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Found 316 results
  1. News Article
    The British Red Cross have found that that 367,000 people, which equates to around one percent of the population in England attend A&E up to 346 times a year. These figures accounted for nearly one in three ambulance call outs and over one in six A&E visits. The research analysis found that a fifth of those repeatedly attending A&E lived alone and also often lived in deprived areas of the country. Frequent users also accounted for 29% of all ambulance call outs and 16% of non-minor-injury A&E visits. The data also revealed that people in their twenties were more likely to repeatedly visit A&E than any other age category. Mike Adamson, chief executive of the British Red Cross, said: 'High intensity use of A&E is closely associated with deprivation and inequalities - if you overlay a map of frequent A&E use and a map of deprivation, they're essentially the same.' Read full story Source: National Health Executive, 29 November 2021
  2. News Article
    Ambulance handover delays could harm 160,000 patients a year, 12,000 of them severely, according to a structured clinical review of cases by service bosses earlier this year. The Association of Ambulance Chief Executives examined a sample of 470 cases where handover to A&E was delayed for an hour or more on 4 January this year. The review, whose findings were shared with HSJ, involved every mainland ambulance service in England. It found that 85% of those who waited more than an hour suffered potential harm, with nine per cent potentially severely harmed. Extrapolated across an entire year, using levels of delays up to September 2021, this suggests 160,000 patients are potentially harmed annually. Patients who waited the longest for handover were at greatest risk of some level of harm, and the risk of severe harm more than tripled for those waiting more than four hours compared with those waiting for 60 to 90 minutes. Read full story Source: HSJ, 14 November 2021
  3. News Article
    A loophole in the law is leaving vulnerable patients at risk of abuse and sexual assault by unregulated private ambulance staff, The Independent has revealed. While many private ambulance providers are regulated, a small number, such as those providing services at events, those providing first aid, and those who are subcontracted, fall outside the reach of the Care Quality Commission (CQC). This is due to a loophole in the legislation, which means that organisations providing healthcare at events are not required to be CQC registered. The Independent has learned that around 10,000 patients a day are seen by ambulance workers who are unregulated and not part of any registered professional body. Alan Howson, chief executive of the Independent Ambulance Association, said he was concerned about healthcare providers that “operate outside of the scope” of the care watchdog and in “plain sight and unchecked”, leaving patients at risk from staff who might “seek to misuse their power”. His concerns were in response to an internal report by the CQC, completed last year, which identified specific risks around sexual harm in relation to private providers, as well as “inconsistency” in providers’ recording of incidents. Read full story Source: The Independent, 14 November 2021
  4. News Article
    People are dying in the back of ambulances and up to 160,000 more a year are coming to harm because they are stuck outside hospitals unable to be offloaded to A&E, a bombshell report has revealed. Patients are also dying soon after finally getting admitted to hospital after spending long periods in the back of an ambulance, while others still in their own homes are not being saved because paramedics are trapped at A&E and unable to answer 999 calls, said the report by NHS ambulance service bosses in England. In addition, about 12,000 of the 160,000 are suffering “severe harm” such as a permanent setback to their health. These include people with life-threatening health emergencies such as chest pains, sepsis, heart problems, epilepsy and COVID-19 because growing numbers of paramedics are having to wait increasingly long times to hand over a patient to A&E staff. Labour and the Liberal Democrats said the “staggering” extent of damage to patients’ health underlined the risks posed by the deepening crisis facing NHS ambulance services. The report, seen by the Guardian, has been drawn up by the Association of Ambulance Chief Executives (AACE) and is based on official NHS figures, which until now were secret. AACE represents the chief executives of England’s 10 regional ambulance services, all of which have had to declare an alert in recent months after being faced with unprecedented demands for help. It concludes that: “When very sick patients arrive at hospital and then have to wait an excessive time for handover to emergency department clinicians to receive assessment and definitive care, it is entirely predictable and almost inevitable that some level of harm will arise. “This may take the form of a deteriorating medical or physical condition, or distress and anxiety, potentially affecting the outcome for patients and definitely creating a poor patient experience.” Read full story Source: The Guardian, 14 November 2021
  5. News Article
    Lives are at risk because patients are facing unacceptably long waits for a 999 response, paramedics across the UK have told a BBC investigation. Average waits for emergency callouts for problems such as heart attacks and strokes are taking more than twice as long as they should in England. Targets are being missed in the rest of UK too, with some seriously-ill waiting up to nine hours for an ambulance. There are numerous investigations ongoing into deaths linked to delays. The problems have forced all ambulance services to be put on their highest levels of alert - meaning patients who can make their own way to hospital are told to do so. A number of services have also brought in the military to support crews. The BBC has received reports of numerous serious incidents across the UK. Margaret Root, 82, waited nearly six hours for an ambulance to come following a stroke, and she then waited for another three hours outside hospital. When she was finally admitted, her family was told it was too late to give her the drugs needed to reverse the effects of the stroke. Her granddaughter Christina White-Smith said her grandmother had been "hugely let down". She said she did not blame the staff because they were "amazing" when they got to her grandmother, but said she is angry the NHS is not getting the help it needs. "I don't think people are aware of the severity of the situation." Read full story Source: BBC News, 11 November 2021
