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Found 322 results
  1. News Article
    Almost 100 members of the army have been brought in to help four ambulance trusts amid staff shortages in the South Central, South West, North East and East areas of England, with Unison saying it was a sign "things were not right". Vicky Court, assistant chief operating officer at North East Ambulance Services has said "It will ensure everyone continues to get the care they need by freeing up paramedics to be more available to attend potentially life-threatening incidents." Read full story. Source: BBC News, 21 August 2021
  2. News Article
    Performance data published by NHS England has revealed a big surge in the number of immediately life-threatening incidents ambulance services have responded to. The data also showed average response times have increased and a large number of patients are attending emergency departments. So far, the reason for the increase remains unclear, however, a potential factor could be the return of respiratory illnesses, particularly in children, as the lockdown has eased. In a statement Association of Ambulance Chief Executives said, ”The reasons for the demand increases are complex and will include some patients who have not accessed care as early as they might have done normally and therefore present to the ambulance service as a high acuity patient and many patients who are contacting us for lower acuity issues which in some cases could have been managed by accessing other parts of the UEC system. We continue to work closely with NHS England to mitigate the demand as much as possible and encourage sign-posting of patients to other parts of the UEC system when that is a safe and more appropriate solution to their problem.” Read full story (paywalled). Source: HSJ, 12 August 2021
  3. News Article
    Latest data has revealed more than one million 999 calls were placed in July, showing paramedics were sent out to 82,000 emergencies last month and 8,000 more than the record set in June. This comes after A&E departments became overwhelmed with an influx of new patients over the summer, with many hospitals having to cancel operations due to being dangerously understaffed. Dr Katherine Henderson, president of the Royal College of Emergency Medicine has said, "The NHS has been running hot for months now and these figures show we are nearly at boiling point. We are worried that the public think things are getting back to normal on the virtual eve of a further reduction in restrictions, and messages from the centre that say things are OK are disingenuous – the reality is that the health service is really struggling." Read full story. Source: The Independent, 12 August 2021
  4. News Article
    A report published today has revealed the creation of single regional boards to commission ambulance services is under discussion with NHS England and Improvement. According to the report titled Rapid response: the role of the ambulance sector in transforming services and coping with the long-term impact of covid-19, ambulance trusts are to be involved in regional, integrated care system and place-level decision-making to maximise their contribution to more integrated services has also been called for. NHS Providers chief executive Chris Hopson and Association of Ambulance Chief Executives chair Daren Mochrie said: “As well as providing mobile treatment services, ambulance trusts have the potential to be an absolutely crucial co-ordinator on the urgent and emergency care pathway. We think there is a real opportunity there that is being missed." Read full story (paywalled). Source: HSJ, 12 August 2021
  5. News Article
    A new BBC report has found ambulance crews are unable to respond to calls quickly due to the pressure on hospitals to find free beds. Some paramedics are even spending most of their 12 hour shift waiting in the back of their ambulance, waiting to be called. "We know there are people in the community that are screaming out for an ambulance, but as you can see, a lot of ambulances are waiting here. It never ever used to be like this. We used to bring poorly patients in, and we were out on the road again in 15 minutes. We could do 10 jobs a shift, today we've done two. It's so demoralising" Paramedic Osian Roberts has said. Read full story. Source: BBC News, 11 August 2021
  6. News Article
    Maria Whale, 67, has died after waiting more than two hours for an ambulance after her husband dialled 999 when she began experiencing "severe abdominal" pain. Mr Whale has said the family have questioned whether she would have lived if the ambulance had arrived sooner, saying they had waited "four to five hours" for it to come. However, the Welsh ambulance service has said its records showed the call was placed at 02:10 BST before a paramedic arrived at 04:22 BST, with the ambulance following shortly thereafter at 04:35 BST - two hours and 25 minutes after the first call. "We are deeply sorry to hear about the passing of Mrs Whale and would like to extend our thoughts and deepest sympathies to her loved ones. An investigation to determine what happened started earlier this month and given this is underway we are unable to comment further at this time." Says Welsh Ambulance operations director, Lee Brooks. Read full story. Source: BBC News, 28 July 2021
  7. News Article
