delightful,
I'm making it.

No, I'm sorry, pass.

They will be joined by Alfa 169,
Cameron and Kiera.

Can you reach?

I'm not taking t' piss. Can you...?

Can you actually reach up there?
HE LAUGHS

Ambulance Service -
is the patient breathing?

In Control,

call handlers are feeling the
pressure from a busy night shift.

So, why do you think you've had a
stroke, what symptoms have you got?

OK.

Oh, OK.

There are 36 patients
waiting for a resource,

and a new call is being answered
every 30 seconds.

PHONE BEEPS
Just take a nice deep breath for me.

I'm not a clinician
so I can't advise of that.

I do have to make you aware that due
to severe pressures,

we are experiencing high demand...

..so is there any way you could
make your own way to hospital?

Alpha 196.

Alpha 196.

Yeah, good morning.

A job in Burnley.

It's a 83-year-old female,
is conscious and breathing.

Fallen, with a chest injury. Oh.

RADIO BEEPS

Oh, no worries, yeah. Thanks
for that, we'll see what's going on.

SIREN SOUNDS

Bushra and Kelsea are 18 minutes
away from the patient

on the floor, who pressed her
panic alarm as a cry for help.

So, it might be us,
that end one there, yeah.

Hello? It's the ambulance!

Oh, hiya, dear, where are you?

Oh, dear. Oh, dear.

Oh, no.

How did you get here, then?

I've been here since ten o'clock
last night.

Oh, no! Oh, no!

When did you press your pendant,
Dawn?

This morning. This morning?

How come you waited
till this morning?

If you fell at ten o'clock
last night?

Because I was hoping it would
all wear off and...

Oh, bless you. Aw!

..I would be able to get up.
Pop your finger in here.

Should have called us
straight away, Dawn.

I can't stand up, that's the thing.

It's all right, we're here.

Yeah, we're here now. Yeah.

Have you any pain in your hips?
No. No.

No, it's just...
Just your ribs. ..my ribs here.

And you've cut your arm,
haven't you? Yeah.

Right, I'll just do your
blood pressure on the other arm.

What I did,
I crawled up to the bed... Yeah.

..pulled me pillows down so that
I had something to lie on.

Yeah. Aww. It's good that.
You've done well. Oh.

You should have pushed
the pendant last night.

I know. All right, I'll just have
a feel of your hips.

Ah! Sore? Ooh...

Under there? Ah, yes.

Sorry. Ah... Is that when I'm...

Oh, yes, that really hurts.

Oh... Yeah, I think
it's just bruising.

We'll support you getting up.

All you've got to do
is push up on your legs, OK?

On three. So, one, two, three.

Fantastic. All right, we'll sit
you... Your bed's just behind you.

All right, do you feel dizzy? Yeah.
Yeah, let's sit you on the bed.

Oh... Just sit yourself down.

We've got you. You're all right.
That's it. Thank you.

There you are, well done.
You're so good.

Does that feel better?
You're so good!

You did all that yourself.

We can have a good chat with you,
Dawn.

Let's get you sat here.

So, you've been on the floor
for about ten hours.

Now, what they say with a long lie

is to always take the patient
to hospital,

because what could
potentially happen

is, later on during the day,
you can start to feel unwell.

I don't want to go to the hospital.
I'm all right. Right.

I'll speak to the nurses.

Right. I'll tell them that you don't
want to go to hospital. No, I don't.

KELSEA CHUCKLES
And they've got no choice

but to bring you some care here.
Right, good.

All right? Do you want a brew?

Oh, yes, please.

Hiya, it's one of the paramedics
from the Ambulance Service.

Hiya. Am I able to speak to a nurse

or somebody to refer
a patient on to you?

When you're newly qualified,
you can have the element

of caring too much.

You do have to give a bit
of yourself to each patient

and share your compassion
and your love and your care

because, at the end of the day,
you want to do the best for them.

It can be quite
emotionally draining,

but it does make you
appreciate life a lot more.

Oh, brilliant.
Thanks a lot for your help.

Right, thank you. Take care, bye.

So, I've spoken to the nurses from
the intensive home support team.

They're going to come round
sometime today

and then they'll just do
a full review again,

um, and they'll dress
that arm properly, OK?

They'll do a better job
than what I've done.

BUSHRA CHUCKLES

You've done very well. Oh, good.
You've all been good.

Aww, thank you. Bless you.

