North West Ambulance Service NHS Trust

3. Miss G complains about how the Trust acted following two calls she made about her father on 4 September 2025. She says the Trust: • incorrectly categorised her first call as category two, despite her reporting her father’s chest pain and difficulty breathing • took too long to depart from her father’s home.

4. Miss G says if the call had been categorised as category one, the crew would have arrived sooner. As her father’s heart stopped on arrival at the hospital, she thinks he would have had a better chance of survival if the crew had left his home sooner.

5. Miss G wants the Trust to acknowledge its failings.

6. Mr J was 87 years old at the time of the events. Miss G made calls two calls within 15 minutes after 9pm in the evening. The crew attended before 10pm and decided Mr J needed to be taken to hospital. Sadly, Mr J did not survive at the hospital. He died the same evening.

10. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications that something has gone wrong.

Call categorisation

11.  The Handbook to the NHS Constitution says patients can expect to be treated at the right time and according to their clinical priority. The Ambulance Response Programme requires ambulance services to utilise an approved clinical triage system.

12. The Trust used NHS Pathways, a structured clinical triage system designed to identify the level of urgency associated with presenting symptoms during a 999 call. The system does not establish a diagnosis but instead identifies whether features indicating an immediately life-threatening condition are present.

13. There are four call categories for an ambulance response. The two highest categories are category one and two. Category one is for calls about people with life-threatening injuries and illnesses, requiring immediate intervention or resuscitation. Category two is for emergency calls. Potentially serious conditions that may require rapid assessment and urgent on-scene intervention and/or urgent transport.

14. On both calls, Miss G did not indicate Mr J was not awake or not conscious. Our adviser explained the highest likely triage outcome within NHS Pathways based on this would fall within a category two emergency, as no additional red flag symptoms were identified.

15. Our adviser said Mr J’s presenting symptoms, specifically significant respiratory distress and suspected cardiac chest pain, are consistent with conditions recognised nationally within category two under the Ambulance Response Programme. As there is no evidence to suggest category one criteria were met, we cannot say there is a sign of a failing here.

Crew attendance

16. The first emergency call was at 9.40pm. The responding ambulance resource was allocated at 9.52pm and arrived on scene at 9.57pm.

17. NHS England Ambulance Response Programme standards identify a national mean response target for category two calls of 18 minutes and a 90th percentile response target of 40 minutes. The Trust’s response was within 18 minutes, so we cannot say there is any sign of a failing here.

18. Our adviser said the records demonstrate that the crew recognised Mr J as critically unwell shortly after arrival. The Trust complaint response says that the crew obtained the first clinical observations approximately three minutes after the crew’s arrival on scene.

19. The Trust’s records show the crew sent a pre-alert to the hospital as they identified severe physiological compromise. Mr J needed to be transferred from the room he was in into a wheelchair, and then into a stretcher to the ambulance. We recognise Miss G felt this meant there was a delay in a time-sensitive situation.

20. The Trust has acknowledged the crew thought the stretcher would fit into the room initially, then realised a wheelchair was necessary. The crew left Mr J’s home at 10.18pm, within 22 minutes. Based on the available information, we cannot say the Trust took too long to transport him.

21. Overall, we have not been able to say things went wrong in the way Miss G felt they did. We hope our investigation helps her and we would like to take this opportunity to offer our condolences for her loss again.

1. We have carefully considered Miss G’s complaint about the Trust. We were sorry to hear her concerns about how its actions affected the care her father, Mr J, received.

2. We have seen no indication that anything went seriously wrong. We hope this reassures Miss G about the care the Trust provided. We recognise it does not change her experience or the loss she has experienced as a result of her bereavement.