Advising with empathy and experience

Lives at risk from long ambulance waits, say paramedics.

 

Sick people’s lives are being placed at greater risk because patients are facing unacceptably long waits for an ambulance after making a 999 call , according to the professional body for ambulance services, the College of Paramedics.

The warning follows NHS data, which shows ambulance service response times in England for serious illnesses, such as heart attacks and strokes, are almost three times as long as stipulated.

Response targets are being missed throughout the UK, with some seriously ill people waiting up to nine hours for an ambulance, according to the BBC.

The College of Paramedics says that investigations are continuing into deaths linked to delays in several UK regions, including a person who died following a cardiac arrest after a five-hour wait in an ambulance outside Worcestershire Royal Hospital and another found dead in the East of England after it took crews an hour to get to a call classed as immediately life-threatening.

Ambulance services have been under their highest state of alert due to unprecedented demand, coupled with the Covid pandemic, and, in some cases, patients have been told to make their own way to hospital.

Ambulance staff across the UK spoke to the BBC about their experiences. One said they felt patients’ lives were being risked on every shift and another described the situation as "horrendous". The College of Paramedics said that the situation is "unacceptable" and that lives were at risk.

Cases involve both waits for crews to reach patients and delays when ambulances arrive at hospital A&E departments but spend hours queuing outside because the hospital is too overcrowded to accept the patient.

Margaret Root, 82, waited nearly six hours for an ambulance following a stroke, and another three hours outside hospital. When she was finally admitted, her family was told it was too late to give her the drugs to reverse the effects of the stroke.

Her granddaughter, Christina White-Smith, said her grandmother had been "hugely let down.” She said she did not blame the staff because they were "amazing" when they got to her grandmother, but is angry that the NHS is not getting the help it needs.

In other cases, a 66-year-old man spent four hours lying face down on the floor at home with a punctured lung and another man waited nine hours for an ambulance following a stroke. His family called six times before an ambulance arrived next day.

A trustee at the College of Paramedics, Richard Webber, a working paramedic, said: "We have members who have been working for 20 or 30 years and they have never before experienced anything like this.

“Every day, services are holding hundreds of 999 calls with no one to send. The ambulance service is not providing the levels of service it should. Patients are waiting too long and it is putting them at risk."

He added that the delays in transferring patients to hospital staff were causing havoc. Waits of three or four hours were common. "It means on a 12-hour shift we can attend only two or three incidents, whereas previously we would do six, seven or eight."

His evidence is supported by data collected by the Association of Ambulance Chief Executives, which shows the number of hours lost to handover delays lasting more than an hour, is now more than twice as high as it was in January 2021.

The latest response times data confirms that, in England, immediately life threatening, category one cases, such as cardiac arrests, took an average of more than nine minutes to reach. Research shows that every one-minute delay reduces survival chances by 10%.

Category two cases, which cover emergencies, including heart attacks, strokes and burns, should be reached in an average of 18 minutes but took nearly 54.

In Wales, the Healthcare Inspectorate recently warned delays were presenting a risk to patients and shortly afterwards the ambulance service requested military help.

Many different reasons are thought to be behind the delays with signs that the pandemic disruption has affected the health of frail and vulnerable people leading to greater demand on services as calls to the ambulance service are around a quarter higher than seen before the pandemic.

Hospitals are also reporting problems trying to discharge medically fit patients because there is no community social care available which is causing significant delays admitting patients onto hospital wards and, in turn, long waits for ambulance crews arriving with patients.

Head of the Scottish Ambulance Service, Pauline Howie, recently apologised  and said that pressures on the service were unprecedented.

Chris Hopson, chief executive NHS Providers, which represents both ambulance and hospital managers in England, said the system was "severely stretched.”

Medical director of the NHS in England, prof Stephen Powis, pointed out that, during autumn 2021, the ambulance service had had to deal with the highest ever number of 999 calls in a single month, while major A&Es had experienced their busiest period.