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Found 321 results
  1. News Article
    A 58-year-old woman died alone curled up in a blanket on the floor of her bedroom as she waited more than five hours for an ambulance. Relatives of Rachel Rose Gibson believe she had a heart attack at her home in Wrexham, north Wales, only a short drive away from a hospital, but died before an ambulance reached her. The Welsh ambulance service said that on the day Gibson died, its crews spent more than 700 hours waiting outside hospitals for patients to be admitted, which meant they could not respond quickly to people needing help. Family members said Gibson, a grandmother of seven, called an ambulance at 4pm on 5 April as she was coughing up blood and in chronic pain. By the time an ambulance arrived at 9.30pm, she had died. Her daughter, Nikita, 29, said: “She was lying on the floor curled up in a blanket. It haunts me to know she died alone in so much pain. “I feel like I can’t fully grieve because I’m so angry. She only lives five minutes away from the hospital, but must have been in too much pain to get into a taxi.” Read full story Source: The Guardian, 22 May 2023
  2. News Article
    Ambulance chiefs have warned a controversial piece of legislation could lead to legal action against their trusts by patients denied an ambulance. The Strikes (Minimum Service Levels) Bill, which is currently going through Parliament, would enable the health and social care secretary to set minimum levels of staffing for ambulance call centres and crews. Employers would be able to issue “work notices” compelling staff to provide cover during any strike. But, in its response to the government consultation on how the system would work, the Association of Ambulance Chief Executives has said it does not support the legislation in its current form as it does not believe it will deliver an improvement for patients, or offer a practical means of delivering minimum service levels. It said the proposed legislation appears to pass responsibility for the service levels to employers, which could leave them “exposed to patient liability risks to a greater extent than before”. Read full story (paywalled) Source: HSJ, 22 May 2023
  3. News Article
    Experts are calling for "do not resuscitate" orders to be scrapped, saying they are being misused and putting people's lives at risk. One woman told BBC News that her elderly father might still be alive if the DNR in his medical file had been properly checked. When Robert Murray began choking on a piece of fruit at breakfast, staff at his care home called 999. He'd stopped breathing and the ambulance service operator immediately sent paramedics to attend. But seconds later, the care home told the dispatcher that the 80-year-old had a do not resuscitate form (DNR) in his medical records. The paramedics were stood down. Mr Murray died minutes later. However, it was all a terrible mistake. It hadn't been made clear to the ambulance service that Mr Murray was choking - the DNR was only meant to apply should he have a cardiac arrest. Mr Murray's death, at a nursing home in Eastbourne in June 2021, is an example of what experts call "mission creep" in the use of DNR - also known as DNACPR (Do Not Attempt Cardiac Pulmonary Resuscitation) - decisions. Researchers from Essex University say some care home residents are "being inappropriately denied transfer to hospital or access to certain medicines" due to the recommendations. Read full story Source: BBC News, 16 May 2023
  4. Content Article
    This is the first national ambulance volunteering strategy, produced by the Association of Ambulance Chief Executives. It recognises the important role volunteers play in the ambulance service and outlines a national approach to volunteering that will be adopted between January 2023 and May 2024. The strategy covers mission, vision, principles and measures of success.
  5. Content Article
    This white paper from CEMBooks aims to unpick some of the deeper issues surrounding bed block and emergency department crowding from the perspective of a frontline medic with two decades of emergency and flow management experience. It aims to provide a greater understanding of the factors influencing the current situation and the measures used to define it followed by some practical implementable solutions.
