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Found 320 results
  1. News Article
    Last month saw the highest number of ambulance callouts for life-threatening conditions since records began, NHS England officials say. There were more than 85,000 category one calls, for situations like cardiac arrests and people stopping breathing. The heatwave could have been one reason for increased demand, but experts say hospitals already face immense pressures. Nearly 30,000 patients waited more than 12 hours to be admitted to hospital. The number is up 33% on the previous month and the highest since records began in 2010. Richard Murray, chief executive of The King's Fund said the pressure on hospitals was also being felt right across the health and social care system. He added: "At the end of July, 13,014 people were still in hospital beds despite being medically fit to be discharged, often due to a lack of available social care support. The challenges affecting the NHS cannot be solved without addressing the issues in social care." Read full story Source BBC News, 12 August 2022
  2. News Article
    Armed police are being sent to save the lives of people in cardiac arrest because ambulances “can’t cope” with demand, The Independent has revealed. Officers are spending up to a third of their time on non-policing matters, a watchdog has warned, including responding to mental health crises and transporting patients to A&E as ambulance services face a “chronic crisis situation”. Andy Cooke, HM chief inspector of constabulary, said that firearms officers have been responding to pleas from struggling NHS colleagues to respond to cardiac arrests. He told The Independent that police are becoming the “first, last and only resort” as NHS services buckle under strain, taking them away from tackling crime at a time when recorded offences are at a record high in England and Wales. Mr Cooke, the former chief constable of Merseyside Police, added: “Recently, officers in armed response vehicles (ARVs) were being sent to reports of people who were having cardiac arrests because the ambulance service couldn’t cope with the demand, because they’re trained in first aid and to use defibrillators." “The ambulance service contacted the police to say ‘we’ve got this heart patient and we haven’t got anyone to send’." “Being first, last and only resort, the police will go. It’s right that they did go but that hides the problems we’ve got in the rest of the system.” Read full story Source: The Independent, 8 August 2022
  3. News Article
    Private and NHS ambulance services are reviewing safety procedures after the Care Quality Commission identified a series of risks to mental health patients being transported by non-emergency providers. The care watchdog wrote to all providers of non-emergency patient transport earlier in the summer, warning of concerns identified at recent inspections about use of restraints, sexual safety, physical health needs, vehicle and equipment safety standards, and unsafe recruitment practices. The letter, seen by HSJ, stated: “We know there are many independent ambulance providers providing a good standard of care. Unfortunately, our recent inspections suggest that this is not always the case." “We expect providers to deliver on their commitment to provide safe, high-quality care and we will do everything within our powers to ensure this happens.” Read full story (paywalled) Source: HSJ, 4 August 2022
  4. News Article
    A call to NHS 111 was abandoned every 10 seconds between 2020 and 2021, figures show. Millions of callers to the helpline hung up at a time when demand for the NHS was at its highest. In 2020, 2,490,663 calls were abandoned, while in 2021 this figure increased to 3,531,186. And 1,174,159 gave up on the line from January to May this year. Callers in Devon take an average of 11 minutes to get through to the NHS 111 service, according to Liberal Democrat research. Daisy Cooper, Lib Dem spokeswoman for health and social care, said: "Ambulance services are being stretched to breaking point, hospitals are reaching full capacity and now people cannot get through to NHS 111. We have called on this government time and time again to get a grip on this issue by recruiting more NHS 111 call handlers now." "The longer they delay, the longer they are leaving people in pain and distress." Helen Hughes, of the Patient Safety Learning charity, said: "These figures represent a serious safety concern. Each call is a potential missed opportunity for patients to receive timely medical advice that may prevent future harm." "With the ongoing severe pressures faced by ambulance services and hospitals this summer, patients are increasingly being signposted to NHS 111 for advice on non-life threatening conditions." "However, it can only relieve the pressure on other areas of the health service if NHS 111 has the capacity and resources to meet rising demand. The NHS leadership needs to urgently assess the reasons for this high number of abandoned calls." Read full story Source: Express, 31 July 2022
  5. News Article
