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A Swansea University study has highlighted the intense emotional and operational strain faced by UK ambulance staff during the Covid-19 pandemic, with frontline workers describing the experience as the most challenging of their careers.
The research, part of the TRIM project (What TRIage model is safest and most effective for the Management of 999 callers with suspected Covid-19), was led by Professor Helen Snooks and examined how emergency responders adapted triage and decision-making under extreme pressure.
Drawing on 25 interviews with paramedics, 999 call handlers and emergency department clinicians across four NHS ambulance services and regional hospitals, the study identified four main themes:
- Prioritisation of urgent care with reduced patient contact.
- A major shift to remote triage.
- Widespread disruption across the health system.
- The profound mental strain on staff.
One call handler described the impact of the crisis: “It was probably the toughest thing I’ve ever done […] I was coming home and standing in the corridor taking my uniform off and running in the shower, and sobbing my heart out day after day after day.”
Despite the challenges, many interviewees expressed pride in how services adapted. An ambulance service manager said:
“I think that we rose to the challenge during Covid, and we did an absolutely astounding job. And every single clinician on the ground […] the call takers, the dispatchers, just showed how flexible and how adaptable, and how resilient we are as a service.”
Dr Alison Porter, Associate Professor in Health Services Research, oversaw the ambulance service strand of the study. She said the findings revealed the “constant change, uncertainty, and overwhelming emotional demands” faced by frontline staff striving to deliver safe and effective care.
The researchers concluded that future emergency services should be built on flexibility, compassion and psychological support, ensuring lessons from the pandemic inform better preparedness.
Dr Mike Brady, Assistant Clinical Director for Remote Clinical Care at the Welsh Ambulance Service and a member of the research team, said the results were highly relevant as the NHS prepares for winter pressures and future pandemics.
“These insights reiterate the importance of UK ambulance services contributing to high-quality and important research.”
Dr Mike Brady.
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