Ambulance handover times reach record levels
A RECORD number of ambulances are queuing for hours outside hospitals waiting to offload their patients, new figures have revealed.
A Freedom of Information request has found that ambulances waited an hour or more to transfer patients to A&E departments 30,693 times last year.
This equated to 13% of all ambulance handovers during 2017-18 – the worst performance for the five years that figures are available.
This compares to 14,314 waits of more than an hour in 2013-14.
Across Wales there were 16,806 calls in 2017-18 that took more than two hours for the patient to be handed to A&E staff – and 2,173 that took more than four hours.
The figures include an ambulance that took 15 hours and 35 minutes to hand over an “amber” call at Princess of Wales Hospital, Bridgend, in December 2017, and another amber call at Swansea’s Morriston Hospital in March 2018 that took 14 hours and 37 minutes.
One “red” call took nine hours and 51 minutes at Morriston Hospital in March 2018.
Red calls to 999 are given to patients who are in an immediately life-threatening situation, including those who are not breathing.
Amber calls are serious but not immediately life-threatening, including patients with suspected strokes and heart attacks.
For red calls, which need to be reached within a target time of eight minutes, ambulance crews waited more than an hour outside A&E on 1,422 occasions in 2017-18.
Ambulances are supposed to hand over patients within 15 minutes of arriving at A&Es so crews can attend their next call.
However, in 2017-18 just 36% of transfers from ambulance to Welsh A&Es took place in less than 15 minutes, the worst performance in five years.
Louise Platt, interim director of operations at the Welsh Ambulance Service, said: “Unfortunately, handover delays are a regular feature for the ambulance service across Wales.
“That said, the data reported here is very much at the extreme end of our delays at hospitals and does not represent the experience of the majority of our patients.
“We recognise that the whole unscheduled care system is under pressure and that our colleagues at hospitals work hard to ensure patients are handed over in a timely manner, and on the basis of the seriousness of their condition. We will be extending our use of advanced paramedic practitioners to help more people stay at home rather than taking them to hospital.
“And we will be encouraging the public to make good use of the NHS Direct Wales online symptom checkers so that people can receive the advice they need without calling an ambulance or going to our busy emergency departments.”
Doctors’ groups described the growing number of long waits across the UK as “very distressing” amid fears that this winter is set to be as challenging, if not worse.
Dr Ian Higginson, the registrar of the Royal College of Emergency Medicine and a consultant in emergency medicine, said: “It’s very distressing for us as emergency physicians not to be able to receive patients into our emergency department as quickly as they need.
“Queuing ambulances are a very clear sign of crowding in departments, as are queues in the corridors.
“In emergency departments, most can work really effectively, because we’ve got some fantastic staff across the country.
“What they need is the conditions to work properly. They need enough space to see patients, they need enough staff to see them, and once they’ve seen them, they need to be able to get into beds or go home so there’s space for the next patients.
“There’s nothing to suggest [this winter is] going to be any better and we know we’re going into winter with data that suggests that hospitals are under more pressure than last year. We see nothing to suggest it’s not going to be more challenging.”
Dr Rob Harwood, chairman of the British Medical Association’s (BMA) consultants committee, said the most recent emergency admission figures were at a record high even before winter hits.
He said: “So when these are then combined with delays in handing over patients at A&E, it is further evidence of what the BMA has been saying for some time – we are no longer experiencing just a winter crisis in the NHS, it is now a truly year-round crisis.
“Hospitals and healthcare providers cannot afford to assume that measures to reduce handover times and emergency admissions will be enough to beat this year’s winter pressures when the figures show that demand for services is increasing at a rate far higher than many had anticipated.”