    The new health and social care secretary has asked officials to hastily organise several “hackathons” to try to address the crisis in ambulance performance. The first, which was instigated just last week, will take place tomorrow (28 July), and a second is planned for August, sources told HSJ. Messages from officials described the work as a “request from our new secretary of state” and explained the short notice by saying he was “pushing… quite strongly for something before the end of the month”. The aim is said to be to examine what is driving poor performance, and the Department of Health and Social Care is “particularly interested in understanding which factors reduce risk to patients”, according to one message seen by HSJ. Hackathons are short, time-limited collaborative design events, typically involving computer programmers and data scientists or analysts, which aim to result in working software or product on the chosen theme by the end. Read full story (paywalled) Source: HSJ, 27 July 2022
  6. News Article
    The NHS has broken its “fundamental promise” to the public that life-saving emergency care will be available when they need it, a top NHS doctor has said, as ambulances continue to lose tens of thousands of hours waiting outside hospitals. Katherine Henderson, the president of the Royal College of Emergency Medicine, said that what she described as the fundamental promise of the NHS to provide an ambulance in a real emergency has been “broken”. Her comments come as the West Midlands Ambulance Service (WMAS) University NHS Trust predicted it would lose 48,000 ambulance hours waiting outside A&E departments in July. This would make it the worst month on record. In papers published on Thursday, WMAS said the impact of handover delays means that patients are waiting longer than needed for an emergency response, including patients in category one, which includes those needing immediate life-saving care. It added: “This means that patients who are immediately time-critical medical emergencies do not get the response they need and may suffer significant harm or death.” Read full story Source: The Independent, 26 July 2022
  7. News Article
    A quarter of Black, Asian and minority ethnic (BAME) non-executive directors of NHS trusts have seen or experienced discrimination in the course of their work, a report reveals. While almost four out of five (79%) of these BAME non-executives said they challenged such behaviour when they encountered it, only half (50%) said that led to a change of policy or behaviour. The other half felt they had been ‘fobbed off’ or subjected to actively hostile behaviour for having spoken up,” says a report commissioned by the Seacole Group, which represents most of the BAME non-executive board members of NHS trusts in England. It adds: “This level of discrimination is unacceptable anywhere and even more so in the boardrooms of NHS organisations. Too many Black, Asian and other ethnic NEDs (non-executive directors) are being subjected to it and left to deal with it on their own.” Read full story Source: The Guardian, 21 July 2022
  8. News Article
    Doctors’ leaders have reacted with incredulity to demands that all hospitals in England take “immediate steps” to find extra space for patients so that no ambulance waits longer than 30 minutes. A letter from NHS England sent to the heads of NHS trusts, integrated care boards, and ambulance trusts acknowledged that this will not be easy “and that it may place additional burden on staff at an already challenging time. The letter was sent on 15 July, in response to the increased pressure on ambulance services over the past year and in light of the current heatwave. It said, “All systems that are currently unable to offload ambulances within 30 minutes should now take further steps to create capacity within acute hospitals to ensure the rapid release of vehicles. This will require risk based decisions to be made about both the use of estate and deployment of clinical workforce.” Vishal Sharma, chair of the consultants committee at the BMA, said, “The government should be ashamed that it has come to this. If hospitals had the space or the staff to allow them to care for these patients, they wouldn’t be waiting in ambulances at the hospital door in the first place. The sad fact is that after decades of underinvestment, our hospitals are under-resourced, under-bedded, and understaffed.” Read full story Source: BMJ, 18 July 2022
  9. News Article
    Serious incidents causing patient harm have increased steeply compared to previous years at an ambulance service whose nursing director still expects will “fail” next month under mounting service pressures. There were 98 patient harm incidents at West Midlands Ambulance Service in June, official data obtained by HSJ suggests, up from 49 in the same month last year. The figures show that from April-June this year, 262 harm incidents have been logged – a 240% on 77 in the same period in 2019 and a 71% on 153 last year. Nursing director Mark Docherty, who previously warned the service was facing a “Titanic moment” and would “all fail” around a specific date of 17 August, said much of the increase can be attributed to worsening hospital handover delays. More than 700 people at one time waited for ambulances “that were not going to turn up” on Monday, according to Mr Docherty, who described the situation as a “really dangerous place to be”. Mr Docherty explained how the harm incidents, including deaths, resulted from growing delays: ”You can’t underplay the risk. If you’ve got 750 patients like we did on Monday waiting, none of those patients have been assessed. “Sadly, amongst them there will have been patients with stroke who won’t be treated because they’ve waited too long." Read full story (paywalled) Source: HSJ, 15 July 2022
