Casualty ‘handover As record hospital delays’ now costing lives
‘We treat patients outside to give them a chance’
AT LEAST 20 patients are dying every week due to ambulance delays, a senior doctor has warned.
Dr Adrian Boyle, vice-president of the Royal College of Emergency Medicine, revealed there are record “handover delays” of up to 24 hours before some patients are admitted to hospital.
And he also issued the stark warning that “tens” of lives are lost every seven days due to slow ambulance response times.
His comments come as a major investigation has been launched by the Healthcare Safety Investigation Branch into the risk to patients from being left for hours in ambulances outside A&E departments.
Some patients have been left waiting as long as 24 hours while the knock-on effects mean dozens have died at home because ambulances were stuck in queues.
Under NHS targets all handovers between ambulance and A&E must take place within 15 minutes, with no patient waiting more than 30 minutes. A report by the Association of Ambulance Chief Executives found many patients are waiting far longer, and suffering “severe or moderate harm and even death” as a result.
Figures show the average time for a patient handover in April was 36 minutes – more than double the 17 minutes recorded a year earlier and well above the target of 15.
A staggering 11,000 handovers took more than three hours with the longest delays being 24 hours.
There were 3,787 incidents of severe harm due to handover delays in April, and almost 10,000 incidents of “moderate” harm.
Warning of “a serious crisis which is killing people”, Dr Boyle said: “We need to be honest about this problem and the fact our elected leaders have a lack of will to deal with it. The dire situation has become grotesquely abnormal and far worse than anything we have seen before.”
The West Midlands Ambulance Service recently said it may be forced to stop responding to 999 calls in August as its ambulance trust faces a “Titanic moment” amid overcrowding in hospitals.
England-wide NHS data for April and March also shows ambulance trusts across the country are missing a raft of targets, including being too slow to respond to the most urgent call outs.
At the same time, experts say that many A&E services across England are now at breaking point as record numbers of patients flood back into the system after delays caused by the pandemic, sparking record waits in casualty units.
Campaign groups, MPS and senior medics say desperate patients are turning to emergency and walk-in services because they cannot get a face-to-face appointment with a GP.
Dr Boyle said: “Our European colleagues are aghast that we have such appalling ambulance handover delays. Our problems are on another scale.
“The ambu
lance handover delays and the delays in response times are a marker of a serious crisis now which is killing people.
“Ambulance transfer times have become particularly bad and the knock-on effect is that people are needlessly dying having called for an ambulance.
“We do not have accurate data on the numbers but we’re looking at tens of people dying every week as a consequence of these delays.”
He said the problems had been exacerbated by staff burnout and fatigue following the pandemic, but he said the crisis was also caused by lack of hospital capacity including a shortage of beds. The college estidocherty, mates UK hospitals need 13,000 extra beds – the equivalent of two wards per hospital – to meet demand. The problem of “bed blockers” in which patients do not have enough support outside hospital to be safely discharged is adding to the crisis.
The problems are also compounded by a lack of staff – particularly nurses. The Royal College of Nursing estimates the country is short of 100,000 nurses.
The frustration among patients was highlighted in a report last month which revealed 6.2 per cent of emergency patients are now leaving A&E without even being seen. Mark West Midlands Ambulance Service nursing director, said earlier this month the West Midlands service will collapse in August due to unsustainable pressure.
He said: “Around August 17 is the day I think it will all fail. That date is when a third of our resources (will be) lost to delays and that will mean we just can’t respond.”
He said patients were “dying every day” from avoidable causes created by ambulance delays.
“Mathematically it will be a bit like a Titanic moment. It will be a mathematical (certainty) that this thing is sinking, and it will be pretty much beyond the tipping point by then.”