  6. News Article
    The number of new ambulances in England will be far less than the hundreds promised by the government, a Freedom of Information request has revealed. In January, 800 new ambulances were announced, with a 10% fleet increase. But vehicles being ordered by trusts are mostly replacements they were prevented from purchasing because of procurement changes and the pandemic. In response to a written question in February, DHSC said the "over 800 new ambulances" advertised equated to about 350 extra vehicles, plus 100 mental health ambulances. However, the FOI responses from England's ambulance trusts suggest the number of extra vehicles will be far fewer. Read full story Source: BBC News, 4 April 2023
  7. News Article
    According to the South West Ambulance Service Foundation Trust, 104 patient deaths reviewed under National Quality Board guidelines in quarter three of 2022-23 related to delays “which are thought to be a result of pressures within the wider health system”. The trust has stressed the deaths were not necessarily directly caused by delays, but that delays were a “common factor” in the 104 cases. Since July 2019, all ambulance trusts have been required to implement Learning from Deaths reviews following a report by the Care Quality Commission three years earlier, which found that opportunities were being missed to learn from patient deaths. A total of 876 incidents were identified as being within the scope of a review at the end of last year by SWASFT, of which 210 were reviewed. Deaths included in the review occurred while the patient is under the care of the ambulance service, from the initial 999 call being made to their care being transferred to another part of the system or to the point where a decision is made not to convey them to hospital. Read full story (paywalled) Source: HSJ, 4 April 2023
  8. News Article
    An ambulance trust that was the subject of a documentary involving covert filming by an employee has warned staff they could be subject to ‘disciplinary action and even prosecution’ if they take this type of action. East of England Ambulance Service Trust sent an all staff email yesterday outlining the potential consequences of filming covertly and reminding staff they must adhere to the trust’s social media and digital guidelines. The email, seen by HSJ, followed Channel 4 broadcasting a documentary called Undercover ambulance: NHS Chaos – Dispatches which featured footage filmed covertly by one of the trust’s apprentice emergency technicians, and laid bare the extreme pressures on hospital and ambulance staff. The message sent on Thursday by the trust’s interim officer Melissa Dowdeswell, said the apprentice who carried out the filming had since resigned and then set out what support staff could access from the trust if they had been affected by “an incredibly difficult couple of weeks”. Read full story (paywalled) Source: HSJ, 17 March 2023
  9. News Article
    A chief executive has apologised after a survey of his trust’s staff from minority ethnic backgrounds found many had been subjected to racist behaviour by colleagues. The staff at East of England Ambulance Service Trust said peers had made monkey noises and referred to banana boats in front of them, excluded them from social events, and assumed they could speak Middle Eastern and Asian languages just because of their skin colour, they told researchers. The trust has had substantial cultural problems for several years, and commissioned the survey to “better understand the experience, perceptions and realities of the trust BME staff”, a board paper said. The report on its findings, published this week in trust board papers, warns: “There are risks that a minority of EEAST employees are demonstrating behaviours or using language which could be perceived as racist. Reports of subsequent inaction by managers further risk this behaviour being normalised.” Read full story (paywalled) Source: HSJ, 15 March 2023
  10. News Article
    More than 500 seriously ill patients died last year before they could get treatment in hospital after the ambulance they called for took up to 15 hours to reach them, an investigation by the Guardian reveals. The fatalities included people who had had a stroke or heart attack or whose breathing had suddenly collapsed, or who had been involved in a road traffic collision. In every case, an ambulance crew took much longer to arrive than the NHS target times for responding to an emergency. Bereaved relatives have spoken of how the pain of losing a loved one has been compounded by the ambulance crew having taken so long to arrive and start treatment. Coroners, senior doctors and ambulance staff say the scale of the loss of life illustrates the growing dangers to patients from the implosion of NHS urgent and emergency care services. “These 500-plus deaths a year when an ambulance hasn’t got there in time are tragic and avoidable,” said Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, which represents A&E doctors. “These numbers are deeply concerning. This is the equivalent of multiple airliners crashing.” Read full story Source: The Guardian, 9 March 2023
  11. Content Article
    In this Channel 4 Dispatches programme, secret footage filmed over the winter reveals ambulance workers battling the odds and A&E departments overwhelmed as patients suffer needless harm and death The footage comes from Daniel Waterhouse, an emergency medical technician who wore a body-mounted camera during his shifts in north-west London for three months this winter, filming every crumbling layer of a system that is close to total destruction.