  10. News Article
    Ambulance services are under intense pressure, with record numbers of callouts and the most urgent, category-one, calls last month. BBC Two's Newsnight programme spent from 08:00 to 20:00 on Monday at six hospitals with the longest delays handing patients over from paramedics to accident and emergency staff. This should take 15 minutes or less - but crews often wait many hours and sometimes whole 12-hour shifts, with ambulances queuing outside unable to respond to other emergency calls. At Royal Cornwall, 25 ambulances were queuing by the afternoon, three for at least 10-and-a-half hours, at Derriford, in Plymouth, 20 were queuing up to 11 hours in an overflow car park and the longest wait at Heartlands was more than five hours. "We're right on the fringe of collapse right now," a paramedic who has worked in emergency care for more than a decade said. "People are phoning and being told that they're not going to get an ambulance for six or nine hours. And that's happening routinely - that is happening pretty much every shift." "It would be wrong to say that there are times when I haven't shed a tear... for the people we haven't been able to help because it's been too late," the paramedic said. "They may have died anyway but there are definitely cases that I've been to where we should have been to them sooner and less harm would have come to them." Read full story Source: BBC News, 15 July 2022
  11. News Article
    A health minister incorrectly told the Commons yesterday “we have procured a contract” for surge support for ambulance services, despite the contract not having been awarded yet, HSJ has learned. There are also doubts about two other points made by health minister Maria Caulfield in Parliament yesterday in a debate about the current high pressure on ambulance services. She said: “We have procured a contract with a total value of £30m for an auxiliary ambulance service, which will provide national surge capacity if needed to support the ambulance response during periods of increased pressure. That capacity is there, should we need it.” However, NHS England, which advertised the contract in May, confirmed to HSJ today that it “is yet to be awarded”. Ms Caulfield was responding to an urgent question from Labour shadow health and social care secretary Wes Streeting about pressure on ambulance services and the heatwave. HSJ reported on Tuesday that all 10 major ambulance services in England were on the highest level of alert. Read full story (paywalled) Source: 14 July 2022
  12. News Article
    A spike in Covid absences and the extended heatwave have left NHS hospitals and ambulance services struggling to cope. The hot weather is also driving more patients to A&E departments, and callers are being urged not to use 999 except in serious emergencies. All 10 ambulance trusts in England are on black alert, the highest level, while health leaders warn that “ill-equipped” hospital buildings are struggling to store medicines correctly amid the abnormally high temperatures. Martin Flaherty, managing director of the Association of Ambulance Chief Executives, said: “The NHS ambulance sector is under intense pressure, with all ambulance services operating at the highest level of four within their local resource escalation action plans, normally only ever reserved for major incidents or short-term periods of unusual demand. “Severe delays in ambulance crews being able to hand over their patients at many hospital emergency departments are having a very significant impact on the ambulance sector’s ability to respond to patients as quickly as we would like to, because our crews and vehicles are stuck outside those hospitals.” Read full story Source: The Independent, 12 July 2022
  13. News Article
    An ambulance trust lost 1,700 hours of working time in one week in April due to vehicles waiting outside a hospital. The BBC has discovered that the figure was reached twice during April as ambulance crews waited outside Gloucestershire Royal Hospital in Gloucester to handover patients. That equates to about 70 days worth of waiting time each week. The trust that runs the hospital said it was facing "significant challenges" as it dealt with "unrelenting demand". Figures show that since the end of January, South Western Ambulance Service NHS Foundation Trust (SWASFT) has lost a minimum of 800 hours of working time each week due to ambulances having to wait outside Gloucestershire Royal Hospital, unable to get patients into A&E. The national target for transferring patients from ambulances in to A&E is 15 minutes, but in some cases people had to wait up to 10 hours in ambulance queues in Gloucester. Read full story Source: BBC News, 12 July 2022
  14. News Article
