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Found 321 results
  1. News Article
    Ambulance staff are being urged to conserve oxygen supplies because of a national shortage of small cylinders used both on ambulances and in some A&E departments. South East Coast Ambulance Service Foundation Trust has told staff the shortage is caused by the high number of patients with respiratory conditions and “the suppliers are reporting that this is higher than during the first wave of the covid pandemic”. In a message to staff last week, East of England Ambulance Service Trust said: “Oxygen suppliers, including BOC, are currently unable to supply sufficient numbers [of small cylinders] to fulfil our orders. “This has been escalated nationally and NHS Procurement are working to support ambulance trusts with supplies.” But it added that over the next few days it would need to “carefully manage” supplies. The type of cylinder affected typically provides about 30 minutes of oxygen on full flow and is widely used on ambulances and also where patients are cohorted in accident and emergency departments or kept in corridors waiting to be passed to hospitals, without access to the normal piped supply. Many ambulances will carry several smaller cylinders, and sometimes they also carry one larger one. However, if a patient requiring oxygen can’t be handed over quickly at A&E, ambulance supplies may start to run low. Read full story (paywalled) Source: HSJ, 30 December 2022
  2. News Article
    Ambulance staff in five areas of England are to stage two further strikes in January, union leaders say. The industrial action on 11 and 23 January is likely to heap more pressure on emergency care, which is already under serious strain. Health Secretary Steve Barclay said further strike action was in no one's best interest. Unison leaders say the action is a direct result of the government's refusal to negotiate over pay. Life-threatening calls to 999, as well as the most serious emergency calls, will still be responded to, they say. Services in London, Yorkshire, the North West, North East and South West will take action over pay and staffing. The January strikes will each last for 24 hours from midnight, Unison says, and will involve all ambulance employees - not just 999 response crews. Read full story Source: BBC News, 22 December 2022
  3. News Article
    The NHS entered the last six hours of the ambulance strike with a sense that the real test will be seen in the coming days. Call volumes were down and many A&Es quieter than in previous days. NHS111 was very busy. Despite the fears expressed by leaders ahead of the strike not yet coming to fruition, the day ended with eight integrated care systems declaring critical incidents, along with all striking ambulance trusts and a number of hospital trusts. Leaders across the country told HSJ they feared that those who stayed away today in response to pleas for “common sense” amid industrial action may come back tomorrow, seeing demand return strongly. A senior London source said: “The ambulances will have stacked some calls and we may have a flood of movement tomorrow.” Read full story (paywalled) Source: HSJ, 21 December 2022
  4. News Article
    Ambulance unions have reacted with anger after the health secretary said they had "taken a conscious choice to inflict harm on patients". Steve Barclay said unions had refused to work with the government at a national level on how they would cover emergency calls during strike action. Unison said it was "utterly shocked" by the comments, while the GMB union said they were "insulting". Paramedics are among those striking in England and Wales on Wednesday. Control room staff and support workers who are members of the Unison, GMB and Unite unions are also involved. NHS bosses are warning patient safety cannot be guaranteed during the action, although unions say life-threatening callouts will still be responded to by an ambulance. They also argue patients are already being put at risk due to waiting times and the pressure on the health service, made worse by staff shortages. Read full story Source: BBC News, 21 December 2022
  5. News Article
    The risk to patients will only get worse unless the government reaches an agreement to prevent further strikes, NHS leaders have warned. In a letter to the prime minister and health secretary, they said there was "deep worry" about today's strike. People are being asked to only call 999 in a life-threatening emergency, but NHS England says emergency care will continue to be provided. Ambulance response times are already twice as long as two years ago. The letter, signed by the leaders of NHS Confederation and NHS Providers, says the action being taken by ambulance workers "isn't just about pay but working conditions: many have said they are doing this because they no longer feel able to provide the level of care that their patients need and deserve." They urged ministers to "do all you can to bring about an agreed solution". Health Secretary Steve Barclay said the pay deal on offer to both ambulance staff and nurses had been agreed by an independent pay review body. In England, eight out of the 10 major ambulance services have declared critical incidents - a sign of the intense pressure they are already under. Ministers have urged the public to take extra care and suggested they avoid contact sports and unnecessary car journeys. Read full story Source: The Guardian, 21 December 2022
  6. News Article