If you start to feel unwell at all,

make sure you call us back,
all right?

Yeah. Don't be waiting
like you did last night. Yeah.

I really appreciate what
you've done. Aww. Thank you.

It's all right. You're all right.

The reality of the job is that
we're not all lights and sirens.

Since I've qualified,

I can already see that there's been
an increase

in going to people
with social problems,

especially with the elderly.

And, to be perfectly honest,

I don't know when
it's going to ever get better.

Back in Control, call handlers
are four hours into the day shift.

PHONE BEEPS

CALL HANDLER: Hello,
it's the Ambulance Service. Hiya.

So, a car has gone into the back
of your car, is that right?

You can't feel your right leg
and you've got pain in your...

..pain in your other knee?

Right, so you can't feel
your left leg

and the pain's in your right knee?

You can't feel your right leg?

All right, OK.

Call volume has almost doubled
since the start of the day,

and a new call is being answered
every 16 seconds.

PHONE BEEPS

RADIO BEEPS

169.

Thank you. I have a 57-year-old male
with abdo pain

who is currently fighting
for breath. All received.

We'll start heading over
to Cameron's hometown of Darwen.

D-town!
THEY CHUCKLE

Alpha 169, Kiera and Cameron,

are ten minutes away
from the Category 2 emergency.

Oh, look at that. Nice little space
outside with our name on it.

KNOCK AT DOOR

Hello. I'm Cameron, this is Kiera.
What do we call you?

Rob. So, what's going on?

I've been going to the hospital
for the last four or five months.

I'm having abdominal pains
in my stomach, and they're all over.

Mm.

I can't keep my food down.
Right, OK.

I've lost five stone
in four and a half months.

Four and a half months, my word.

WOMAN: The weight loss
since Christmas has been massive.

Right. We've seen him really,
really drop weight. Right.

I'd say he's lost quite a lot of it
in the last four weeks. Mm.

All the skin... Skin's...
Yeah, right, OK, we can see that.

I can't keep food down and
every time I go to the hospital...

Right. ..they just send me home.

And it's a substantial amount
of weight, isn't it? Yes.

And how would you describe the pain?

Very sharp. Right. Very...
It's like a stabbing. Yeah.

The pain is always, always there.
Constantly there.

A little bit of background -
Robert was street homeless.

How long were you homeless for, Rob?
I mean, I've been over here from...

..since I was 17.
I've been here 40...

Right. ..40 years. My word.

Have a lie down
and I can have a listen.

ROB INHALES SHARPLY
Is that painful?

Is it more painful when
I'm pressing down or coming away?

It's... If I'm... No matter
what state I'm in... Mm-hm.

..or what shape,
the pain comes anyway.

It's still there. So...
Right. It doesn't matter.

I don't want to be left
like this any more. No.

Cos if yous do, I'm just going to
walk out in the street

and go back on the street
and give this up. Yeah.

I've got... To that point. Yeah.

Yeah. I'm just sick and tired of it.
Yeah. Yeah.

Chronic pain is... Horrendous.
It does get you down, doesn't it?

Mm-hm. We can't leave you like this.

We are going to get you up to A&E.
All right, Rob?

Um...
ROB GROANS

Do you feel not believed
sometimes, as well?

Do you think people
don't take you seriously

because they can't find, you know,
for what's going on?

How many patients do we go to and
they get discharged with nothing?

With nothing. No diagnosis at all.

You know, it's...

Yeah. Yeah.

Come on, my love.
Let's get your pain sorted.

I'll just pop you on the bed and
then you're a bit more comfortable.

I think A&E are going
to be sick of me.

How many times have you been,
if you don't mind me asking?

About seven or eight times.

Right, OK.

All they're doing is sending me
home to an empty house on me own.

Mm. It's just crazy that they
haven't found a reason, you know?

Yeah. They haven't found
a diagnosis as of yet.

I know there's people
worse off than me,

but I think everybody
should have a right.

Oh, yeah, of course, yeah.
Of course. And not be...

..fobbed off. That's it. Mm, yeah

How do we... How do I get out? Oh!

That's really...

AUTOMATED VOICE: Mind your head.
No way. Is she our driver?

It's weird. Yeah.

Mind your head. And she says...
She's asking you how to get out?

Your crash helmet
is under your seat.

Your exits are here, here and here.
ROB CHUCKLES

Scream if you want to go faster. Oh.
LAUGHTER

Oh. I know. Better get belted up.

