“It has some major knock-on effects”: ambulance clinicians’ experiences of attending alcohol-related call-outs and perceived impact on the Scottish ambulance service (IMPAACT study)

Introduction: Alcohol consumption places a heavy burden on emergency services worldwide. In Scotland, around one in six ambulance call-outs is alcohol-related, yet little is known about frontline experiences. We aimed to understand ambulance clinicians’ experiences of alcohol-related call-outs including any personal or professional impacts. Methods: In-depth telephone interviews were conducted with 27 ambulance clinicians and 4 managers (May 2019–Dec 2021), varied in gender, role, Scottish region, and experience. Interviews were transcribed and thematically analyzed. Results: Clinicians reported anxiety linked to the unpredictable behavior of intoxicated patients, alongside frequent experiences of aggression, violence, and sexual harassment. Many saw such incidents as routine. The repetitive nature of alcohol-related calls led to frustration and reduced morale. Senior staff empathized and stressed the pressure on staff time and on the service from such calls. Often, these calls were not perceived as clinical emergencies on arrival at the scene, and were seen as potentially delaying responses to other, more clinically urgent, calls. Conclusions: Alcohol-related call-outs have a significant personal and organizational impact on ambulance staff and the Scottish Ambulance Service respectively. Improvements in care pathways, added funding to support treatment for alcohol dependence, staff training and uptake of incident reporting systems, may help manage these calls more effectively.