    The Welsh ambulance service has apologised after a 93-year-old woman was left “screaming in pain” while lying on the floor with a broken hip during a 25-hour ambulance wait. Elizabeth Davies fell at her care home on Saturday and was finally picked up at 1.15pm on Sunday and admitted to Ysbyty Gwynedd hospital in Bangor on Monday, where she endured another 12-hour wait before being admitted to a ward. A hip fracture was later confirmed in surgery. Her family have said the incident, which occurred before a 24-hour strike on Wednesday by ambulance workers, was “unacceptable”. Her son, Ian Davies, from Pwllheli, said: “It was very upsetting to have to see her lying on the floor screaming in pain for over 24 hours.” After her injury, staff at the care home, where Davies has lived for 17 years, are understood to have propped a pillow under her head and tried to make her comfortable on the wooden floor, using a small heater to keep her warm in case she went into shock, as well as providing an absorbent pad so she could urinate. Her son, a community care worker, said: “They called for an ambulance but were advised an ambulance wouldn’t be available for six to eight hours as they were so busy. “They said my mother would be a priority because of her age. The care home then called us and we came immediately. “I don’t blame the ambulance staff because they are told what jobs to do and my mother wasn’t on the list.” It is understood the care home made nine calls, with a 10th made by Ian Davies. Read full story Source: The Guardian, 20 December 2022
  7. News Article
    Health minister Will Quince has warned the public to avoid any “risky activities” on Wednesday as ambulance drivers stage strike action. The NHS is set to be hit by major disruption as ambulance workers including paramedics, control room workers and technicians walk out in England and Wales. During the strike, the military will not drive ambulances on blue lights for the most serious calls but are expected to provide support on other calls. Mr Quince urged the public to avoid anything risky on Wednesday, telling BBC Breakfast: “Where people are planning any risky activity, I would strongly encourage them not to do so because there will be disruption on the day.” The health minister did not offer examples of what might be defined as risky behaviour but told the public that in any emergency calling 999 should still be the first option. Read full story Source: The Independent, 20 December 2022
  8. News Article
    Nine ambulance trusts in England and Wales are expected to be affected by industrial action on Wednesday, coordinated by the GMB, Unison and Unite unions. The ambulance strikes will involve paramedics as well as control-room staff and support workers. The threat to patient safety on Wednesday will be exceptional. Under trade union laws, life-preserving care must be provided during the strikes. But there remains a lack of clarity about what will be offered. Even at this late stage, NHS leaders say negotiations are continuing between unions and ambulance services to agree which incidents will be exempt from strike action. All category 1 calls – the most life-threatening cases – will be responded to, while some ambulance trusts have agreed exemptions with unions for specific incidents within category 2 calls. However, in some cases, elderly people who fall during the strikes may not be sent help until they have spent several hours on the floor. Heart attack and stroke patients may get an ambulance only if treatment is deemed “time critical”. There is no doubt that many of those patients making 999 calls on Wednesday will not get the care they need. Some will probably die as a result. NHS leaders believe Wednesday’s strike will present a completely different magnitude of risk. Quite simply, patients not getting emergency treatment quickly enough can mean the difference between life and death. Read full story Source: The Guardian, 19 December 2022
  9. News Article
    Patients should “make their own way to hospital” if they can do so during Wednesday’s strike by ambulance workers, a cabinet minister said yesterday, as the government warned that the industrial action would put lives at risk. Senior government figures said that ambulance unions had still not agreed national criteria for what conditions would be considered life threatening and responded to during the strike. Steve Barclay, the health secretary, is understood to be writing to all striking unions, including nurses, seeking discussions on patient safety. Yesterday Oliver Dowden, the Cabinet Office minister, said people should still call 999 in an emergency but might in less serious cases have to make their own way to hospital. “We are working to ensure that if you have a serious injury, in particular a life-threatening injury, you can continue to rely on the ambulance service, and we would urge people in those circumstances to dial 999,” he told Sunday with Laura Kuenssberg on BBC1. “If it is the case that you have less serious injuries, you should be in touch with 111, and you should seek to make your way to hospital on your own if you are able to do so.” Read full story (paywalled) Source: The Times, 19 December 2022
  10. Content Article
    Letter from Sir David Sloman Chief, Operating Officer NHS England, Professor Sir Stephen Powis, National Medical Director NHS England, and Dame Ruth May, Chief Nursing Officer, to ICBs and Trusts regarding the upcoming ambulance industrial action.
