‘More will die’ in back of ambulances at A&E
MORE patients will suffer serious harm or die – that was the warning from West Midlands ambulance chiefs as they prepare to move to the highest state of alert in the service’s history amid fears over delays in getting 999 patients into hospital.
The move to an unprecedented ‘level 25’ rating (out of 25) means the service expects patients to suffer ‘catastrophic consequences’ with repeated serious harm or death ‘almost certain’.
It comes as ambulances with critically ill patients on board are being held routinely outside emergency departments across the region – sometimes for a staggering 10 hours or more. Handovers are meant to take 15 minutes.
Investigations are already under way after a patient who had been waiting in an ambulance for five hours outside Worcestershire Royal Hospital deteriorated and later died.
West Midlands Ambulance Service is already in talks with regional and national NHS chiefs and local hospitals about the crisis.
They fear a catastrophic effect on ill patients waiting on ambulances but also on people waiting desperately for ambulances to arrive that are being held up.
Some 15,000 ambulance hours are set to be lost this month because of delayed handovers.
For their part, hospitals say they are working frantically to safely offload patients into emergency departments, but face a desperate shortage of beds, staff and space.
The ambulance delays are the most visible sign of mounting pressure on health services, from overwhelmed GPs to cancer op backlogs.
Health Secretary Sajid Javid recently said he does not believe the pressure being faced by the NHS is currently “unsustainable”.
The West Midlands Ambulance Service board report highlights that on October 4, the average waiting time for an ambulance arriving at the Royal Shrewsbury Hospital was four hours; at Worcestershire Royal it was two hours. Across the region the average wait was more than an hour at five hospitals.
“One patient was in an ambulance for over 13 hours while waiting to be handed over in Shrewsbury,” says the report.
Nearly every hospital in the region is seeing delays. In September, more than 1,000 ambulance hours were lost held up outside Good Hope, Heartlands, Queen Elizabeth in Birmingham, Worcestershire Royal, Royal Shrewsbury, Russells Hall in Dudley, New Cross in Wolverhampton, University Hospitals Coventry and Warwickshire and Royal Stoke hospitals.
It adds: “Unfortunately, there have been several cases where severe patient harm has occurred due to the hospital delay resulting in several serious incidents. Although significant delays and harm to patients awaiting handover at hospital has, and continues to occur, there is perhaps a greater risk to patients in the community who cannot receive a timely and appropriate ambulance response, because of ambulances being held at hospital.
“Patients waiting for assistance are on the increase and it is not unusual to see over 200 incidents outstanding, many of which can be for several hours.”
Efforts are made to ensure patients ringing 999 are directed elsewhere if appropriate, reducing the need for an ambulance, the report adds. When ambulances do arrive, they attempt to treat on the scene and only convey to hospital the most critical cases.