London Ambulance Service: A New System Causes a Disaster

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System and Problems


The dispatching problem of the London Ambulance Service is regarded to be problem, associated with improper management in the spheres of IT and HR, as numerous drawbacks were identified in the debugging, testing, implementation and training aspects of the new computerized dispatching system. Taking into consideration that the problems were stated and analyzed, the consequences of that “complete nightmare” are still not overcome.

The fact is that; the proper dispatch system should correspond to particular criteria for being effective. First of all, independently on the basis (electronic or paper), the system should provide the quick response to the call (3 min max). The system, if computerized, should trace the location of every ambulance unit through GPS. The office should be small, however, the workers of the dispatching department require proper training and qualification improvement for they could perform their tasks duly.


Originally, the dispatching system should be as simple as possible for providing the effective performance of the assigned functions. The aim to set up the computerized system of dispatching the emergency ambulance calls was aimed at decreasing the routine work for the dispatchers, nevertheless, the improper training of the staff caused the essential problems, which were aggravated by bugs in software.

The scheme of processing the ambulance calls should look the following:

Processing the ambulance calls

Ambulance dispatch, in its turn, allocates the ambulance unit, processes the incoming call, locates the geographical position of the caller (if necessary), and fills in the data base. Moreover, the dispatch system, while processing the call, should locate the list of the nearest ambulance stations. The computerized system, for being effective, should constantly update status of available ambulances in each dispatch location in case of no ambulance is available in a service area.

A key factor that contributed the problem was the speed at which the new system was introduced, the fundamental lack of testing procedure, and the reorganization of existing work stations. This coupled with staff reluctance, lack of training and support system lead to the failure of the work system to provide the users with the desired outcome and this lead to the deaths of clients. A secondary problem was the analytical nature of the new system, which did not allow for discerned human intervention, is problem situations.


The thorough analysis of the ambulance system requires the detailed research on the maters of the amount of everyday calls. Originally, the results of the research are represented on the graph 1

The Daily Average amount of Ambulance Calls
Graph 1. The Daily Average amount of Ambulance Calls.

In spite of the fact that the largest amount of the calls are made in the day time, the nightmare of the London Ambulance Service was associated with the increased flow of the unprocessed calls. The system could not cope with the proper and timely processing of the information about the calls, thus, it caused the breakdown of the allover emergency structure.

Analysis and Possibilities


  • Customers. There are no original possibilities, as “customers” address the service in the case of live importance and extreme emergency. These are the people who require urgent medical assistance.
  • Products and services. The services, which are provided are associated with the timely reaction, location of the nearest Ambulance Unit on duty, and sending this unit to the stated address.
  • Work Practices. The work practices entail the processing of the call, filling in the form and updating the data base in order to foster the data processing, if the customer will call repeatedly.
  • Participants. The participants of the project are the Ambulance service workers (mainly dispatchers), and data processing staff. LAS also included IT specialists for the implementation of the computerized system
  • Information. The information, which is processed, is the address of the caller, the reason of the call and the ID of the Ambulance unit, which was assigned for the particular emergency call.
  • Technologies. These are the equipment aimed at proper dispatching of the incoming calls and the update and address of the database.
  • Infrastructure. This entails the phone connection, intranet and the GPS equipment for the allover control of the Ambulance units.
  • Environment. This is the unified dispatching system, the aim of which is to accept and process the incoming calls, and provide the necessary assistance by sending Ambulance units to patients.
  • Strategies. The only strategy which is used is the quick response for the incoming calls.
  • Work System as a whole. In general, it should be stated that the system works properly, nevertheless, the management of improvement requires essential control for excluding similar “nightmares” in future.

In the light of the facts, stated in the checklist, it should be stated that the possibilities, which the system offers mainly depend on the human resources and their encouragement to work properly. Nevertheless, the analysis of the system reveals the notion that the system requires deep modernization in the terms of call processing and assigning the units for the emergency reaction.

Computerized system would help liberate part of the Human Resources engaged in the dispatching process, nevertheless, those who would stay working in this system should be provided the opportunity of qualification improvement and training for operating the computerized systems. It should be emphasized that there is no room to move within the system and isolated from each other. Loss of control over their work place has increased their stress levels. Error exception reports prevented patients from being able to call in an emergency.

Analysis Templates

Work System Owner The owner of the system is the London Ambulance Service. For the proper, the owner should train the workers to operate the computerized dispatching system.
Project Manager Project manager should control the process of new system implementation, and take care for the timely and effective training of the dispatching staff. Anyway, training and qualification improvement should be among the central points of the performance strategy, which project manager should be responsible for.
Source of Funding Funding of the project is completely municipal, as the Emergency Call Centers can not be the profit organizations.



The represented chart shows the universal process of project implementation, which presupposes the thorough management of all the stages of implementation. Front end stage requires detailed planning of the project creation, implementation and operation. This should have the room for maneuvers, as mistakes are inevitable and testing would be required for finding and checking them.

The execution stage is the final preparation stage for the implementation of the project, as it presupposes the preparation and development of the document base, and beginning of the staff training. The final stage – operation – includes stabilization, testing and launch of the project. This stage requires the highest responsibility, as testing and stabilization of the system is the last opportunity to avoid crucial mistakes and bugs in the work of the system.

Recommendation and Justification


  • Customers. The only recommendation which should be given is that the clients of the system should be satisfied, as their lives depend on it.
  • Products and services. The services should be aimed at decreasing the routine work and shortening the dispatching team by proper computerizing of the system.
  • Work Practices. The allover practices should be aimed at the increase of HR strategy effectiveness, and improvement of the managerial practices in order to avoid the mistakes and drawbacks in implementing the projects in future.
  • Personnel. The team should be encouraged for the constant self improvement.
  • Information. The information flow is the crucial factor of the successful activity of the dispatching system, thus, everything should be made in order to improve this process.
  • Technologies. The only recommendation for the sphere of technologies that should be given, is that technological base should be reliable and highly durable, as human lives will be trusted to it.
  • Environment. The working environment is full of stresses, thus, the workers will have to be granted an opportunity of relaxation and restoring of the moral resources.
  • Work System as a whole. Justification for the working system will be provided only when the system works correctly. Thus, there is strong necessity to rearrange the managerial system, and implement the new project bearing in mind the mistakes of the previous effort.


Initiation As it has been emphasized, this stage requires the detailed plan of the project, the strategy of implementation and the reserve plan, if the initial one fails. Anyway, the mistakes and unforeseen circumstances should be taken into consideration, and the steps for overcoming the consequences of these mistakes should be also included into the plan.
Development The development of the project is the stage, which requires the technical assistance and the preparation of the working structure towards the implementation.
Implementation This phase is one of the most difficult, as organizations are often reluctant for the deep changes. On the other hand, the difficulties will be explained by the necessity of proper testing of the system
Operation This stage would require the proper technical maintenance of the system.


Finally, there is strong necessity to emphasize that the implementation of the new project, associated with the emergency calls and ambulance dispatching system requires high responsibility levels, as mistakes may be fatal. The level three analysis of the London Ambulance Service revealed the fact that the managerial principles and strategies of this service require essential improvement. In the light of the fact, that the organization is not for profit, it should be stated that the management system is not oriented at constant improvement of the services, and the only effort to improve the system appeared to be unsuccessful.

Reference List

Atler, S. 2006, ‘The work system method’, Work System Press, Larspur.

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