  11. News Article
    Unions must ensure there will be "sufficient" staffing during this week's ambulance strike to protect patients, the health secretary says. Workers in England and Wales will walk out on Wednesday in a dispute over pay, but life-threatening emergencies will be responded to. Unions say discussions were still taking place with ambulance trusts to draw up detailed plans for cover. Steve Barclay said there is a lack of clarity about what is being offered. He said it was for the unions to ensure they "meet their obligations" for emergency cover so that people in crisis get the care they need. But Unite leader Sharon Graham, whose union is co-ordinating the ambulance strikes with Unison and GMB, said Mr Barclay will "have to carry the can if patients suffer". The ambulance walkouts will involve paramedics as well as control room staff and support workers. The action by the three main ambulance unions - Unison, GMB and Unite - will affect non-life threatening calls, meaning those who suffer trips, falls or other injuries may not receive treatment. Read full story Source: BBC News, 19 December 2022
  12. News Article
    Elderly people who fall may only be sent an ambulance after they have spent four hours on the floor, and some category 2 calls may not be responded to under one of the first agreements with ambulance unions about next week’s strikes. But the deal between South East Coast Ambulance Service and the GMB union will see many union staff continue to work on ambulances and in control rooms – and others may be asked to come off the picket line if operational pressures escalate. HSJ has seen the details of the deal – thought to be one of the first agreed before next Wednesday’s strike. Some other trusts are hoping to conclude negotiations shortly, but for several — such as in the North West and London — it is thought no strike “derogations” (exceptions) have so far been agreed, and managers are concerned that unions are resistant. Trusts have been pushing for more cover on strike days – especially around category 2 calls. Read full story (paywalled) Source: HSJ, 15 December 2022
  13. News Article
    The ambulance staff strike next week represents a far higher risk to patient safety and services than the nurses’ strike, but a blanket elective ban will only be used as “an absolute last resort”, a senior NHS England director said today. However, NHSE elective recovery chief Sir Jim Mackey’s comments come despite several local leaders telling HSJ significant amounts of elective activity are likely to need to be postponed due to the ambulance staff walkout on 21 and 28 December, to free up capacity to deal with emergency care pressure. Speaking at a King’s Fund conference this morning, Sir Jim said: “The ambulance strike is a completely different order of magnitude of risk [than the nurses’ strike]. I think that’s the main thing people are worried about because of the complexity and fragility of urgent care.” However, he added: “If we were to give [national guidance on what elective activity to cancel] today, the only guidance we could give would be to cancel absolutely everything, and that’s really not going to help anybody… “I think we’ll just have to take it day-by-day and keep learning from each other and sharing intelligence… and then, if at some point, there is a case for blanket order, we’ll consider that… But, we really want to do that as an absolute last resort.” Read full story (paywalled) Source: HSJ, 15 December 2022
  14. News Article
    Medics and nurses have been urgently called upon to support London Ambulance Service during next week’s strike action, as it will otherwise have to rely on staff only able to provide ‘first aid’. The North East London primary care team has sent out a request for clinical staff working for integrated care boards to be released from duties ahead of industrial action on 21 December. Unison members are preparing to walk out, alongside thousands of other staff at nine other ambulance trusts across the country, in a dispute over pay. The letter, seen by HSJ, was sent yesterday afternoon. It said: “LAS are keen to have experienced medics and nurses, who have current urgent and emergency clinical exposure, have knowledge of how to navigate the system and can operate as a senior clinical decision maker. Medical Practitioners would ideally be from general practice and emergency medicine. “Advanced Paramedics and Advanced Care Practitioners with urgent care or IUC CAS experience are also required. A knowledge of ambulance services is preferred as it removes the need to learn very quickly the significant differences in ambulance services and LAS control rooms." Read full story (paywalled) Source: HSJ, 13 December 2022
  15. News Article
    All ambulance services have declared the highest level of alert due to ‘extreme pressures’ facing the urgent and emergency care system. One senior ambulance chief told HSJ that ambulance response times have dropped dramatically in the last few days, while A&E handover delays have surged. They said: “The wheels are falling off [the emergency care system] now, we’re in a really awful situation.” They said ambulance leaders have major concerns about the planned strike action by nurses on Thursday, fearing this will exacerbate discharge delays and have a knock-on effect on ambulance handover problems. It also comes ahead of strike action planned by ambulance staff for next week. HSJ has seen internal communications which confirm all ten ambulance trusts in England are now in level four of their “resource escalation action plan”, which means they can seek assistance from other nearby trusts or services. However, this is more difficult when an entire sector is under pressure, as is the case currently. Read full story (paywalled) Source: HSJ, 13 December 2022
  16. News Article
