Tenfold rise in patients held in ambulances outside A&E

Wait times exceed eight hours with ‘deaths on daily basis’ as wards struggle to make beds available

THE number of patients waiting more than eight hours for transfer from an ambulance to A&E has increased almost tenfold since before the pandemic.

Some 218 patients waited eight hours or more outside English hospitals in 2021, compared with 23 in 2019. Experts said “patients are dying every day” because of the delays, which they said were caused by infection control procedures limiting bed capacity, the social care crisis and staffing problems.

The data, which cover up to October this year, are from eight out of the 10 main ambulance services in England which responded to this newspaper’s requests, meaning the true figures are likely to be even higher. The number of handovers taking between four and eight hours also increased more than fourfold from 1,351 to 5,642.

Dr Ian Higginson, of the Royal College of Emergency Medicine, said hospital bed capacity was limited because of wards being split between Covid and other patients. “There are patients ready [for discharge] but for whom care cannot be organised,” he said.

Separate figures showed 10,500 hospital beds are blocked daily by patients fit enough to be discharged, representing around one in 10 hospital beds.

“Ambulances are held at the front door because emergency departments are full,” Dr Higginson said. “Eight out of ten patients held in ambulances come to harm, and every day patients are dying because of these problems.”

In October a patient died in an ambulance outside Addenbrooke’s Hospital, Cambridge, when paramedics were forced to wait outside because the A&E department was overwhelmed.

Another patient died waiting outside the Norfolk and Norwich University Hospital last month.

A handover delay does not always mean a patient has waited in the ambulance; they may have been moved into an A&E department, but staff were not available to complete the handover.

But the delays also mean paramedics are unable to respond to other 999 calls. In November, a person died after nine ambulances were stuck at the James Paget Hospital, Gorleston, waiting to handover other patients.

The longest handover times have dramatically increased in some services. In 2019, the London Ambulance Service’s longest handover time was six hours 51 minutes in January, but this more than doubled to 14 hours 55 minutes in September 2021.

Martin Flaherty, managing director of the Association of Ambulance Chief Executives, said patients suffering “life changing illnesses are coming to even greater harm because ambulances are tied up at hospitals and unable to reach patients quickly enough”.

An NHS spokesman said: “NHS services are working collaboratively to support hospitals with the significant demand they are facing this winter.”