Let me know when you're happy,
Cam. Yeah, good to go, thank you.

Robert will be taken the four miles
to the Royal Blackburn Hospital.

Just need to try
and get you sorted

because you've had a long time
of suffering really, you know.

The thing is, no-one
should be homeless, should they?

It's mental that we live in
a country,

an affluent western country...

There shouldn't be anyone.

Look at the state this country's in.
Mm.

Oh. He were a lovely,
lovely bloke. Lovely man.

I actually felt really sad for him.
Yeah, absolutely.

Because I do actually think
his physical health

is impacting on his mental health.

Oh, yeah. I think he's just fed up.

Yeah, yeah. Chronic pain with...
It's really common, innit?

We see that a lot.
Course it is, yeah.

And when he got upset,
I were like, "Oh, God."

Oh, bless him.

PHONE BEEPS

An ambulance is being arranged.
However, currently they say

it's likely it could be over
an hour and 15 minutes.

And I understand that, but
unfortunately we are just very busy.

Nine hours into the shift

and Control have answered
over 2,000 calls for help.

So what's your main
concern right now?

So it was an accidental overdose?

You phoned us accidentally?

So do you still need an ambulance?

Yeah.

Yeah. OK.

Alpha 196, I have a Cat 2
that's just come in in Clitheroe

from a health centre.

65-year-old male, acute abdomen.

His NEW score, he's quite
a poorly guy. NEW score of nine.

Oh, my God.

We'll head over, thank you.

He must be one of them where,
like, they only go hospital

when they're, like, proper dying.
Yeah.

Alpha 196, Bushra and Kelsea,
are the nearest available ambulance

for the patient with a worryingly
high National Early Warning score,

a system used to assess how
acutely ill a patient is.

I'm really curious to know
what's wrong with him. I know.

To have a NEW score of nine. Yeah,
and for, like, a doctor to call in.

It could be septic.
It could be, yeah.

Oh, it's here apparently.
Oh, entrance.

This should be all right.

Hiya, is this Keith? Hello. Hello.

My name's Bushra.

So at the moment right now
it's just abdominal pain?

DOCTOR: Bad abdominal pain,
very dry, diabetic,

not properly controlled
at the moment. Yeah.

Been vomiting,
so I've been worried about sepsis.

Shall we get you onto our ambulance?
Yeah. Yeah.

Got a lot going on, hasn't he?

That's it.

Brilliant. And swing your legs up,
if you can. That's it.

Do you normally have tremors in your
hands? I have, but not this bad.

No, it's worse. OK. No worries.

We'll do some checks on you,
all right, Keith? All right.

Yeah, so did you hear the nurse
about you being septic,

which means that you've just got
sort of a severe infection?

She said severe infection.

We're just going to also do
a little ECG on you, all right?

Yep. Just to see
what your heart's doing.

Have you still got that abdominal
pain, Keith? I certainly have.

Where is it? One minute. Can you
just point to me with one finger?

Here? Not too bad there.
No. Just more down here?

Does it go up in your chest at all?
It does, it goes back up there.

Just nice and still as you can.

What did you used to do, Keith?
I still am.

Oh, yeah. What do you do?

A gravedigger. A what?
A gravedigger. A gravedigger?

Oh! Oh, my goodness.

How did you get into that?

I've been doing it since I was 15.
Really? Blooming heck.

So you left school and went
straight into that? Yeah.

So did you say you live alone,
Keith, sorry? I do, yeah. Yeah.

Any kids or owt? No.
No missus or owt? No. No.

Would you be able to tell me
what that tremor is?

It might just be something as simple
as you're just really unwell. Right.

It might be that your temperature's
too high as well.

Right. It could be
a load of possibilities.

Are you all right? Yeah.

999 mode activated.

ETA is 21 minutes at the minute.

Alpha 196,

am I able to do a pre-alert
to Blackburn Hospital, please?

Yeah, go ahead with
the observations.

Keith will be taken the 13 miles
to Royal Blackburn Hospital

on lights and sirens.

And you said you've got
no kids or owt? No.

No, did you just not fancy having
any? Nobody would have me. Aw.

Do you have mates?
I have some friends. Yeah. Yeah.

Would you consider getting a dog
for company? Yeah, I could do. Yeah.

Something that you could come
home to. That's right. Yeah. Yeah.

Are you feeling quite dizzy
at the moment? Yeah.

Are you all right, Keith?

