NHS trusts have been told to act immediately on ambulance delays leaked data short some stroke patients waiting four hours while thousands more A&E patients experience “dangerous” hold-ups in emergency departments.
It comes as data seen by The Independent shows some patients with potentially life threatening conditions waited more than four hours for an ambulance against a target time of 40 minutes.
Ambulances services across the country have reported extreme pressures, with West Midlands Ambulance Service Trust warning that at least 72 patients the last year are likely to have died as a result of response delays.
NHS figures also showed emergency departments suffering, with an average of 1,173 patients each day are waiting more than 12 hours in A&E from time of arrival for a bed over the last 6 weeks – this is around 6 per cent of attendances.
Figures published by NHS England on Thursday revealed 20 A&E departments last week had to divert ambulances, while data showed more than 9000 ambulances were delayed by over an hour outside of A&E.
Royal College of Emergency Medicine president Dr Adrian Boyle has said the 12 hour stays in A&E from arrival are “dangerous” for patients and warned healthcare leaders need to create more hospital capacity to address this and the problem of ambulance delays.
Several NHS trust chiefs have said there has been a “big push” during meetings over the last week on ambulance handover delays and NHS England have told trusts there needs to an “immediate” response as ambulance response times have increased “exponentially.”
One warned of the need for “cohorting” ambulances outside A&Es — the practice of grouping patients in order to allow some paramedics to leave.
An ambulance service director told The Independent of several hundred lost hours due to delays outside of A&E.
The source added: “If you have a look at the rate of deterioration things have got twice as bad in the last six months lost hours have almost doubled and the rate of decline is now exponential. So if we’re not careful we won’t get through the summer, let alone next winter as long as the handover delays get worse, we won’t get to patients in time and patients will almost certainly die.”
According to internal data in the Midlands, some Category 2 patients — those with suspected strokes or heart attacks — waited more than four hours this week, while the average response times ranged between around 1.5 hours to almost two, against a target of 40 minutes.
For the most ill patients, category one, with immediate life-threatening conditions, waits for an ambulance response reached 18 minutes last week, where as the target is 7 minutes.
Adrian Boyle, president of the Royal College of Emergency Medicine said: “If you look at all the performance indicators, we’ve got everything going the wrong way and it doesn’t feel like we’re recovering at all from a very tough winter .
“The pressure that we’re seeing in most frontline over the last couple of years has been a year round problem. It’s tough all the time. The fundamental problem is not because of respiratory disease, although those can make bad situations worse. It’s actually lack of capacity within our hospitals and lack of flows through our hospitals, which means that people get backed up and stuck in an emergency departments.”
Dr Boyle added that “long waits in emergency departments are not just frustrating and tedious, they’re actually dangerous.”
He also warned against “ambulance cohorting” calling it the “worst possible solution for an undeniably important problem.”
“We absolutely recognize the importance of reducing ambulance handover delays, we recognize that people are dying, because ambulances aren’t getting to them in time and that’s the catch 22 but the idea of just warehousing people outside is the wrong solution for an important problem .”
He said NHS leaders needed to focus on creating more capacity within hospitals, and addressing the causes of delayed discharging of patients including as staff sickness and lack of available social care.
George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.