  12. News Article
    The crisis in the NHS is leading to continued higher-than-usual death levels in England and Wales, experts have said. Figures from the Office for National Statistics reveal that almost 170,000 more people than normal died in England and Wales between March 2020, when coronavirus was declared a pandemic, and the end of 2022 – 11% higher than the five-year average. However, the new data also shows that the number of excess deaths has continued, even as the virus’s fatality rate has declined thanks to vaccinations and weaker strains, with 90% of the excess deaths in 2022 occurring in the second half of the year, coinciding with recent NHS pressures and the impact of a cold winter. Prof David Spiegelhalter of Cambridge University said that “analyses have suggested that delays in ambulance arrivals and in A&E will have had a substantial impact, as well as the cold weather and the early flu season”. Read full story Source: The Guardian, 9 March 2023
  13. News Article
    In posts on two Facebook forums, GP Survival and Resilient GP, family doctors write anonymously, revealing their concerns about how hard they sometimes find it to get an ambulance to attend to a sick patient – and the risks that can pose. “I ended up in the back of a police car with sirens going with a stranger who’d had a probable stroke on the street. Category 2 ambulance hadn’t come after 45 minutes so flagged down a cop car. They bundled us in. “Emergency department full of waiting ambulances unable to unload and I eventually left him in the very capable hands of the stroke team. Terrifying how broken our system is and how many people had likely just walked past him before I spotted him from my car." “Our emergency care practitioner called an ambulance at 6pm on Wednesday 6 July. Very elderly gentleman. Off legs, urinary symptoms, not eating/drinking. Guess when crew arrived? This morning, Friday 8 July, around 10am – 40 hours [later]. And the ECP had to wait 35 minutes just for 999 call to be answered!” “I recently complained [to the local ambulance service] for first time ever when ambulance refused to take a very sick patient of mine into hospital that I’d assessed over the phone because ‘her obs are normal’. They weren’t but even if they had been the reliance on these alone, ignoring the medical background, the family history and my history was just wrong. “I then had to go out and see her, re-call 999 (with many hours additional delay) and she died after a few days in hospital.” Read full story Source: The Guardian, 9 March 2023
  14. News Article
    More than half of ambulance workers have seen a patient die because of a delay in reaching them after a 999 call or overcrowding in A&E, a new survey has found. The findings, from a survey of frontline paramedics and other ambulance staff, are another stark illustration of the patient safety risks created by the crisis in NHS urgent and emergency care. “These findings are utterly terrifying,” said Rachel Harrison, the national secretary of the GMB union, which sought the views of more than 1,200 members working in NHS ambulance services in England and Wales. It asked them if they had ever witnessed a death that had occurred because of a delay involving an ambulance or other part of the care system. Just over half (53%) said they had done so and another 30% were aware of it happening with a colleague. The findings are disclosed in a Channel 4 Dispatches documentary being shown this Thursday about how long delays in ambulance crews handing over patients to A&E staff, and thus being unable to respond quickly to 999 calls, are affecting both patients and staff. “The delay and dilation of care that we see is just unconscionable,” Dr Adrian Boyle, the president of the Royal College of Emergency Medicine, told the programme. Read full story Source: The Guardian, 6 March 2023
  15. News Article
    An NHS whistleblower has sacrificed his career to capture on hidden camera the brutal reality of working in an ambulance service. After watching yet another patient die needlessly in the back of his ambulance, Daniel Waterhouse became a whistleblower. That decision would end his career with the NHS at the age of only 30. Waterhouse, from Finchley, north London, said his decision to go undercover for a Channel 4 Dispatches programme to be broadcast on Thursday was not easy. “I thought about it for quite a while,” said Waterhouse, an emergency medical technician who wore hidden cameras and microphones while on shift for the East of England Ambulance Service. “It was a moral choice, and there’s a caveat to that as well, because going undercover in those situations could be considered immoral and will draw criticism I’m sure. “But I think patient safety outweighs that, and those occasions were so strong in my head that I thought, ‘If only some change can happen, where some people don’t have to go through that and die or suffer permanent disability, then it would be worth it’.” Read full story (paywalled) Source: The Times, 3 March 2023
  16. News Article
    Ambulance chiefs have warned of a ‘significant escalation’ in the strike action being planned by unions next week – saying the flexibilities that helped deal with previous walk-outs will no longer be available. In a letter to local NHS leaders, seen by HSJ, North West Ambulance Service said unions are “becoming more stringent in their approach”, and the trust’s ability to respond to incidents will be severely weakened. For the last day of strike action in February, the GMB union told NWAS it was abandoning exemptions (derogations) for category 2 calls, which include heart attacks and strokes. The NWAS letter, sent yesterday, said the Unite union also now intends to take this approach on 6 March. Last month the head of the London Ambulance Service said the reduced level of service in the capital “causes harm to our patients” Read full story (paywalled) Source: HSJ, 2 March 2023
  17. Content Article
    Emergency care services in the UK face an unparalleled crisis, with more patients than ever before experiencing extremely long waiting times in Emergency Departments (EDs), associated with patient harm and excess deaths. This explainer from the Royal College of Emergency Medicine (RCEM) outlines the latest data on ED waiting times and the impact this is having on patient safety.