It's all right, Keith.

We're going to have a feel
of your pulse.

Oh, my God.

Kelsea? Yeah? We're going very red
here and we're also going in SVT.

It looked like VF at one point,
he looks quite poorly.

Keith's heart has begun to fluctuate

between beating dangerously
fast and then dangerously slow,

a condition that can lead
to cardiac arrest.

Alpha 196.

Alpha 196, can you just update
Blackburn Hospital, please,

that we're in SVT now.

Heart rate's going about 224

and we have occasional episodes
where he's going very bradycardic

with a heart rate of 34.

SVT and his heart rate is rising
to 224. Bradycardic at 34.

Yeah, no worries, I'll update them
and let them know. Thank you.

We're just about five minutes away.

KEITH COUGHS

I've got you, don't worry.

Just about one minute away.

RADIO CHIMES

Alpha 196.

Alpha 196.

Yeah, just looking for update
on that last one.

I can see you heading to
Royal Blackburn.

Yeah, we headed to Royal Blackburn.
He seemed quite steady...

Are you all right?

What's the matter? I'm feeling just
really stressed. It's all right.

What are you stressed about?

Oh, my God. You know when you just
let it out? What's stressed you out?

If you could take that?

RADIO CHIMES

Sorry, we got disconnected.

Yeah, Bushra just got a bit
overwhelmed. It's been a long day.

Yeah, he was all right when
we picked him up,

but he wasn't well, obviously.

But he was quite steady,

and then on the way he seemed to
take a bit of a turn for the worse.

Yeah, hopefully he'll be all right.
Ah, no worries.

Totally appreciate everything you
have done today.

So thank you so much for all
your help.

What happened? You know when you're
like keeping your shit together?

What's stressed you out, though?

I don't know. Like when you
just keep yourself together,

and then at the end
you just let it go? Yeah.

I just thought he was going to
go off on me.

Yeah. No-one's arrested on me yet.
No.

I think that was it, like he's going
to arrest on me. Yeah.

And there's no treatments
that we could give him.

I was just stood there, like stood
over him waiting for him to die.

It's overwhelming. Yeah. Oh, my God.
You did really well.

Come here.

I'll stop crying.

Oh, my God.

Goodness. Bless you.

It can be really difficult not to
think about a job afterwards.

All the emotions can start
flooding back.

You are responsible
for people's lives.

And I was prepared for that, but I
wasn't expecting it to be this much.

I love a good cry. I think it's
cos I'm new. It's overwhelming.

Yeah. When you're new,
it's REALLY overwhelming.

It can be quite hard
disconnecting emotions.

But the privileges that we have,

the different things
that we see every day,

I'm grateful for that.

I feel grateful that I could change
someone's life for the better.

I've found my place.

I'll be helping people
for the rest of my life.

Ambulance Service,
is the patient breathing?

Right, OK.

Alpha 169, Kiera and Cameron,

are dispatched to the patient
with suicidal thoughts.

KNOCKING

Hello, sir. Hello.

Are we all right to come in?

Yes, please.

Thank you very much.

You're welcome. Oh!

My name's Cameron.
This is Kiera just behind me. Hello.

What's your name?

Ahmed.

Ahmed.

How can we try and help you today?

Please, I have lots of problems
because, you know what I mean?

I don't know how I can explain
to you.

I lost my wife, I lost my children.

You see my photos of my children?

Oh, right, OK. Yeah.

Because I have a CD. I have a record
of everything, man.

Because me left the children, man.

Aw! That's a lovely photo.
Me left the children, man.

Me left the wife, man.

Me left with letters
from the daughter. Yeah.

You know what I mean?

Yeah, you've kept everything,
haven't you?

You know, I've lost it.

I've lost everything, yeah? Yeah.

So you're in a bad place,
aren't you?

Yeah, and...

..I don't want to be alive.

I want to die.

And have you say to me,

"Mr Ahmed, are you working?

"You pay all the bills?"

Come on, all payslips,

working two years in a factory.

Where's my wife?

Where's my daughter? OK.

That is shameful, this country.

Honest to God, a shame for
this country again.

The Home Office that's not
letting him go back.

Is it not that the family
can't join him? Oh, right.

I think he got sold the dream
that if he came

and did asylum seeking, worked,

proved that he can have an income,
worked at the factory,

got the wage slips,
blah, blah, blah,

and the family's still not here.

