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Showing results for tags 'Ambulance'.
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News Article
Patients ‘treated in ambulances as there was no space in A&E’
Patient Safety Learning posted a news article in News
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 -
News Article
Ambulance handover delays at A&E are putting patients at risk
Patient Safety Learning posted a news article in News
Between April 2020 and March 2021 there were approximately 185,000 ambulance handovers to emergency departments throughout Wales. However, less than half of them (79,500) occurred within the target time of 15 minutes. During that period there were also 32,699 incidents recorded where handover delays were in excess of 60 minutes, with almost half (16,405) involving patients over the age of 65 who are more likely to be vulnerable and at risk of unnecessary harm. Data published by the Welsh Government highlighted that in December 2020 alone, a total of 11,542 hours were lost by the ambulance service due to handover delays. This figure has been rising sharply and has now reached pre-pandemic levels once again. Inspectors said these delays have consistently led to multiple ambulances waiting outside A&E departments for excessive amounts of time, unable to respond to emergencies within their communities. "These delays have serious implications on the ability of the service to provide timely responses to patients requiring urgent and life-threatening care," the report stated. Read full story Source: Wales Online, 7 October 2021 -
News Article
‘The system is broken’: Patients told to sit on chairs outside A&E
Patient Safety Learning posted a news article in News
Sick patients have been forced to wait outside a hospital A&E department on chairs and wrapped only in blankets while being treated by nurses in shocking photographs and videos captured by one worried relative. The situation, at Addenbrooke's Hospital in Cambridge, is a regular occurrence, workers have told The Independent. Footage shared with The Independent by a concerned member of the public shows one patient being cannulated, where a needle and intravenous line is inserted into a vein, while another patient has a monitor attached to track their vital signs. Patients waiting outside the A&E were said to be extremely sick, with some vomiting and complaining of worsening symptoms. “It was like something out of a horror movie,” said Maria, who has asked for her surname not to be used. “The system is completely broken from the beginning to the end..." Addenbrooke’s Hospital has been under severe pressure for months with patients queuing out the door earlier this year and patients waiting over 24 hours for a bed. One mental health patient was detained in the back of an ambulance for over 12 hours. It is just one symptom of a nationwide summer crisis in the NHS, with the military called in to support ambulance services that have reported their busiest months ever. A&E units are also witnessing record levels of attendance. Patients are being made to wait so regularly outside Addenbrooke’s A&E that heat lamps have been installed on the walls outside one entrance, used by non-Covid patients. The hospital has also built a marquee as a permanent space for waiting patients. Read full story Source: The Independent, 28 September 2021 -
News Article
Fears over NHS plan to close all local ambulance stations in London
Patient Safety Learning posted a news article in News
NHS bosses plan to shut every local ambulance station in London, prompting fears that patients could be harmed if 999 crews take longer to reach them, the Guardian can reveal. The London ambulance service (LAS) has started a controversial programme to close all 68 ambulance stations and replace them with 18 new “ambulance deployment centres” or “hubs”. A patient group has criticised the plan as “dangerous” and MPs are worried that having fewer ambulance stations around the capital could mean patients wait longer to get to hospital. “This move to shut every ambulance station in London could cause significant harm to patients because of the delays that will take place in getting to them,” said Malcolm Alexander, the chair of the LAS Patients’ Forum, a non-statutory watchdog, and Hackney Healthwatch, a government-funded statutory body that scrutinises NHS services in the east London borough. “We have come across many situations where people have suffered harm because ambulances have taken too long to get there. It looks like this is quite dangerous from the point of view of patient safety.” Read full story Source: The Guardian, 25 September 2021 -
News ArticleThe Scottish government has asked the MoD for military assistance for the country's ambulance service. Nicola Sturgeon said health services were dealing with the most challenging combination of circumstances in their history due to the COVID-19 pandemic. Opposition politicians have highlighted a series of serious ambulance delays, including one where a man died after a 40-hour wait. They said this should not be happening in Scotland in 2021. Ms Sturgeon said her government was looking at a range of plans to deal with the significant challenges facing the health services, with the detail of a request for military assistance being considered. Investigations are ongoing into several cases reported in the media on Thursday, including one where a Glasgow pensioner died after a 40-hour wait for an ambulance. The Herald newspaper reported that the family of 65-year-old Gerard Brown were told that he could have survived had help arrived sooner. Mr Brown's GP - who is said to have repeatedly warned 999 call handlers that the patient's status was critical - was quoted as describing the crisis engulfing the Scottish Ambulance Service as being like "third world medicine". The Scottish Ambulance Service is investigating the circumstances of the case, and said it will be "in contact with Mr Brown's family directly to apologise for the delay". Read full story Source: BBC News, 16 September 2021