  6. News Article
    An NHS ambulance service boss has urged 999 callers to not hang up as "there may be a delay before we pick up". The East of England Ambulance Service (EEAS) said demands on the health service meant it was extremely busy. Marcus Bailey, EEAS chief operating officer, said delays were due to a "combination" of Covid, winter pressures and recruitment. He said the service planned to recruit 100 call-handlers over the next few months to help ease pressure. The EEAS has published posters online telling emergency callers to be patient. The service covers Bedfordshire, Cambridgeshire, Essex, Hertfordshire, Norfolk and Suffolk. Mr Bailey told BBC Look East: "It's about us warning people who are phoning 999 that it's really busy and at some points there may be a delay before we pick up the 999 call. "Remain on the line, don't hang up, and we will get to you as soon as possible." Read full story Source: BBC News, 9 November 2021
  7. News Article
    Ambulance handover delays lasting more than 60 minutes have increased four-fold compared to this time last year, according to internal NHS data. NHS data seen by HSJ suggests there were around 28,900 ambulance handovers lasting longer than an hour during a four-week period in October. This was almost four times higher than the 7,772 hour-long handovers recorded in October 2020. It is also significantly higher than the 17,137 seen in January 2021, which was the peak of the coronavirus pandemic. Last week NHS England wrote to trusts and integrated care systems telling them to take urgent action to “immediately stop all delays” to ambulance handovers, and that “corridor care” is “unacceptable as a solution”. Read full story (paywalled) Source: HSJ, 3 November 2021
  8. News Article
    Patients are being put at "catastrophic risk" of harm due to ambulance handover delays, health bosses say. West Midlands Ambulance Service (WMAS) has raised its risk rating for such delays to its highest level for the first time in its history. The risk rating shows the trust believes patient harm is "almost certain" due to the handover hold-ups. Mark Docherty, director of nursing and clinical commissioning, said it was a "completely unacceptable situation". It comes as a patient died after waiting more than five hours in the back of an ambulance in Worcestershire. At a meeting on Wednesday, the ambulance service's board of directors heard the amount of time being lost to delays had reached previously unseen levels, the Local Democracy Reporting Service said. Mr Docherty warned the situation was set to get worse over the coming months as a result of winter pressures. "Despite everything we are doing by way of mitigation, we know that patients are coming to harm as a result of delays," he said. "We know that there are patients that are having significant harm and indeed, through our review of learning from deaths, we know that sadly some patients are dying before we get to them." Read full story Source: BBC News, 28 October 2021
  9. News Article
    · Trusts told to identify actions to “immediately stop all delays” · Letter calls for issue to be discussed at every board meeting · It follows concern over harm to patients from delays Trusts and integrated care systems are being told by NHS England and Improvement to take urgent action to ”immediately stop all delays” to ambulance handovers, which will require “difficult choices”. A letter yesterday from NHS England’s medical director, director for emergency and elective care, and its regional directors was sent to all local chief executives and chairs yesterday. It also says they should discuss the issue of ambulance handovers at every board meeting they hold, warns that “corridor care” is “unacceptable as a solution”, and says ambulances should not be used as “additional ED cubicles”. The move comes amid signs of large numbers of very long handover delays, and concern about the risk to patients from this and the knock-on damage to ambulance response times. Read the full article here (paywalled) Original source: Health Service Journal
  10. News Article
    A major hospital has declared a “critical incident” after a surge in demand saw more than 100 patients awaiting treatment in A&E and 25 ambulances queueing outside. The Royal Cornwall Hospital Treliske, in Truro said “unprecedented” pressure this week is worse “than at any point during the pandemic.” It urged “families, friends and neighbours” to collect any patients who are able to “to leave hospital sooner.” Managers at Cornwall’s main hospital raised the operating level from OPEL4 — known as a ‘black alert’ — to an ‘internal critical incident’ to allow for greater cooperation to ease the crisis. It comes as the government is under intense pressure to reimpose some COVID-19 measures amid a surge in cases, with many other NHS clinics and hospitals across the country facing similar pressure. Allister Grant, medical director of the RCHT, said: “There is unprecedented demand on health and care services in Cornwall, more so this week than at any point during the pandemic. “As a result, we have escalated our operational level from OPEL4 to an internal critical incident. “Pressure will always be most visible at the Emergency Department where ambulances are waiting, and our priority here is to move people into wards as soon as we can.” Read full story Source: The Independent, 21 October 2021
  11. News Article
