Ambulance service left ‘troubled’ by effects of delays
AMBULANCE handover times have “reached the highest levels recorded” – while the North East Ambulance Service NHS Trust is “worried and troubled” about the long delays some patients have faced before paramedics were able to get to them.
New NHS data shows more than 50,000 calls were made to NEAS in November, and while the trust had the best record in the country last month in terms of how quickly it was getting to the most serious cases, others, including stroke and heart attack patients, are waiting on average 40 minutes for an ambulance.
In a report submitted to a trust board meeting on December 9, bosses were told of three cases where complaints against NEAS had been upheld.
One involved a woman who had had a heart attack was waiting more than an hour for an ambulance – and though she was resuscitated when paramedics arrived, she later died in hospital.
In its report, NEAS said its investigation had found she should have been attended to within 40 minutes, but “sadly due to demand on the service there was no ambulance availability prior to the vehicle which responded”.
In another case highlighted, a man in his 80s had fallen and was waiting almost nine and a half hours for an ambulance. On the day in question, the NEAS investigation found some calls categorised as “category 3” – defined as “an urgent problem” – saw waits of 14 or 15 hours for an ambulance. The target for this kind of call is two hours.
Trust medical director Dr Mathew Beattie said: “It’s been very, very busy. We have seen levels of activity far beyond what we would normally expect.
“It’s not just Covid. It’s also all of the viruses that you expect to see at this time of year. That’s RSV, Croup, para-flu viruses and flu itself – and the many many thousands of other viruses that circulate in the community.
“We are seeing a very, very pressured situation – and that’s continued all the way through from the summer.”
The Trust is just two seconds outside of the seven-minute target for getting an ambulance to the most serious cases.
Referring to the delays some have faced, Dr Beattie said one consequence of such a large number of calls was that call handlers were forced to “stack” cases in priority – treating the most vulnerable. He added: “Unfortunately that may mean patients sometimes have to wait considerable periods of time – that’s something which worries us and troubles us a great deal.”
Dr Beattie explained this was connected to the continuing pressures on the whole of the health service, saying: “If there aren’t any beds available then the A&E department can’t move patients into beds and that means ambulances end up waiting to handover patients to them.
“It’s a big concern for us and we are looking at anything we can do to try to manage things in different ways and improve the flow across the system. There’s so much activity going on at the moment.”
In a report to the trust board, execs were told: “Average handover times have reached the highest levels recorded and continue to put significant pressure on road capacity.”
The report also added that accounting for handovers to A&E which took longer than 15 minutes, 2,730 hours were lost in October. The main issues are in the south of NEAS’ area in Teesside and at University Hospital of North Durham.
The average handover time was more than 26 minutes.
Responding to the complaints raised at the board meeting, Helen Ray – NEAS chief exec – added: “This is demonstrating, without a shadow of a doubt, harm is coming to patients due to delays.
“I think we are a transparent organisation and we should be comfortable saying that out loud – and we are. It’s not a position that we want to be in. It’s not a position that the system wants to be in. But it is a fact as we stand here now.”
Dr Beattie said work being done to improve things ranged from recruiting more health advisors to handle 999 calls and working out better ways of treating frail patients.
He said: “We are looking at how we might be able to manage older patients with frailty issues – some of them may benefit from being looked after in the community rather than being taken to hospital.
“Then if you look at the 111 system there’s a whole programme to see how we can manage calls on a national basis. We are looking at opportunities to do more “see and treat” and better utilise resources from our acute colleagues and GPs. Basically we’re looking at how we can manage patients to improve things and give patients the care they need in the right way.”
Stats show that in October, 60% of calls to the non-emergency 111 service were abandoned. Dr Beattie said often people grew “understandably” frustrated with long waits, and decided to call 999 instead. He urged people to avoid doing this as the build-up of 999 calls had a serious knock-on impact.
Looking forward, he said: This winter is completely different to last year, and last winter was different to all of the winters that had come before.”
We have seen levels of activity far beyond what we would normally expect.