    The Royal College of Midwives (RCM) has not met thresholds required to strike in its vote, it announced today, but physiotherapy staff are set to strike at more than 100 trusts in their first ever action ballot over pay. The trade union announced this afternoon that its ballot had not reached the turnout required to take strike action. 88& of those who voted said they supported strike action, but only about 47% of eligible members voted. Law requires a turnout of at least 50%, the RCM said. It comes as nurses prepare to take industrial action on 15 and 20 December, over pay and safety concerns, with ambulance staff across the GMB Union, Unison and Unite set to walk out on 21 December (and GMB also on 28 December). Read full story (paywalled) Source: HSJ, 13 December 2022
  17. News Article
    Bosses at the North West Ambulance Service issued an urgent warning to members of the public on 999 calls and apologised for delays last night. At 5pm on Monday (December 12), more than 600 patients were waiting for an ambulance across the North West, the service said. Another 100 emergency vehicles were parked outside of hospitals waiting to handover patients. 'Severe weather and hospital handover delays' had an impact on the service last night, as well as 'significant demand'. Ambulance chiefs said they had to 'maximise resources' by putting all clinically-trained staff on the frontline and increasing use of private providers. In an urgent message issued on Monday night, medical director Dr Chris Grant said: "This is an urgent message for the public across the whole of the North West. Tonight, across both our 111 and 999 services, we're seeing a really significant demand and I apologise for the delay in getting care to you but I do need your help. "We've called in all our operational and clinical resources to make sure we prioritise those who have the most life-threatening conditions. We need to keep our phone lines free so please only call us back if you no longer need our help or if your own condition has got significantly worse. Thanks for your support." Ged Blezard, director of operations at NWAS said: "Please only call 999 if someone has a serious illness or injury, you think their life is at risk, and you cannot get them to hospital by any other means. We know there are patients waiting for our help and we are sorry that we are unable to respond as quickly as we would like. Read full story Source: Manchester Evening News, 13 December 2022
  18. News Article
    A man who had broken his hip was taken to hospital strapped to a plank in the back of a van after his granddaughter was told no ambulances were available. Nicole Lea found Melvyn Ryan behind the door of his home after he pressed an emergency call button around his neck. When she got there she discovered the 89-year-old also had a broken shoulder. She said she went to grandfather-of-eight Mr Ryan's home, in Cwmbran, Torfaen, after being contacted just after midnight on Friday. She said: "I didn't waste any time in calling 999 and gave them my details. And they turned around and said they were unable to send anyone, there wasn't any help to send and that I'd have to find a way of getting him there myself." The call handler advised her to call the out-of-hours GP before saying she had to go to deal with other calls. She did not call the GP as she thought it would be a waste of time. "With my partner and my mum's help we managed to come up with the idea of getting him onto a plank of wood and into the back of my partner's van to get him up to hospital," Ms Lea said. "Mr Ryan has had what sounds like the most appalling of experience," said Dr Iona Collins, chairwoman of the British Medical Association (BMA) Cymru. "How must the ambulance service feel when they are getting calls like this? Obvious its an emergency and they need help and they are unable to help," she told Radio Wales Breakfast. Read full story Source: BBC News, 12 December 2022
  19. Content Article
    This report by The Patient Experience Library looks at patient experience in urgent and emergency care (UEC), reviewing four years' worth of studies from sources including government bodies, policy think tanks, academic institutions and the local Healthwatch network.
  20. News Article
    Ambulance staff across most of England and Wales will go on strike on 21 December in a dispute over pay. The coordinated walkout by the three main ambulance unions - Unison, GMB and Unite - will affect non-life threatening calls only. But it could mean people who have had trips and falls not being responded to. Members of GMB, which represents nearly a third of the 50,000-strong workforce, will then follow that up with another walkout on 28 December. It comes as Royal College of Nursing members are also preparing to go on strike on 15 and 20 December in parts of England, Wales and Northern Ireland. The walkouts will involve paramedics as well as control room staff and support workers, with the military on standby to help out. The only service which will be completely unaffected, however, is the East of England. Under trade union rules, life-preserving care has to be provided so the two highest category calls - covering everything from heart attacks and strokes to major trauma - will still be responded to. But Matthew Taylor, of the NHS Confederation, which represents health managers, said he was worried the action would "undoubtedly" affect patient care and how quickly ambulance services could respond and may even deter people from seeking help. "The prospect of industrial action over Christmas is very concerning," he added. Read full story Source: BBC News, 6 December 2022
  21. News Article
    When 85-year-old Koulla fell at home, her family immediately rang for an ambulance. She was in agonising pain - she had broken her hip. It was around 8pm. It took another 14 hours for an ambulance to get to her, leaving her pregnant granddaughter to care for her through the night. When they arrived the crews were able to give her pain relief and quickly transported her to the Royal Cornwall Hospital. But there the wait continued - there were around 30 ambulances queuing to handover patients to A&E staff. It was another 26 hours before she was taken inside to A&E. She then faced many hours in A&E before being taken for surgery. Koulla's daughter, Marianna Flint, 53, said: "It was awful. You feel helpless because you're giving your trust over to them to look after a family member who's in agony and who needs surgery." She has since received a written apology from the Royal Cornwall for the care provided to her mother in August. Ms Flint said: "I almost feel sorry for those looking after her. It's not down to them. There was no room inside to accept her in." Read full story Source: BBC News, 1 December 2022