    An NHS trust has spent more than two weeks running on emergency measures after skyrocketing demand since mid-September, while others have kept people waiting for more than a dozen hours in the backs of ambulances. The Independent has learnt one patient in the West Midlands spent 13 hours waiting to be handed over to staff at the Shrewsbury and Telford Hospitals Trust. Gloucester Hospitals Trust declared its internal incident on 19 September and only stood it down on 5 October, while London’s Barnet Hospital took similar extraordinary action on Monday due to high demand. And at North Middlesex Hospital staff saw more than 200 patients crowd into the emergency department on Monday afternoon. Declaring an internal incident is designed to activate measures that help hospitals deal with a sudden peak of demand and should only last for a short time. Such pressures are being felt across the country with NHS managers seriously concerned about what the coming months will look like as temperatures dip. One said they had not seen things as bad in more than a decade. Read full story Source: The Independent, 13 October 2021
  12. 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
  13. 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
  14. 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
  15. 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
  16. News Article
    North West Ambulance Service has declared a “major incident” over a high number of calls. People were warned they could be asked to make their own way to hospital if their call was not life-threatening, while some patients faced delays. There were no signs the surge in demand was linked to coronavirus, a spokesperson for the service said. “North West Ambulance Service has declared a major incident due to the high level of activity in the North West region, in particular the Greater Manchester area,” the service said on Monday evening. “If your call is not life-threatening, you may be asked if you can seek an alternative source of care or make your way to hospital by alternate means," the statement on Facebook said. The Independent understands at one point hundreds of calls were live - which triggered the major incident alert. Read full story Source: The Independent, 3 November 2020
  17. News Article
    Ambulance chiefs have warned coronavirus precautions in hospital emergency departments are putting patients’ lives at risk because of long delays before patients are being treated. West Midlands Ambulance Service has written a formal warning to three hospitals in the region over the delays to handing over patients from ambulance to hospital staff. In one case, a patient was left waiting with ambulance crews for up to three and a half hours. According to the letter, obtained by the Health Service Journal, the delays are being caused because of tougher infection control measures with ambulance bosses warning the situation is “dangerous”. Director of nursing Mark Docherty said the delays meant ambulances could not be sent to “life threatening emergencies”, and warned: “Lives will be put at risk and patients will come to harm as a result”. He added: “I alerted you to a serious concern about patients being kept on ambulances outside your hospital. Of great concern is the fact that a hospital risk assessment identifies this process as a mitigation to reduce risk in your hospital…" Read full story Source: The Independent, 29 October 2020
  18. News Article
    Following a damning report by the Care Quality Commission (CQC), the East of England Ambulance Service NHS Trust (EEAST) has been placed into special measures. It comes after inspectors uncovered a culture of bullying and sexual harassment at the trust. As a result of the decision, EEAST will receive enhanced support to improve its services. A statement from NHS England and NHS Improvement outlined that the Trust would be supported with the appointment of an improvement director, the facilitation of a tailored ‘Freedom to Speak Up’ support package, the arrangement of an external ‘buddying’ with fellow ambulance services and Board development sessions. This follows a CQC recommendation to place the trust in special measures due to challenges around patient and staff safety concerns, workforce processes, complaints and learning, private ambulance service (PAS) oversight and monitoring, and the need for improvement in the trust’s overarching culture to tackle inappropriate behaviours and encourage people to speak up. Ann Radmore, East of England Regional Director said, “While the East of England Ambulance Service NHS Trust has been working through its many challenges, there are long-standing concerns around culture, leadership and governance, and it is important that the trust supports its staff to deliver the high-quality care that patients deserve." “We know that the trust welcomes this decision and shares our commitment to reshape its culture and address quality concerns for the benefit of staff, patients and the wider community.” Read full story Source: Bedford Independent, 19 October 2020
  19. News Article
    An ambulance service could be put in special measures after a damning report criticised poor leadership for fostering bullying and not acting decisively on allegations of predatory sexual behaviour towards patients. East of England Ambulance Service Trust failed to protect patients and staff from sexual abuse, inappropriate behaviour and harassment, the Care Quality Commission said. It failed to support the mental health and wellbeing of staff, with high levels of bullying and harassment. Staff who raised concerns were not treated with respect and some senior leaders adopted a “combative and defensive approach” which stopped staff speaking out. “The leadership, governance and culture still did not support delivery of high-quality care,” the CQC said. Read full story (paywalled) Source: HSJ, 30 September 2020
  20. 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
  21. 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
  22. 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
  23. News Article
    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
  24. News Article
    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
  25. News Article
    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
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