    The care watchdog has warned patient care may be being affected by the current pressures on the NHS with healthcare workers suffering significant levels of stress. Concerns have been raised in recent weeks after a surge in Covid-19 infections has resulted in record numbers of people calling for ambulances and attending emergency departments, overwhelming the service. Professor Ted Baker, the Care Quality Commission’s chief inspector of hospitals has said “It's imperative that not only do we deal with the immediate pressures on the system, we also need to deal with the underlying problems with the models of care. If we don't do that, patients will not be able to receive the care we want them to, and the pressure on staff to provide care under these difficult circumstances will continue.” Read full story. Source: The Independent, 22 July 2021
  8. News Article
    The London Ambulance service declared a 'business continuity incident' on Monday after a surge in 999 calls. Paramedics were told the ambulance service was under extreme demand after the calls threatened to overwhelm the service. The announcement was made after more than 400 calls were made in a single hour during Monday afternoon. “Yesterday we saw high levels of demand for our services and used tested processes to care for our patients – this allowed some people with the least urgent care needs to be treated through alternative routes" said a London Ambulance Service spokesperson. Read full story. Source: The Independent, 20 July 2021
  9. News Article
    999 calls soar as patients experience record waiting times in the back of ambulances. The Independent has seen a leaked brief from the West Midlands Ambulance Service and has found patients have been waiting for hours outside hospitals, meaning ambulances could not respond to any emergency 999 calls. Ambulance staff have also faced hours of delays resulting in at least four hours or more at the end of their 12 hour shift. The briefing in June said "“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.” Read full story. Source: The Independent, 9 July 2021
  10. News Article
    Thousands of ambulance crews in England will be given body cameras after a sharp rise in attacks on NHS staff treating patients, the government has announced. Data shows that 3,569 ambulance staff were physically assaulted by members of the public last year – 30% more than in 2016-17. The plans come after successful trials in London and the north-east. The cameras will be given to crews in 10 ambulance trusts across the country. Medics will wear the cameras and be able to press a button to start recording if patients or the public become aggressive or abusive, and the film will be given to the police where needed. Prerana Issar, the chief people officer for the NHS, said: “Every member of our dedicated and hardworking NHS staff has the fundamental right to be safe at work and it is our priority to eliminate violence and abuse, which we will not tolerate. As well as reducing the number of incidents towards our staff, these cameras are a vital step towards ensuring our people feel safe too.” Read full story Source: The Guardian, 2 June 2021
  11. Content Article
    West Midlands Ambulance Service has highlighted the death of a woman which it says was due to “being delayed on the back of an ambulance”, just two days after it warned that lives were ‘at risk’ from long handovers. Below is the full account from the organisation's board paper.
  12. News Article
    An ambulance trust has highlighted the death of a woman which it says was due to “being delayed on the back of an ambulance”, just two days after it warned that lives were ‘at risk’ from long handovers. West Midlands Ambulance Service University Foundation Trust’s board papers this month reveal the woman in her 90s — who has not been named — was taken to hospital because a severe nose bleed would not stop. Its clinical quality board paper says the “patient story” showed ”how a patient being delayed on the back of an ambulance resulted in significant deterioration and ultimately the death of a patient”. Read full story (paywalled) Source: HSJ, 28 May 2021
  13. Content Article
    Myla Deviren had congenital intestinal malrotation and developed a volvulus on 26 August 2015. Her mother checked the NHS Symptom finder on line and the advice was to take her to A&E but she called 111 for advice. The Health Assistant who took the call did not appreciate the significance of key symptoms due to multiplicity of symptoms described at the outset. He passed the caller on a “ warm” transfer to the Clinical Adviser whose initial reaction on hearing that the symptoms included blue lips and breathlessness was to call an ambulance, ignored her instincts and took mum through a series of digital pathways re lesser symptoms. When directly asking about the breathlessness Myla's mum put the phone close to her daughter enabling the Clinical Adviser to hear the rapid breathing herself however they did not appreciate the significance of it and did not call an ambulance. She did however pass the call to the Out Of Hours Nurse who decided that this was a case of gastroenteritis early in the call and did not appreciate the description of a child with worsening signs. Whilst the precise point at which Myla stopped breathing is not known it was sometime between when she was last seen alive approximately 06.00 and then found unresponsive at 08.00 on the 27 August 2015. She was then taken by ambulance to Peterborough City Hospital where, despite attempts at resuscitation, she did not recover a heartbeat and she died. Post mortem revealed small bowel infarction from untreated small intestinal volvulus. It is probable that with earlier transfer to hospital by ambulance and with appropriate treatment Myla would have survived. 
