Shocking eight-hour wait at A&E
PATIENTS are spending more then EIGHT hours on ambulance stretchers waiting to get into cloggedup A&Es – against a guideline time of 15 minutes.
A probe by the Sunday People reveals the number of people suffering at least three hours before a hand-over to hospital medics has nearly quadrupled in three years.
The longest delay so far this year was in July, when one patient waited eight hours and 37 minutes at Southport and Formby District General Hospital on Merseyside.
And as paramedics are forced to wait with patients, they cannot attend other emergencies, meaning ambulance response times are not being met.
The lengthy delays have been blamed on a national shortage of doctors and nurses, a lack of hospital beds and a rise in A&E attendances. Dr Tajek Hassan, president of the Royal College of Emergency Medicine and an A&E consultant in Leeds, said: “If you have been brought in by ambulance, the likelihood is you have something quite seriously wrong and it is awful that patients are waiting so long.
“They will be waiting on a stretcher in corridors or in the back of a cold ambulance and it is totally unacceptable. The longer you delay getting a patient to treatment, the greater the risk they might die.”
Data obtained under Freedom of Information laws from the 10 ambulance trusts in England reveals 114,043 patients waited more than an hour to be handed over last year – equivalent to 312 every day.
The figures also show 2,561 patients waited three hours or more, a 287 per cent rise from the 661 in 2013/ 14. And in the first four months of the 2016/ 17 financial year, 1,021 patients faced waits of at least three hours, meaning the total for the year could top 3,000.
Labour’s Diane Abbott, speaking ahead of her move from Shadow Health Minister to Shadow Home Secretary in Jeremy Corbyn’s Cabinet reshuffle this week, said: “The figures are quite shocking. If patients are made to wait longer than what is acceptable, some may die unnecessarily.
Disaster
“These waiting times are not acceptable for the fifth-largest economy in the world and are another grim reminder that Tory health policies have failed and pushed the NHS to the brink of disaster.”
Our research shows that last year, hospitals missed the 15- minute hand-over target 1.63 million times, compared with 1.18 million times three years ago.
Katherine Murphy, chief executive of The Patients Association, said: “Clearly, things have gone significantly awry when the 15- minute target for ambulance crews to hand over patients to A&E was missed 1.63 million times last
year alone. It is outrageous that this has been allowed to happen so systematically across the length and breadth of the country.
“When presented with data from Leeds to London portraying a national map blotted with NHS shortcomings, t he evidence s hould s eem overwhelming enough to any government to compel action.
“The NHS is in dire need of proper investment in ambulance services and hospitals to ensure that there are the resources available to delivereliver timely and high standards of care.
“The governmentnt needs to have a plan of action to ensure that we e have enough paramedics, doctors, nurses and support staff to fill the long list of vacancies in A&E departments andd ambulance trusts acrossss the country.”
Crews are not allowed wed to leave until patients are e signed over to the care of hospital doctors, meaning they are not available to respond to other 999 calls.
Rehana Azam, GMB’s national secretary for public services, said: “It is like a bus station outside most A&Es – ambulances are queueing up with patients inside, unable to hand them over. Meanwhile, new 999 calls are coming in and crews are not able to respond to them. “The consequence is that ambulance response times are not being met and patients are dying because crews aren’t getting to them in time.” The Sunday People highlighted the issue of delayed ambulance handovers in November last year, when NHS whistleblower Martin Jackson sent us a shocking photo of seriously ill patients on stretchers queuing in corrido corridors to be checked in at A&E A&E. The a mbulance w worker took the image a t Northumbria Specialist Emergency Care Hospital in C Cramlington – which w was hailed as a “vision fo for the NHS” when it op opened in June 2015. Dem Demand for emergency ser services ices is at an all-time high, with 10.8 million calls in England last year – a seven per cent increase on the previous year. In July, the latest month for which data is available, more than 2.08 million patients attended A&Es in England with 201,988 patients waiting more than four hours to be admitted to a ward or treated and discharged.
This breached the national target for 95 per cent of patients to be admitted or discharged within four hours of arriving at A&E.
Unsustainable
Dr Hassan added: “The situation is unsustainable. Doctors and nurses in A&E are having to work 110 per cent and they are burning out. They can’t cope with the demand and at busy times the quality of patient care undoubtedly suffers.
“We can’t carry on stretching an already fragile workforce like this. The very significant rise in demand needs to be recognised and we need more doctors and nurses.” He said the problem was made worse by “exit block”, in which patients find themselves stuck in A& E because there are no beds available on wards.
He said: “Studies have shown that exit block leads to increased mortality. This is because you get delays in patients getting antibiotics and other treatments.”
A report by the RCEM estimates that exit block is responsible for 1,000 avoidable deaths every year.
Dr Hassan said one of the causes was delays at the “back door” of hospitals, in which patients face delays in being discharged because of a problem in securing a care package in the community. He added: “It is a complex chain and the Government needs to focus on sorting it out.”
NHS England said: “A&E departments do sometimes come under pressure and there are occasions when it is appropriate and best for the patient that their handover is delayed while they are, of course, still receiving care from skilled ambulance staff.
“In many areas financial incentives have been introduced alongside measures to reduce handover delays, and we expect to see results over the coming months. Staff work hard to keep these occurrences to a minimum.”