  22. News Article
    Ambulance services across England are set to go on strike before Christmas as thousands of paramedics and call handlers voted for action. The announcement by union Unison comes as the Royal College of Nursing (RCN) confirmed 100,000 nurses across England, Wales and Northern Ireland will walk out on 15 and 20 December. The union is calling for action on pay and a big increase in staff numbers, warning that unless these things happen, services will continue to decline. Saffron Cordery, interim chief of NHS Providers, said on BBC radio four: “I think in terms of the ambulance strike, we know the challenges already of not having enough paramedics, call handlers available, because we’ve seen the challenges to ambulance handover times that we have at the moment in terms of not being able to transfer patients from ambulances into A&E departments and the challenges that brings when they can’t get back out on the road. “Additional challenges on top of that, I think, will make response times incredibly stretched.” Sources told The Independent that one option could be for services to maintain levels of staff to be able to respond to the most serious calls - category one and two calls - and deprioritise the less serious category three and four calls. This has previously been negotiated during smaller-scale strikes. However, senior sources suggested that on a larger scale it would be hard to not respond to category three calls, which might include an older person who has fallen. It is also unclear how 999 call centres would operate during strikes as this work would likely count as life-saving emergency care, The Independent understands. Read full story Source: The Independent, 2 December 2022
  23. News Article
    More than 11,000 ambulances a week are caught in queues of at least an hour outside A&E units in England, a BBC News analysis shows. The total - the highest since records began, in 2010 - means one in seven crews faced delays on this scale by late November. Paramedics warned the problems were causing patients severe harm. One family told BBC News an 85-year-old woman with a broken hip had waited 40 hours before a hospital admission. She waited an "agonising" 14 hours for the ambulance to arrive and then 26 in the ambulance outside hospital. When finally admitted, to the Royal Cornwall Hospital, which has apologised for her care, she had surgery. Both ambulance response times and A&E waits have hit their worst levels on record in all parts of the UK in recent months. In Cornwall, patients facing emergencies such as heart attacks and strokes are now waiting more than two hours on average for an ambulance. The target is 18 minutes. They are thought to be among the worst delays in the country but none of England's ambulance services is close to the target, while Wales, Scotland and Northern Ireland are all missing their targets. Read full story Source: BBC News, 1 December 2022
  24. News Article
    Some of the country’s GP are advising patients requiring urgent hospital care to “get an Uber” or use a relative’s car because of the worst ever delays in the ambulance service in England. Patients with breathing difficulties and other potentially serious conditions are being told in some cases that they are likely to be transferred more quickly from a general practice to accident and emergency if they travel by cab or private vehicle. NHS England data shows that October’s average ambulance response times for category 1 to 3 emergencies, which cover all urgent conditions, appear to be the highest since the categories were introduced nationally in 2017. Some patients who require emergency treatment may have to wait several hours for an ambulance to arrive. Dr Selvaseelan Selvarajah, a GP partner in east London, said: “If somebody is not having a heart attack or a stroke, my default advice is ‘have you got someone who can drive you or do you want to get an Uber?’ “These are patients who may have breathing difficulty or are suffering severe abdominal pain, but their life is not in immediate danger.” He said such patients would have previously been transferred by ambulance. Read full story Source: The Guardian, 27 November 2022
  25. News Article
    The NHS in England is facing a “perfect winter storm” with 10 times more people in hospital with flu than this time last year, and ambulances experiencing deadly delays when arriving at A&E with sick patients. There were an average of 344 patients a day in hospitals in England with flu last week, more than 10 times the number at the beginning of last December. And as many as 3 in 10 patients arriving at hospitals by ambulance are waiting at least 30 minutes to be handed over to A&E teams. Health chiefs say the crisis is leading to deaths. The figures on flu and ambulance delays were published by NHS England on Thursday and offered the first weekly snapshot of how hospitals are performing this season. Matthew Taylor, the chief executive of the NHS Confederation, which represents the healthcare system in England, said: “These figures really hammer home just how stretched services already are as we head into a perfect winter storm. Significantly higher numbers of people are in hospital because of flu compared to this time last year, coupled with the fact that Covid-19 has not gone away.” He added: “The life-saving safety net that NHS ambulance services provide is being severely compromised by these unnecessary delays, and patients are dying and coming to harm as a result on a daily basis.” Read full story Source: The Guardian, 24 November 2022
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