So I think the frustration is that
we're doing everything right

and we're doing...
He's sort of saying,

"I got told that if I did this then
I'd be able to get my family."

I think that's... Yeah, yeah.

Ahmed? Yes. Thank you
for telling us all that. Yes.

Our job here today is just to
work out what support

we can put in place for you.

I have letters from...MP.

Right. Ahmed. Ahmed,
just listen a minute. Yes.

We're from the Ambulance Service.

So all these problems -

I know they're bothering you,
I know you're in pain,

you're having a few issues,

but that's not
why we're here today, OK?

So we need to try and stay on track

and we need to try and deal
with the problems today.

I want my son to come over.

I need your government
your immigration,

your Home Office bring my son
to over here.

Mm. Mm-hm. Yeah.

I see them people going
to Parliament,

talking too much blah, blah, blah.

Well, come and talk to me first.

How many people like me break heart?
Mm.

Do you know what I mean? Yeah.

Do you want to harm yourself?

No. No, I don't want to.

I'm out of ideas, really. I don't...
Yeah.

There is nothing medically wrong.

So, Ahmed? Yes.

Our advice would be to call
the social services tomorrow.

Right. Yes.

Because really, at the moment,

there isn't really anything
that we can offer you now. Yes.

OK?

Right, Ahmed.
We're going to go now, OK?

Thank you very much for coming.
All right, no problem.

Nice to talk to you.
Nice to meet you, Ahmed.

Have a nice day.
Thank you. Same to you.

Have a very good night.

Oh!

That was intense.

It's quite clearly a social issue.
Yeah.

But all of his social help
is in place.

It's all... You know,
he's got housing. Mm.

He has a social worker.

He's had mental health
meetings put in place.

He was due to go to one today
but didn't go.

He's got food. He's got income.

Every... Yeah.

Yeah, everything. He has everything
already in place,

which makes it just so difficult.

Because you don't feel like
you've done very much.

That's the sort of job
that you go to

and you're just thinking,
"Why are we here?"

You know, there was no need
for an emergency ambulance

to be held up for something that is
nothing to do with us, really. No.

When you're in a situation where
you don't know who to ring,

nine times out of ten
you'll ring the Ambulance Service.

We're not just
prehospital conditions.

We're social workers, we are mental
health nurses, we are carers.

The job kind of changes
with society.

Funding's been cut from other areas

such as, you know, your social care,
rehabilitation centres -

mental health services has hardly
any funding whatsoever -

but that's having a knock-on effect
to the Ambulance Service, then.

Because we're kind of
the default service

that deals with everything.

But then the workload's increasing,
the pressure's increasing.

Something has to give.

# You're broken down and tired

# Of living life on a merry-go-round

# And you can't find the fighter

# But I see it in you
So we're gonna walk it out... #

Alpha 169, we've made it.

169. We have.

Get yourselves off home,
and goodnight.

I hope you sleep well.

As always. Thank you so much, Vicky,
for looking after us.

You, too. Thank you. Goodnight.

# And I'll rise up

# I'll rise like the day

# I'll rise up... #

A lot of the time,
we're going to people

who don't know what else to do.

They don't know where else to turn.

People are frustrated
with the system

but they see that green uniform
and they're like,

"Right, help's here.

"Everything's going to be fine."

We'll deal with whatever's
in front of us

in the best way that we can.

We're there to deal with people
who've slipped through the net,

who don't have anywhere
else to turn.

It's just the Ambulance Service.

And we'll always come.

Alpha 196.

Alpha 196.

Oh, I'm going to miss his voice.

Hey, there.

I'm not going to lie,

I feel a bit upset
that I'm finishing the shift.

Oh, that makes me really sad.

Do you want a joke to cheer you up?

Go on, then.

What do you call a bald guy
called Gary?

I don't know.
What do you call a bald Gary?

Garibaldi!

LAUGHTER

Thank you for looking after us.

You are very welcome.

Thank you for making the days
bearable.

Bye, Gary. Bye, Gary. Love you.

Love you more. Take care.

# I'll rise up... #

Even though things aren't looking
the best at the moment,

I still want to continue helping
our patients

the best that I possibly can,

and just be there for them
when no-one else is.

Oh, thanks for taking care of me!

We took care of each other.

# And we'll rise up

# High like the waves

# We'll rise up

# In spite of the ache

# We'll rise up

# And we'll do it
a thousand times again

# For you

# For you

# For you

# For you... #