  18. Content Article
    With the NHS often characterised as being trapped in a permacrisis, what can be done to shift the dial? In this NHS Confederation podcast, Daniel Elkeles, chief executive of the London Ambulance Service NHS Trust, talks about improvements in the urgent and emergency care pathway, shifting the narrative on primary care and busting the barriers holding the health and care system back. With industrial action taking a toll, Daniel, who leads the world’s largest ambulance service, sheds light on the untold impact of strikes, the effect on long-term innovation and recovery and why culture change in the ambulance service is top of his mission list.
  19. Content Article
    The Healthcare Safety Investigation Branch (HSIB) have published a third interim report for this investigation which focuses on staff wellbeing across the urgent and emergency care systems and the impact that this has on patient safety.
  20. News Article
    NHS Ambulance service have a “fear of speaking up” amid pervasive “cliquey”, sexist, racist and homophobic cultures, a watchdog has warned. A national guardian has warned of negative cultures in trusts preventing workers from raising concerns as she called for a “cultural review” of ambulance organisations. The review into whistleblower concerns, by the Freedom to Speak Up Guardian’s office, has found widespread cultural issues including clique-like behaviour and bullying and harassment. Dr Jayne Chidgey-Clark, the NHS National Freedom to Speak Up Guardian, has now called on ministers and the NHS to independently review ambulance services, after speaking with ambulance staff across five NHS trusts. The report has called for a cultural review of the ambulance service by NHS England, the Care Quality Commission, the Association of Ambulance Chief Executives and ministers. Read full story Source: The Independent, 24 February 2023
  21. Content Article
    The National Guardian’s Office has published Listening to Workers – the report following its Speak Up review of NHS ambulance trusts in England. The review found the culture in ambulance trusts did not support workers to speak up and that this was having an impact on worker wellbeing and ultimately patient safety.
  22. News Article
    The London Ambulance Service (LAS) failing on diversity and must implement specific targets for improvements, its leadership has been warned. According to LAS data, just 20% of the workforce is from a Black, Asian or from a minority ethnic background despite almost half of the capital’s population (46.2%) being made up of non-white communities. Of that 20%, 40.9% are in the lowest paid roles, compared to 15.9% who are in the highest wage bands, according to the LAS’ Integrated Performance report. The LAS is in the process of developing a new strategy to help attract more diverse staff, which will be published early next year. Research shows that ethnic minority groups suffer disproportionately higher levels of inadequate ambulance care due to a combination of issues such as a lack of cultural awareness among professionals, language and communication difficulties and a limited understanding of how the healthcare system operates for some minority groups. Read full story Source: The Independent, 21 February 2023
  23. Content Article
    A BBC Newsnight investigation hears devastating evidence and testimony of ambulance failings in the north east of England. What does it take to run a safe service that patients can trust? 
  24. News Article
    Thousands of severely disabled children's lives are at risk because of long waits for ambulances, doctors and other experts have warned. Emergency care is a vital part of their everyday lives, the British Academy of Childhood Disability says. Almost 100,000 children have life-limiting conditions or need regular ventilator support in the UK. They often rely on ambulances as part of their healthcare plan, because their condition can become life-threatening in an instant. Dr Toni Wolff, who chairs the British Academy of Childhood Disability, told BBC News some families with severely disabled children had "what are essentially high-dependency units" of medical equipment at home. "As part of their healthcare plan, we would normally say, 'If the child starts to deteriorate, call for an ambulance and it will be there within 10 or 20 minutes,'" she said. "Now, we can't give that reassurance." Despite their child being classed as a priority, parents have told BBC News they face the difficult decision to wait for an ambulance or take them, often in a life-threatening condition, to hospital themselves - a risk because of the huge amounts of equipment needed to keep them alive, Read full story Source: BBC News, 16 February 2023
  25. News Article
    A new way of screening ambulance calls is to be introduced across England in an effort to improve response times. NHS England is asking ambulance crews to review which emergency calls other than those classed as immediately life threatening can be treated elsewhere. The calls - known as category two - include emergencies such as heart attacks and strokes. But the category also covers some that may not need such a fast response, such as burns and severe headaches. About 40% of these lower priority calls classed as category two by call handlers will now receive callbacks from a doctor, nurse or paramedic to see whether there is an alternative to sending an ambulance. In trials in London and across the West Midlands, nearly half of those receiving a callback were advised to go instead to an urgent treatment clinic, their GP or a pharmacist. NHS England is now asking the other eight ambulance services in England to adopt the approach. Read full story Source: BBC News, 16 February 2023
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