Revealed – Thousands of ambulance hours wasted waiting at A&E
Frontline ambulance staff spent the equivalent of half a year waiting to handover patients to A&E at our hospitals.
More than 4,200 ambulance hours – or 178 days – were lost to handover delays at Ipswich, Colchester and West Suffolk hospitals January to the end of June this year.
Delays at West Suffolk went up by 13% – from 1,233 hours to 1,398 – on the same period last year, while at Ipswich wasted hours fell by 17%, from 1,735 to 1,437.
Colchester Hospital – which has smashed the national four-hour A&E target for several months in a row – managed to halve the number of hours lost to handover delays compared to the same period in 2017, from 2,722 to 1,452.
More than 1,100 of these lost hours were in January as trusts grappled with a surge in winter demand.
How long is it supposed to take?
Handing over a patient from an ambulance to a hospital A&E is expected to take no more than 15 minutes.
Crews then have a further 15 minutes to make their vehicles sterile, sort out paperwork and restock.
How are patients affected?
Delays beyond these times put patients at risk, NHS England bosses claim.
They said diagnosis and treatment can be delayed, fewer ambulances are out on the road, and the response to serious or major incidents can be “seriously compromised”.
“Patients shouldn’t be waiting outside A&E – they are in that ambulance for a reason, and require rapid treatment,” said Sasha Pearce, head of health at UNISON eastern region.
“This is a real concern for the patients and for ambulance staff as well, because they want to be back on the road. Both are suffering as a result of these delays.
“If they are trapped at A&E it can also lead to their shift over-running, and they are then tired going back out.
She added: “The East of England Ambulance Service are understaffed as it is – they’ve just been given extra funding to find 300 more staff – but it’s going to take a lot of effort and money to fix it.”
Why are ambulances being delayed?
All of our hospitals blamed an increase in demand for the delays.
West Suffolk Hospital’s chief operating officer Helen Beck said the trust had more than 6,100 people at their A&E in June 2018, a 4% increase on last year. She added: “Like many NHS trusts, we have continued to see unprecedented increases in demand over the last year,” she said.
“We are committed to providing a high-quality service and don’t want ambulance crews and patients waiting unnecessarily, but we will always need to prioritise our sickest patients to ensure they receive the care they need first.”
Complex emergency care ‘increasing’
Jan Ingle, of Ipswich and Colchester hospitals, said complex emergency care – for frailer/older patients – is increasing.
“Getting ambulances and their crew back on the road as soon as possible is a big commitment to us,” she said.
“What we have at the moment is lots of peaks in demand – lots of ambulances arriving together.
“Because we see many people who are frailer, older, and with complex problems, it becomes more difficult to hand over.
“It’s that growing and underlying demand that causes delays.”
Colchester manages to half handover delays
Bosses at Colchester Hospital said an “enormous” amount of work has gone into reducing delays at A&E.
“The emergency department at Colchester is constantly seeing patients treated within four hours,” said Mrs Ingle.
“Everyone is working incredibly hard. An enormous amount of work has happened in Colchester to really make sure we can keep our promises to patients.
But she added: “We are looking at how we can sustain that improvement and keep it going, delivering it across all of our hospital sites.”
How is the ambulance trust faring as a whole?
Delays across the east of England fell slightly in the first six months of 2018, compared to the same period last year.
However, 32,116 ambulance hours – the equivalent of more than 1,300 days, which works out at three-and-a-half years – were still wasted due to crews waiting to hand over at hospitals.
That is down 3% from 33,066 ambulance hours lost in the first six months of 2017.
Both sets of figures, from EEAST themselves, contain information from 18 hospitals, across six counties – Suffolk, Essex, Norfolk, Cambridgeshire, Hertfordshire and Bedfordshire.
New handover process ‘reducing delays’
Ambulance service chiefs say they introduced a new handover process across the east of England earlier this year.
The scheme sets out a “clear escalation procedure” should crews have to wait longer than 15 minutes to hand over a patient.
If a person is waiting more than 30 minutes, hospitals and ambulance crews will work together to ensure a safe transfer.
“The number of hours lost while waiting to transfer patients to the emergency department has reduced,” a spokesman said.
“We are continuing to work with our partners to improve the way we respond to higher levels of demand, including how patients are handed into the care of hospitals as smoothly and quickly as possible.
“This then makes crews available for other calls in our communities more quickly.
“Last winter was one of the busiest experienced in the NHS as a whole and we already have draft plans in place for next winter.”