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An over-complicated system and incomplete training for control staff
and ambulance crews are the likely causes of the collapse of London’s computerised
ambulance dispatch system two weeks ago. One software company says that
the London Ambulance Services (LAS) underestimated the pressure on staff
at the control centre, which makes working there ‘like a wartime action
°ù´Ç´Ç³¾â€™.

An inquiry into the failure began this week. It is led by Don Page,
chief executive of the South Yorkshire ambulance service, with Paul Williams,
a computer consultant from the City firm Binder Hamlyn, and Dennis Boyd,
a retired chief conciliation officer from the arbitration service ACAS.
They have been told to report by February.

Speaking before the inquiry began, Williams said: ‘In general, systems
fail because people don’t specify their requirements properly in the first
place.’ Williams will take the main responsibility for evaluating the computing
side of the failure. He has 13 years’ experience in investigating computer
systems, although he admits he has never looked into the ‘safety-critical’
system such as this before. However, he says he will be able to call on
expert help from his firm and the computer industry.

Michael Page, managing director of Action information Management, warned
the LAS’s chief executive, Jon Wilby, last June that the system was too
complex and that it should be built using the skills of the individuals
working there. Wilby has since resigned over the system’s failure, while
the LAS has reverted to manual methods.

With 37 years’ experience of designing systems for the navy, Page says
he has learnt that ‘you should design from the individual people outwards,
rather than . . . imposing a solution and getting people to drive it’. His
company has developed control software for the ambulance services in
West Yorkshire, Berkshire and Gloucester.

Page’s response to the suggestion that this might be sour grapes because
his company lost the bid is: ‘Life’s too short for that. There is a lesson
to be learnt. The emergency services are going down the road to automation.
I’m offering acquired wisdom that might be useful.’ Most computer systems,
he says, ‘are too complicated, with too many bells and buzzers’.

The LAS control room staff had virtually no previous experience of using
computers. The switch to a computerised system began in January of this
year. Previously the staff had used manual methods. Call details such as
the nature and location of the accident were written on paper, which would
be passed to an allocation, who then chose the nearest available ambulance
and forwarded details to a dispatcher, who would give the driver orders
by radio or telephone. Further communication with the control room was via
radio

The system’s prime weaknesses were that at peak times the radio bandwidths
became congested, and the paper with the details could get lost.

Using the computerised system, two members of staff using a computer
terminal acted as call-taker, allocator and dispatcher. Once the call details
were entered on the PC, an algorithm would suggest the nearest available
ambulance. Details would then be telephoned to the appropriate ambulance
base, or transmitted – more quickly than voice radio – to a terminal in
the ambulance when moving.

Ambulance crews had to press combinations of six buttons in the cab,
which radioed data back to headquarters to indicate where they were. The
London Ambulance Services says that during dummy runs, 87 per cent of crews
were pressing the buttons successfully.