Commercial Fixed Wing
Flight Crew Air Transport Pilot (ATP)
Flight Crew Last 90 Days 80; Flight Crew Total 11000; Flight Crew Type 4000
Time Pressure; Workload; Communication Breakdown
Flight Deck / Cabin / Aircraft Event Illness / Injury
Air Traffic Control Issued New Clearance; Flight Crew Returned To Departure Airport; Flight Crew Requested ATC Assistance / Clarification
Human Factors
Approaching top of climb FL350 with autopilot on we received a call from FAs of ill passenger. Immediately ACARSed Dispatch 'Call Me MD.' The company has been really pushing us as pilots to coordinate with Dispatch and MedLink before diverting. Within next 30 seconds it sounded as if the PAX was going downhill very quickly; Captain and I made joint decision to return to [departure airport] immediately. Still no word from Dispatch. Captain established that I had plane and radio while he handled FAs and Dispatch. I coordinated medical emergency return with Center who was able to turn us nearly immediately back to field. We had approximately 35 minutes prior to landing to:1. Discuss/agree that [departure airport] was best option2. Run Medical Emergency checklist in FOM (Capt)3. Coordinate with FAs and get pax info4. Coordinate with ATC5. Set up FMC/ACARS for arrival6. Set up cockpit for approach7. Run App/descent/approach/landing checklists8. Coordinate gate/medical response on ground9. Plan overweight landing/discuss aspects/run performance numbers10. And; of course; above all else; fly airplane and not create undesirable aircraft stateThis all went quite smoothly and the outcome was direct immediate return to [departure airport] where medical was standing by and a gate was available.However; there was no excess time for any deviation from these items being able to be accomplished quickly and accurately.The Captain and I debriefed the event on the ground. We both agreed there was only one lacking area: Dispatch.Dispatch failed to respond timely to my initial ACARS. Then the Capt wrote a follow up ACARS that we were med emergency diverting to [departure airport]. Dispatch acknowledged this but did not give us a frequency to coordinate Medlink. This delayed the process a bit as the Captain I'm sure was thinking of all the communications we've received from the company stressing the importance of Medlink coordination. My opinion was that with or without Medlink we knew if was an immediate divert situation based on the reports from the attending medical professionals and we simply couldn't wait for Dispatch. He agreed.About halfway into the return process ATC told us 'company wants to talk to you on commercial radio'. We said we agreed and were waiting for a frequency. ATC said they would look up the appropriate one. (For the record in every LOE we do the first ACARS response is 'contact me on radio (freq)').The Captain looked up the radio frequency in the Jepp manual in JeppFD-Pro; something he's never looked for before; and contacted Dispatch on the appropriate frequency.The only other thing I would do differently is to inform ATC we would be coordinating emergency response and medical details with Dispatch. As it was we started coordinating those with ATC who wanted age/sex condition of pax as (eventually) so did Dispatch. This created duplicate unnecessary efforts.I have noticed a drop in Dispatch support capability over the past 5 years with the company. I believe this is due to the massive furloughs years ago and subsequent hiring of new inexperienced dispatchers. I can only conclude these dispatchers are not receiving adequate training. I have seen holes in their performance similar to this incident in the past including lack of understanding of the implication of being overweight for takeoff with regard to landing weight and how to deal with that; to total inability to run a landing/go around performance analysis on another medical divert we did some years ago.
B737 NG First Officer reported difficulty coordinating with Dispatch because of passenger illness; which increased the workload during the return to departure airport.