Time lost by staff left ‘in limbo’ atA&E revealed
FRONTLINE staff at the Welsh Ambulance Service “lost” nearly 80,000 hours last year waiting to transfer patients into hospitals, figures have revealed.
According to the trust’s Ambulance Quality Indicators (AQI), which look at all aspects of their performance and clinical care, handover delays totalled hours 76,691 in 2017 – the equivalent of 3,195 days or eight-and-a-half years.
That was a significant rise on 2016 when handover delays totalled 59,694 hours.
According to NHS Wales guidance, patients should be transferred from an ambulance to a hospital within 15 minutes, with any time over that being classed as a delay. But only around half of patients were able to be transferred within that timeframe last year.
Scores of ambulances queuing outside emergency departments has become an all-too familiar site across Wales due to a high influx of patients coming through their doors.
A lack of hospital beds, higher volumes of elderly patients with chronic conditions and delays in setting up social care packages have all been blamed for creating a backlog outside A&E.
Darron Dupre, Unison organiser, said ambulance staff on the frontline are being “failed by the system” and are growing increasingly frustrated.
“Every lost hour sat outside an emergency department is felt with a profound sense of frustration by emergency medical teams all across Wales,” he said.
“Indeed, it has now become almost a norm that some crews will spend more time stuck in limbo outside of hospitals than actually on the roads saving lives. It cannot be right that every month we have a now customary debate on how hard everyone is working and that everyone is ‘committed’ to a more joined-up system. This needs to be translated from hopeful press releases into real, sustainable action.
“While I have not met one paramedic who says that caring for a patient in their ambulance outside an emergency department is ‘wasted’ time, they do call it ‘lost’ time.
“Lost time in not being able to get to other patients in as timely fashion as they would want for their own families. Lost time because they are being failed by the very system that should be there to underpin their worldclass skills and the most lifethreatened patients who depend upon them.”
According to the AQI figures, 209,552 patients who called 999 were taken to a hospital or other healthcare destination in 2017.
Welsh Ambulance Service staff experienced the most handover delays in the last quarter of 2017 (October to December) when 19,554 hours were “lost”.
Health boards across Wales say they are doing everything they can to get patients into their hospitals as quickly as possible.
Richard Lee, the Welsh Ambulance Service’s director of operations, said hospital handover delays remain a challenge.
He said: “They’re frustrating for our ambulance crews whose time could be spent helping other patients in the community and they’re frustrating for our hospital colleagues who are working flat out to speed up the flow of patients through the emergency department.
“We’re working collaboratively with our health board colleagues to reduce the number of patients we convey to hospital; currently we only convey around 60% of 999 calls that we receive.
“We’re deploying falls teams to keep uninjured patients at home, and are preventing around 2,000 ambulance dispatches a month by helping patients over the telephone.
“We have positioned nurses and paramedics in police control rooms to coordinate our activity, and we have referral pathways to other NHS services for patients with less serious conditions. This month we have also appointed Hospital Ambulance Liaison Officers who work with our crews and hospital staff in order to reduce the time an ambulance spends at the emergency department.
“The public can help us by using our service wisely – last weekend we attended 64 incidents where there was no patient on scene when we arrived. We attended 124 calls where the ambulance crew referred the patient back to their GP, and we treated 474 patients at scene with no onward referral required.
“If you’re not sure which service you require, please call NHS Direct Wales on 0845 46 47 (or 111 if you live in Swansea, Neath Port Talbot, Bridgend or Carmarthenshire) for an immediate source of advice.
“There are more than a dozen symptom checkers at www.nhsdirect.wales.nhs.uk which can help you to choose the right treatment, and local pharmacies are also a great source of advice.”