Community Midwife calls

The 3x Labour calls that require a community midwife are

Labour - Waters Broken
Labour - Premature Birth
Labour - Home Birth

and their unit requirements are kinda high.

Labour - Water Broken - Surely this call would either require CMs and would become the standard home birth version, not necessarily requiring an ambulance at all, or it would be a transport job to the hospital for delivery there, at which point I can maybe see 1x CM and 1x Ambo, but I cant see why you would need 2+2.

Labour - Premature Birth - I can see this call being more resource intensive, but im not entirely sure why 2x Ambulances would be required though. 1 yes, to transport the patient, as well as something to handle the CC requirements. but 2x DCAs and something for CC.

Labour - Home Birth - Would 2x CM vehicles be required?

Overall, I do think a core part of this change could be changing the CMs requirement to be personnel rather than vehicles, which would help streamline the calls a little, as they feel kinda resource intensive and require a lot of CMs to be deployed within a setup, but the ambulance requirements seem a little high on at least the water broken call.

There is also the Child Birth that has no CM requirements, not even a chance of needing of them, and only a 30% transport chance? Just seems maybe a little low?

Quote from dog-r-me2

I feel like the RRVs should be made use of more too. They kinda sit idle at the mo

I make use of them for CC, so instead of ambos being trained in CC by default (I do have a few, but not many) I have all RRVs trained in CC, so any calls needing CC get an RRV. But yes, that is another option, change it so that rather than needing 2x Ambos, it could be 1x Ambo and 1x RRV/Ambo or something

Quote from Alctw10

The unit requirements for the Labour calls are spot on.

Labour - Waters Broken. This mission (like the other 2) was introduced as part of the CP introducing CMs. This mission is to simulate an ambulance response, the CMs often would turn up before/after crews. Again, this is intended as an ambulance mission not CM only.

Labour - Premature Birth. All Labour calls where delivery is imminent require 2 x DCA, this is because there are 2 patients that may also need transporting separately. This means you can not change it to 1 x DCA and 1 x RRV. The chance for CC is because of the call itself, no explanation needed.

Labour - Home Birth. This mission was introduced to give the CMs something they could complete without the need for ambulances, hence why the chance first responders can take full care is set to 100. This would simulate a planned home Birth with no complications. 2x CMs is the right response as they would not work alone.

Child Birth. This mission predates the CMs. I will put this mission for removal.

I can see the requirement for 2x DCAs for the Premature birth in that case.

But would 2x DCAs be needed for the water broken all the time?

And for both the Home Birth and Water Broken, I dont have issue with needing multiple Community Midwife trained personnel, but is there any perticular reason its handled via vehicle requirement and not personnel requirement (like how all the Transport Police calls work for example). Also given that the CM vehicles can seat 2?

This would help mitigate some of the resource demands needed for some of these calls.

As for the Child Birth call. I dont know if it necessarily needs removal persay, but maybe a name update?

I kinda see it like someone has gone into labour somewhere away from home and needs transporting to the hospital directly, without waiting for a CM? I assume that does happen from time to time?

Quote from Alctw10

RRVs are not just for critical care, any mission where the transport percent is below 100 has a chance to be completed by an RRV without the need for a DCA. Similarly these missions also have a chance to be dealt with any other first responder such as CFR/Co-Responder.

The issue I have here is that its not always clear what calls do and do not require transport. Like with CC, it can feel a little random at times where a call can be dealt with without transport or need an Ambo. CC, was just my way of making CC a little more involved without needing to go super detailed on Custom ARRs (such as the notorious sprained calls, that I know you guys didnt have much say in)

Quote from Alctw10

CMs often use their own vehicles (atleast in my area and surrounding) to respond, this is usually during their working day in the community or from home while on call. This is why the requirement was set as vehicles to simulate this.

Ah I see, yes that would make sense on that front as well then.

Quote from Gooochy

Though i would like perhaps min of 1 and a max of 2 paitents, as some trusts (mine included) will transport in two seperate vehicles of avaliable?

That is a good idea as well.

Quote from Alctw10

Welcome to the world of dispatching.

But seriously, if it was obvious what missions didn't need transport then the community would complain it's not realistic.

If you really want to see before dispatching then you can by viewing the mission details, time consuming yes but if it bothers players that much its an option.

Fair, though for some calls the transport chance just feels a little high

Then you also have some wierd ones like: Broken Ankle call has 100% chance the first responder can treat the patinet, but still has a 70% transport chance?, so not sure by that if it does or does not need a transport

Quote from Gooochy

Thank you Alctw10 for considering increasing paitents to 2 - it is very much appreciated

Yep, that would be a good. I think this in-part why I was a tad confused by the 2x DCAs for only 1x Patient, figuring that the mother and baby would usually always be transported together and if they werent it would be 2x Patients. (assuming the mother wasnt just transported whilst still in labour and instead transported after birth)

So with that change, plus some tweaks to the transport chance / adding a line for the water broken call for first responders to be able to handle the call without transport (like on the home birth call)

Then yeah, it makes sense.

Quote from Gooochy

For my local trust - Community Midwifes are run essentially the same as CFRs, they get equipment from trust, and use personal vehicles without blue lights to attend. Someone i know does this role for my local trust. She works as a midwife in hospital, but on days off will assist ambulance service, when she can. Its perfectly realistic to require one for most calls as the Ambulance Service will always try to get two if possible.

This and Alctw's earlier explanation then makes far more sense regarding the 2x CM vehicle requirement.

Quote from Gooochy

Labour - Breech Birth

Yeah, that would be a good one. Could expand the list quite a fair bit I think, and maybe also having them have a chance of upgrading as well.

Like home birth (no transport requirement) becoming a breach birth needing transport.

Another one might just be changing the current Child Birth call into one where the mother is just transported straight to the hospital whilst in labour? 1x DCA + 1x CM? "Labour - Active Labour"? or something like that?

Quote from Alctw10

We will be revisiting all patient probabilities in the future.

The broken ankle call was not one of ours.

Yeah, that I think is all that is needed for a lot of the calls. Just a review and a little refinement. And where some are your calls and some aren't, the lack of consistency can make things a tad confusing.