  14. News Article
    Ambulance crews will start using iPads to send photographs of accident and stroke victims to specialist hospital doctors so that they can make rapid diagnoses and save some patients a trip to A&E. NHS England is giving 30,000 iPads to regional ambulance services to help paramedics decide what care to give and whether to take someone to hospital or treat them at the scene. The tablet computers will be a vital link between ambulance crews and hospital consultants, whose digital interaction will make treatment faster and better, NHS England said. For example, the devices will let paramedics show an A&E department how badly injured patients have been in a road traffic crash, so that they can prepare for their arrival. They will also allow crews access to patients’ medical records to help them build a better picture of their health. “Ambulance crews have been at the forefront of the pandemic, routinely dealing with life-and-death situations and often first on scene to treat and diagnose critically ill patients,” said Sir Simon Stevens, NHS England’s chief executive. “These devices are another tool for our highly skilled paramedics and ambulance technicians as they continue to respond to the country’s most critically ill and injured patients.” Read full story Source: The Guardian, 18 May 2021
  15. News Article
    The Equality and Human Rights Commission has required an ambulance trust to sign a legally-binding agreement stating how it will protect its staff from sexual harassment. This is thought to be the first time the EHRC has taken such action against an English NHS organisation and follows repeated concerns about the culture at East of England Ambulance Service Trust. As a result, EHRC will now monitor the trust’s action plan for protecting staff from sexual harassment. The Care Quality Commission asked the EHRC to consider taking enforcement action against the trust last summer, after a CQC investigation found evidence of “bullying and predatory behaviour” and warned the trust’s leaders were not adequately promoting patients’ and staff’s wellbeing. The CQC also found at least 10 incidents in 2019-20 involving allegations of sexual assault, harassment or inappropriate behaviours, and 13 instances of staff, including those working for subcontractors, being referred to the police for sexual misconduct and predatory behaviour. The trust was subsequently placed in special measures for quality. Read full story (paywalled) Source: HSJ, 28 April 2021
  16. Content Article
    This Healthcare Safety Investigation Branch (HSIB) investigation explores the impact of ambulance delays on the emergency treatment of heart attack. The current preferred model of care in the NHS in England is for patients to receive primary percutaneous coronary intervention (PPCI), a procedure which involves widening a blocked artery and inserting a stent to keep the artery open. The effectiveness of PPCI is dependent on the timescale in which it can be carried out. National figures have identified increasing delays in ambulances taking people with a type of heart attack known as ST-elevation myocardial infarction (STEMI) to hospital so that PPCI can be provided within target timescales. This may lead to worse outcomes for these patients. Alternative treatment using thrombolytic medicine (medicines used to dissolve blood clots) is advised where specific timescales for providing PPCI may not be met. This investigation started after a patient notified HSIB of a delay in an ambulance attending him after suffering a heart attack (STEMI).
  17. Content Article
    In this blog post, Liv System’s Nigel Scard talks with Courtney Grant, a Senior Human Factors engineer with Transport for London (TfL). Nigel and Courtney worked together for a number of years at TfL on a number of station and line upgrade projects. A few years ago, Courtney applied his Human Factors and research skills with great tenacity, to a serious healthcare related incident which impacted him personally. This resulted in an important, lifesaving change to ambulance service procedures. In this interview, Courtney describes this in detail and also describes his recent work in supporting the Chartered Institute of Ergonomics and Human Factors (CIEHF) in supporting the response to the COVID-19 pandemic.
  18. Content Article
    This book aims to teach the key principles of patient safety to a diverse audience: physicians, nurses, pharmacists, other healthcare providers, quality and safety professionals, risk managers, hospital administrators, and others. It is suitable for all levels of readers: from the senior physician trying to learn this new way of approaching his or her work, to the medical or nursing student, to the risk manager or hospital board member seeking to get more involved in institutional safety efforts. Understanding Patient Safety is divided into three main sections. In Section I, it describes the epidemiology of error, distinguishes safety from quality, discusses the key mental models that inform our modern understanding of the safety field, and summarises the policy environment for patient safety. In Section II, it reviews different error types, taking advantage of real cases to describe various kinds of mistakes and safety hazards, introduces new terminology, and discusses what we know about how errors happen and how they can be prevented. Although many prevention strategies will be touched on in Section II, more general issues regarding various strategies (from both individual institutional and broader policy perspectives) will be reviewed in Section III. After a concluding chapter, the Appendix includes a wide array of resources, from helpful Web sites to a patient safety glossary.
