‘Terrible’ waits for ambulances in England put lives at risk | Emergency services

Lives are at risk as 999 callers face unacceptable and appalling waits for ambulances in Englanddeclared the best emergency doctor in the country.

Dr Katherine Henderson, president of the Royal College of Emergency Medicine, said the pressure in the NHS was now so serious that it was breaking its “basic agreement” with the public to treat the sickest in a timely manner.

In an extraordinary intervention, Henderson said urgent and urgent care was in a ‘deeper crisis than ever’, and for the first time in its history the NHS could no longer live up to its ‘contract’ with the nation to reach critically ill patients quickly. who dials 999.

Patients with life-threatening conditions such as heart attacks and strokes have to wait far too long for emergency care, she said, and vulnerable elderly people in some cases spend all night on the floor home after a fall.

The rapidly worsening crisis is caused by growing demand, huge staff shortages in the NHS and social care which have been made worse by Covid-related absences, and a drastic shortage of hospital beds and homes of care.

Chart: Ambulance response times, April 2018-February 2022

“The real obstacle to resolving this crisis is political reluctance,” Henderson said. “The current situation is breaking the workforce and breaking our hearts.”

Hospitals are dealing with record demand for patients coming forward after two years of the pandemic, while struggling to get patients out due to the social care crisis.

As a result, Henderson said, doctors are struggling to find room for patients arriving at A&E. This is causing record delays in ambulances delivering patients, leading to waits of up to 10pm for 999 callers.

In an interview with the Guardian, Henderson said she had no choice but to sound the alarm over the ‘shocking’ and ‘incredibly bad’ delays in emergency care as the growing crisis was dangerous and life-threatening.

“It’s not acceptable,” Henderson said. “It is a very, very significant loss of that basic agreement with the public about the NHS that if you dial 999 and need an ambulance – which an elderly person who has fallen down has need – you will get one in a timely manner.

“And we broke that contract with the public. It’s shameful for me that we are in this situation. We have elderly and vulnerable people at home who need an ambulance…and we can’t get them in.

The results of a survey by the Royal College of Emergency Medicine, shared exclusively with the Guardian, reveal the scale of the crisis. Eighty percent of the country’s emergency department clinical managers said they had held ambulances every day in the past week, a 15% increase from the same survey in December.

More than half of clinical managers (55%) said their longest patient stay in A&E in the past three days was more than 24 hours, the survey found. Almost a quarter (23%) said their longest stay was longer than 48 hours.

“The fact that there’s someone in this category is shocking, but the fact that over 50% of departments have people over 24 hours…it’s incredibly bad,” Henderson said. “There’s no clinical reason for a patient to be there, really, longer than six hours. The fact that there is someone in the over 48 hour category is just incredibly appalling.

Delays in moving 999 patients from ambulances to A&E and then to a ward are having a catastrophic effect on ambulance response times, Henderson said. South West Ambulances have the worst record of any of England’s 10 ambulance trusts for the most urgent calls for four of the last five months, according to a Guardian analysis of NHS England data.

In February, the month for which the most recent data is available, its average response time to the most urgent Category 1 calls – patients with life-threatening conditions – was 11 minutes and 39 seconds, the second fastest since that the NHS started publishing data in 2017. By contrast, ambulances in the North East, which had the best record in February, reached the average Category 1 call in six minutes and 37 seconds.

A spokesman for the South West Ambulance Service said it was experiencing a prolonged period of high demand and transfer delays at hospitals were preventing its teams from getting back on the road.

Unison’s deputy chief health officer, Helga Pile, said: ‘The colossal demands placed on the ambulance service in the South West are mirrored across the UK. Dealing with repeated pressure spikes with an exhausted workforce is expensive. »

National Category 1 response times also lengthened during the year through February. In the most recent month, the average Category 1 response time in England was eight minutes and 51 seconds, above NHS targets that all ambulance trusts must respond to Category 1 calls in seven minutes on average.

Even after 999 patients have been picked up by ambulance, taken to A&E and a decision made to admit them to hospital, many then face new expectations as staff try to find them a home. bed in a ward, Henderson said. As well as being “incredibly undignified”, waiting on trolleys in hallways can lead to patients’ condition deteriorating as A&E staff move on to subsequent patients entering the ward.

Hallways are increasingly crowded with patients waiting for beds on wards that staff are resorting to desperate measures, Henderson said. “We’ve all started using office spaces and storage spaces that you can quickly convert into a cubicle.”

Some patients receive all of their care in the back of an ambulance outside of a hospital. “It’s surreal,” Henderson said. “We almost moved emergency medicine to the parking lot.” She said she couldn’t remember a month in April when the pressure on the NHS had been as great as it is now.

MP Daisy Cooper, the Liberal Democrats’ health spokesperson, said: “Record wait times for ambulances lead to heartbreaking stories of people waiting hours for an ambulance to arrive, with devastating consequences for patients and their families.”

She said ministers had ‘turned a blind eye’ to the ambulance service and emergency care crisis which left many patients ‘waiting in pain and distress’.

NHS England said staff were working ‘flat out’ amid rising numbers of Covid patients, record A&E attendance and tens of thousands of Covid-related absences, while tackling the backlog of care. A spokesperson said patients should still “show up for care” if they need it.

A department of Health and Social Care spokesperson said: ‘The Government is absolutely committed to supporting the NHS and improving the patient experience. Claims to the contrary are entirely baseless.

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