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News Article
Increased ambulance handover delays threatening patient safety
Patient Safety Learning posted a news article in News
A new snapshot survey by the Royal College of Emergency Medicine has found that in August 2021 half of respondents stated that their Emergency Department had been forced to hold patients outside in ambulances every day, compared to just over a quarter in October 2020 and less than one-fifth in March 2020. The survey, sent out to Emergency Department Clinical Leads across the UK, also found that half of respondents described how their Emergency Department had been forced to provide care for patients in corridors every day, while nearly three-quarters said their department was unable to maintain social distancing every day. One-third said that the longest patient stay they had had in their Emergency Department was between 24 and 48 hours, with 7% reporting the longest stay to be more than 48 hours. Dr Ian Higginson, Vice President of the Royal College of Emergency Medicine, said: “It is shocking to see the extent of the challenges faced by Emergency Departments across the UK. Holding ambulances, corridor care, long stays – these are all unconscionable practices that cause harm to patients. But the scale of the pressures right now leaves doctors and nurses no options. We are doing all we can to maintain flow, maximise infection prevention control measures, and maintain social distancing. Our priority is to keep patients safe, and ensure we deliver effective care quickly and efficiently, but it is extremely difficult right now." Read full story Source: The Royal College of Emergency Medicine, 6 September 2021 -
News ArticleThe family of a senior medic and lifelong NHS campaigner have called for an investigation into his death as it took paramedics more than half an hour to arrive at his home after operators were told he was suffering a cardiac arrest. Professor Kailash Chand, a former British Medical Association deputy chair, had complained of chest pains before one of his neighbours, a consultant anaesthetist at Manchester Royal Infirmary, called 111 for help before telling the call handler within three minutes that he believed his friend was having a cardiac arrest. “I was answering their questions when Kailash’s eyes began rolling and he slipped into unconsciousness. That’s when I said ‘this looks like a cardiac arrest’ and to upgrade the call. They kept asking questions as I started CPR and asked for an urgent ambulance. That was two or two and a half minutes into the call." Evidence seen by i News shows that it took another 30 minutes after the neighbour told the operator about the cardiac arrest for the paramedics to arrive at Professor Chand’s flat in Didsbury, Greater Manchester. National standards for ambulance trusts show that ambulance trusts must respond to category 1 calls – those that are classified as life-threatening and needing immediate intervention and/or resuscitation, such as cardiac or respiratory arrest – in 7 minutes on average, and respond to 90% of Category 1 calls in 15 minutes. Read full story Source: iNews, 3 September 2021
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News Article
Private ambulance firm deregistered by CQC
Patient-Safety-Learning posted a news article in News
A private ambulance company, KFA Medical, which provided patient transport services for the NHS has been deregistered by the Care Quality Commission over concerns for patient safety. Concerns included lack of basic training and Disclosure and Barring Service checks on employees were not up to date or had not been carried out and when looking at four staff files none had current basic life support training. Sarah Dronsfield, the CQC’s head of hospital inspection, said: “We have been working with the provider since their suspension in January, however when we carried out this inspection, we found the provider had been unable to implement and sustain the necessary improvements to assure us that people were receiving safe care. This action should send a very clear message to all providers of independent health and care services that while taking enforcement action of this nature is not something we take lightly, we will always take action where appropriate to protect the health and safety of patients,” Read full story (paywalled). Source: 03 September 2021 -
News ArticleAccording to reports, a hospital in the northeast of England is having to turn away non-emergency patients from A&E due to "unrelenting" pressures on the service. This new policy was announced on Tuesday by Hull Teaching Hospitals Trust, warning patients they may need to travel up to 30 miles in order to receive care. Dr Makani Purva, chief medical officer said in a statement on the trust website on Tuesday: “Staff are working incredibly hard to provide care for patients in challenging circumstances but we need people to use the full range of services available. One in four patients who attend A&E in Hull could have been treated more appropriately elsewhere, that’s around 100 patients every day. So from today, after an initial screening process, those arriving at A&E who could safely be cared for elsewhere will be referred on to one of several alternative care centres and providers. Doing so will help us to reduce waiting times for more seriously ill patients and ensure they receive the priority care they need in hospital, while enabling those patients with non-urgent needs to receive care more quickly from a suitably skilled health professional elsewhere.” Read full story. Source: The Independent, 24 August 2021