  19. News Article
    Rotating clinicians and keeping ventilation running are among Public Health England’s (PHE) recommendations for how to avoid spreading covid while looking after patients in the back of ambulances outside emergency departments. The suggestions are made in unprecedented new guidance issued by PHE amid sky-high rates of very long ambulance handovers outside hospitals. This is because emergency departments (EDs) are struggling with attempts to maintain distancing for infection control, along with high occupancy and severe operational pressures elsewhere in hospitals. It has led over the past two months to large numbers of patients being looked after in ambulances for extended times while they wait for space in ED. The PHE guidance, added last week to existing covid guidance for ambulance services, says it should only happen in “exceptional circumstances”. But it says staff in this situation should adopt infection prevention and control procedures including: if more than one clinician is available, rotating them regularly, so allowing them time to change PPE and have a drink; keeping ventilation systems running which may require the engine to be kept running; ensuring patients and any essential escorts wear surgical masks, as long as patient care is not compromised; minimising the number of people within the patient compartment and avoiding sitting face-to-face with patients; and decontaminating contact surfaces more frequently and during the delay if possible. Read full story (paywalled) Source: HSJ, 25 January 2021
  20. News Article
    A London hospital is being forced to send patients back to ambulances for treatment due to an ‘overwhelming’ number of Covid patients on ICU wards, according to a frontline doctor. The medic, who asked to remain anonymous, said A&E staff are "running" into waiting ambulances to treat patients there until space becomes available. He said: "It’s not the fault of the staff, but the sheer numbers are so unprecedented and being full like this means that you just have to do your best to adapt. But it’s not the standard (of care) I signed up to." "It’s extremely stressful for us to be doing our best but knowing that significant patient harm is happening because there isn’t space and the patient load is too high." He raised concerns that "significant patient harm" was occurring due to a lack of beds available and the emergency system means medics are limited in the care they can provide. Read full story Source: The Metro, 14 January 2021
  21. News Article
    Hundreds of people a day across London are waiting hours for an emergency ambulance to get to them, as paramedics warn that patients are dying as a result of delays. Patients in emergency calls classified as category two, such as those involving a suspected stroke or chest pains, should be seen by paramedics within an average of 18 minutes but are being forced in some cases to wait up to 10 hours. Even life-threatening calls where patients are in cardiac arrest and should be reached within seven minutes have experienced delays, with data suggesting one such call was waiting 20 minutes on Monday. Internal data shared with The Independent shows that London Ambulance Service is holding hundreds of open 999 calls for hours at a time with the service’s boss acknowledging in an email to staff that the service is struggling to maintain standards. Experts warned that the problems in the capital were reflected in ambulance services across the country. One paramedic told The Independent: “Patients desperately requiring ambulances aren’t getting them and, anecdotally, people are deteriorating and dying whilst waiting. Our poor dispatchers have to stare at screens of held calls, working out who gets the next available resource and who waits, suffers or dies.” Read full story Source: The Independent, 5 January 2021
  22. News Article
    Elderly people who suffer falls are having to wait up to six hours for an ambulance because of rising Covid pressures, a medical body has warned. The delays are due to paramedics having to prioritise 999 calls from people suffering from coronavirus related breathing difficulties. Read full story (paywalled) Source: The Telegraph, 1 January 2021
  23. News Article
    One of England’s largest hospital trusts has been forced to divert ambulances and cancel operations, after seeing a very steep increase in covid-19 admissions over the past week. Whipps Cross Hospital in north east London, part of Barts Health Trust, declared a critical incident over the weekend, the trust has confirmed. The trust has also declared a “high pressure phase” of covid response. A well placed source said Whipps Cross had been forced to divert ambulances in recent days, because of pressure on its emergency services, while a message to staff said it was deferring some planned operations, along with other steps aimed at protecting safety. It is also understood to be attempting to further speed up discharges from hospital. Read full story (paywalled) Source: HSJ, 16 December 2020
  24. News Article
    Eleven patients have suffered harm after being kept waiting in ambulances outside accident and emergency departments, a review has found. South East Coast Ambulance (SECamb) Service Foundation Trust launched the review after a specific incident at Medway Foundation Trust on Monday 16 November. Although details of the incident have not been released, HSJ has been told one patient waited for nine hours before being seen in the trust’s A&E department that day. The review covered all long waits across SECAmb’s area over the last few weeks. Out of 120 cases examined, 11 patients were found to have suffered some degree of harm, SECAmb’s executive director of nursing and quality Bethan Eaton-Haskins told Kent’s health overview and scrutiny committee last week. However, the trust has not revealed which hospitals were involved. Ms Eaton-Haskins said the ambulance trust was “struggling significantly” with handovers and expecting the recent pressure experienced at Medway FT to affect the county’s other hospitals soon. However, she indicated some other trusts in Surrey and Sussex had also had long delays. Ambulance services have been concerned for some time that handover delays could pose significant problems this winter. They are thought to have contributed to the North West Ambulance Service Trust declaring a major incident earlier this month. HSJ has also been told of waits of several hours in other ambulance trusts. Read full story (paywalled) Source: HSJ, 1 December 2020
  25. Content Article
    The Scottish Ambulance Service has recently launched a positive reporting scheme called GREATix. GREATix is a peer-to-peer tool for recognising and learning from positive feedback in the workplace. Feedback will be used to pass on words of gratitude and identify improvement strategies.
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