FIT TO SIT
NHS’s plan to get ambulances stacked up at A&Es back on the road? Take sick patients from stretchers and treat them in chairs the second they’re deemed
SERIOUSLY ill patients arriving by ambulance at besieged casualty units are being forced off stretchers and treated on chairs – to get overstretched paramedics back on the road.
Under a desperate new move to deal with the winter crisis gripping the NHS, sick and injured patients are assessed by hospital staff to see if they are ‘fit to sit’.
Managers hope the scheme will reduce lengthy delays that have seen up to 25 ambulances queuing at hospitals with patients on board.
George Eliot Hospital in Warwickshire wrote in its ‘winter plan action matrix’ that ‘fit to sit’ would ‘ i mprove ambulance handover delays’ and late last year it ‘ordered appropriate seating’ t hat met infection control requirements.
The NHS Improvement quango told all trusts that last winter saw ‘record numbers of delayed hospital handovers’ across England.
Patients should be transferred from ambulance to A&E within 15 minutes but latest figures show many having to wait far longer, with 111,524 handovers taking more than an hour in 2016-17.
In the new action plan, trusts were told they ‘must avoid the use of ambulance trolleys for patients who are “fit to sit’, and should move them to a chair if appropriate.
‘This can expedite investigations and facilitates discharge assessments. Such an approach assists greatly the use of ambulatory care pathways and reduces the demand on trolley/cubicle spaces.
‘Hospital staff including handover staff, and ambulance staff should be made aware of the fit to sit guidance.’
Separate guidance published last year explained: ‘On arrival or at the time of initial assessment, patients on trolleys should be assessed for their suitability to be transferred to wait in a chair. Fit to sit assessments help release ambulances to respond to the next call.’ In Lanca- shire, the introduction of fit to sit ‘resulted in increased space on the corridor in times of pressure’.
Not all patients are happy. One woman wrote on social media: ‘Being classed as “fit to sit” in A&E waiting room when they are probably close to death is an absolute joke’.
Health service sources defended the scheme last night and said it did not mean patients received any worse treatment than those in beds.
One said: ‘Fit to sit is an initiative to make sure patients who have been conveyed to hospital on an ambulance stretcher but do not need to continue lying down – and would actually be more comfortable sitting up – are placed in a bay with a chair rather than a trolley.’