Four out of the ten ambulance trusts have declared black alerts or level 4 incidents in the past few days due to overwhelming demand. This includes East Midlands Ambulance Service, London Ambulance Service, South Western Ambulance Service and North West Ambulance Service. A black alert means they cannot maintain services and safety is at risk.
An NHS Chief Executive has admitted that patients are coming to harm because of long waits in the back of ambulances, as ambulance services across England are reporting record emergency demand.
A leaked briefing to staff at West Midlands Ambulance Service, allegedly seen by The Independent, has stated that patients are being delayed outside hospitals for hours, which in turn means that ambulances are unable to respond to other 999 calls. Some staff have reported delays of 4 hours or more at the end of their 12 hour day, waiting to transfer a patient to A&E staff. Six out of ten of the busiest days ever for the West Midlands Service have been in July 2021, with 36,336 999 calls between 1 and 7 July 2021 – a 32% increase on the same period in 2019. On 5 July 2021, the Trust recorded its busiest day in history, with 5,455 emergency 999 calls. Yorkshire Ambulance Service also saw 22% more 999 calls on 6 July 2021, with one worker exclaiming the service was on a “knife-edge”.
The briefing showed that June 2021 had been the second worst month for patients waiting over an hour to be handed over at A&E, with 4,649 incidents. The time spent waiting was the equivalent to 760 staff working 12-hour shifts. It has been stated that in some cases, paramedics have been forced to “cohort” patients with another crew, so paramedic can end their shifts on time, which can often result in longer delays for the remaining crew.
In relation to staff, the briefing stated “this current situation is unacceptable and leads to fatigue, poor morale, has impacts on patient safety and potentially non-compliance with the Working Time Directive.” Other health bosses have also warned patient safety in the NHS will be at risk if the country experiences a wave of COVID infections this summer.
Matthew Taylor, head of the NHS Confederation has recently stated:
“The quality and safety of patient care is always going to be more at risk in a system which is struggling to cope, and we have a system that is struggling to cope.”
This comes as on 7 July 2021 Leeds Teaching Hospitals Trust revealed surgery for cancer patients had to be cancelled as the A&E department was overwhelmed and existing COVID wards were full.
West Midlands Chief Executive, Anthony Marsh, told the staff the situation was unacceptable and the problems at the hospital were worsening. He stated:
“You have told us how late finishes are impacting your lives and your mental health. It is also causing serious detriment to patient care with tragic consequences in some cases. It cannot be right that we are not able to get to some category 2 patients in a timely manner – these are patients with heart attacks and strokes where time really matters. There is no question that patients are coming to harm.”
Further to this, he added that too many NHS Trusts were “simply ignoring” advice from the Care Quality Commission to take over the management of patients when an ambulance arrives at A&E, due to lack of beds, consequently transferring the problem to the paramedics.
The West Midlands Trust is now engaging with hospitals to bring in a new policy to try and prevent paramedics waiting with patients for hours after their shift ends. A new approach would mean hospitals being alerted to staff approaching their end of shift so they could be helped. However, with A&E staff under great pressure, it’s unclear how effective this would be.
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