Without NVMC, Harvard ambulance will rely on Concord, Leominster, Clinton hospitals

The abrupt closure of the Nashoba Valley Medical Center has triggered expressions of alarm from Harvard’s Select Board, Board of Health, and Council on Aging. Many of the concerns that these groups have raised are focused on emergency medical care. What should a Harvard resident do in a medical emergency, now that NVMC has closed?

Jason Cotting, Harvard’s coordinator of emergency medical services, answered that question as he would have before: “We hope that they will call 911.”

“It’s going to affect everybody that we are losing a critical resource,” Cotting said of the closure. “But the impact on other communities will be greater.” He noted that about 45% of ambulance patients from Harvard went to NVMC; for Ayer, that figure was 80%.

NVMC was also the affiliate hospital medical director for the Harvard Ambulance Service. Every ambulance service is required to have such an affiliate, and Harvard’s new medical director is now UMass Health Alliance-Clinton.

Cotting had already laid out the most probable results of NVMC’s closure in his report to the Select Board on Aug. 20. Harvard’s ambulance trips will now have to go to Emerson Hospital in Concord or to the UMass Memorial Health Alliance campus in either Leominster or Clinton. All three emergency rooms are farther away than NVMC was. Each drive will each take an average of seven more minutes to get to the hospital and another extra seven minutes to return. Waiting times at each hospital will also likely be longer than before, as those emergency rooms become busier in the absence of NVMC.

Usually, Cotting said, the ambulance simply takes a person to the nearest hospital. For most parts of Harvard, Emerson and Leominster are about equidistant. For Still River, Clinton is the closest. If a patient expresses a preference for one hospital, he said, the crew will try to honor it. But other factors can affect the decision. For example, going westbound to Leominster on Route 2 at 4 p.m. on a weekday could be too slow a trip in an emergency.

Sometimes the choice of hospital depends on the patient’s medical problem, Cotting explained. For example, someone who needs cardiac catheterization would be taken directly to Lowell General Hospital or UMass Memorial Medical Center in Worcester.

Advanced Life Support services will probably be less available than before, according to Cotting’s report to the Select Board. Ayer has been the main provider of those services for nearby towns, and the overall impact of the NVMC closure will be most acute for Ayer’s ambulance service. One possible solution is for Harvard’s ambulance crews to get the additional training and equipment needed for ALS licensure, although this would add to costs.

While ambulance travel times to hospital emergency rooms and waiting times once there will both likely increase, Cotting said one thing will not change. With very few exceptions, emergency rooms are forbidden by law to turn away a patient who arrives by ambulance. Only in extreme cases—for example, if the hospital itself has lost power or is flooded—can a hospital ask an ambulance crew that has already arrived to leave and go to another emergency room. Cotting said the dispatch center would notify the ambulance service if an emergency room was unable to accept patients. And the ambulance crew also calls ahead to hospitals and would be notified directly of any such problem.