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News Article
Army supporting ambulance services in England
Patient-Safety-Learning posted a news article in News
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 -
News Article
Big surge in the most serious ambulance calls
Patient-Safety-Learning posted a news article in News
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 -
News Article
Record 1 million 999 calls made to NHS in July
Patient-Safety-Learning posted a news article in News
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 -
News Article
Ambulance services seek regional commissioning
Patient-Safety-Learning posted a news article in News
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 -
News Article
A&E queues mean Wales' ambulances 'can't take 999 calls'
Patient-Safety-Learning posted a news article in News
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 -
News Article
Woman died in Cardiff home after waiting 'hours' for ambulance
Patient-Safety-Learning posted a news article in News
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 -
News ArticleThe 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
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News Article
London Ambulance Service declares incident as 999 calls surge
Patient-Safety-Learning posted a news article in News
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 -
News Article
Ambulance trusts on 'black alert'
Patient-Safety-Learning posted a news article in News
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 -
News Article
Ambulance crews in England to get body cameras after 30% rise in assaults
Patient Safety Learning posted a news article in News
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 -
News Article
Ambulance trust reveals patient’s death amid handover delays row
Patient Safety Learning posted a news article in News
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 -
News Article
Ambulance crews in England to use iPads to assess accident and stroke victims
Patient Safety Learning posted a news article in News
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 -
Content Article
National ambulance data (to end May 2022)
Patient Safety Learning posted an article in Data and insight
Report from the Association of Ambulance Chief Executives on national ambulance data. -
Content ArticleOver the past year, delays in transferring patients from an ambulance to a hospital have risen exponentially. In April 2022 there were over 41,000 delays of over 60 minutes, up over a staggering 450 per cent in 12 months. This equates to 71,000 hours lost, with a significant risk of harm to patients, even though the proportion being taken to hospital by ambulance has fallen thanks to successful initiatives such as “hear and treat” and “see and treat”. These delays mean that, too often, ambulance crews are not able to respond to 999 calls from critically ill patients. Instead they are being held in “stacks” of hundreds each day – as ambulance control room teams strive to prioritise overstretched resources. The current reality is that crews are often waiting with patients in hospital corridors or outside, hearing urgent calls to which they are unable to respond. In addition to the direct impact on patients, this is incredibly demoralising, even traumatising, for many staff involved. So why is this happening? In an article for the Independent, Daren Mochrie, chair of AACE – the Association of Ambulance Chief Executives, and Saffron Cordrey, interim chief executive at NHS Provider, discusses what is happening in the NHS.
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Content ArticleWhen critically ill premature infants require transfer by ambulance to another hospital, they frequently require mechanical ventilation. This observational study investigated acceleration during emergency transfers and looked at whether they result from changes in ambulance speed and direction, or from vibration due to road conditions. It aimed to assess how these forces impact on performance of neonatal ventilators and on patient-ventilator interactions. The authors found that infants are exposed to significant acceleration and vibration during emergency transport. Although these forces do not interfere with overall maintenance of ventilator parameters, they make the pressure-volume loops more irregular.
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation explores issues around patient handover to emergency care. Patients who wait in ambulances at an emergency department are at potential risk of coming to harm due to deterioration or not being able to access timely and appropriate treatment. HSIB has published an interim report outlining early investigation findings, and recommends a national response to tackle this urgent issue. Findings so far emphasise that an effective response should consider the interactions of the whole system: an end-to-end approach that does not just focus on one area of healthcare and prioritises patient safety. For its reference case, the investigation looks at the case of a patient who was found unconscious at home and taken to hospital by ambulance. The patient was then held in the ambulance at the emergency department for 3 hours and 20 minutes, and during this wait their condition did not improve. They were taken directly to the intensive care unit where they remained for nine days before being transferred to a specialist centre for further treatment.