    Hospital leaders say they have been pressured to deliver more ‘corridor care’ as a result of efforts to ease the ambulance handover crisis. Due to the collapse in ambulance response times over the last year, hospitals have been told to receive patients from ambulance crews more quickly, to enable those crews to respond to new incidents in the community. This can mean patients being kept on trolley beds in corridors, with a lack of appropriate staff to care for them. Tracy Bullock, chief executive of University Hospitals of North Midlands, told HSJ her trust almost eradicated “corridor care” before the pandemic. But she added: “There have been discussions about going back to corridor care, but we have resisted that, as it brought significant patient safety and staff wellbeing issues… although these never received the same airtime as ambulance waits as they are unseen and only impact on the acutes. “The terminology has now changed and instead of corridor care it’s ‘cohorting’, and the space is not necessarily a corridor but a designated space for ambulances to drop more patients off.” She said this only works with enough staff, “otherwise you end up with the same safety issues that we had delivering corridor care pre-pandemic”. Read full story (paywalled) Source: HSJ, 11 July 2022
  15. News Article
    An acute trust has had to stand down a new service which led to a ‘marked improvement’ in ambulance handover times, due to a lack of permanent funding to support it. In recent months, York and Scarborough Teaching Hospitals Foundation Trust has deployed additional staff to receive and care for patients arriving by ambulance, meaning ambulance crews could be released more quickly. A report to the trust board last month said of the scheme: “Data shows a marked improvement in ambulance release times when deployed.” However, it would cost £1m per year to fully implement the service and the report said commissioners had confirmed there is “no external funding to support this cost”. There have been mounting concerns in recent months over the handover delays experienced by paramedics when taking patients to hospital, which have severely affected their response times for new incidents. In a statement, the trust said it was discussing with system partners how the service, which was introduced on a “short-term basis”, could be supported in future. It was delivered by independent ambulance and healthcare provider CIPHER Medical and used at peak times such as bank holiday weekends. Read full story (paywalled) Source: HSJ, 6 July 2022
  16. News Article
    Student paramedics are missing out on learning how to save lives because they are wasting hours in ambulances outside A&E instead of attending calls, it has been revealed. The College of Paramedics and ambulance directors say the hold-ups mean trainees are missing vital on-the-job experience, leading to fears over the safety of patients. Will Boughton, of the College of Paramedics Trustee for Professional Standards, said handover delays had become a problem for trainees’ development and exposure to real-life experience, meaning training had become “unpredictable”. If steps weren’t taken to increase training opportunities and address wider quality concerns in education, “it is very possible that patient safety may be at risk due to missed experience during practice education”, he warned. “A student could complete a regular shift and see lots of patients, getting lots of things in their portfolio signed off, or they could be the unlucky ambulance that joins the back of a queue and is then at hospital X for however many hours waiting to release that patient, so and it varies from county to county and service to service,” he said. Read full story Source: The Independent, 22 June 2022
  17. News Article
    Violence against ambulance staff in England has reached a record high, as the NHS crisis in emergency care continues to deepen. An estimated 12,626 incidents were reported in the 12 months to April 2022, according to nationwide data shared with The Independent – a 7% rise on the previous year. However, since 2016, the number of paramedics who have been verbally or physically assaulted, or threatened with assault, has nearly doubled, rising from 7,689. Adam Hopper, the national ambulance violence prevention and reduction lead for the Association of Ambulance Chief Executives (AACE), which provided the data, said the findings “confirm the worrying trend of increasing violence against ambulance staff”. One paramedic told The Independent a bone was broken in his neck after he was strangled by a drunken patient he was attempting to treat. Matthew Taylor, chief executive of the NHS Confederation, a membership body for trusts in England, said that alcohol is the most prominent factor in such assaults, followed by drugs and people being in mental health crisis. “Race and sexuality have also increased as exacerbating factors in these assaults, as have delays to treatment and arrival times,” he added. Read full story Source: The Independent, 19 June 2022
  18. News Article
    Delays unloading ambulances at busy hospitals are causing serious harm to patients, a safety watchdog is warning. The Healthcare Safety Investigation Branch has been investigating how the long waits are delaying 999 emergency response times across England. Kenneth Shadbolt, 94, waited more than five hours for an ambulance after a bad fall - an accident that proved fatal. Logs show that in his final 999 call he asked: "Can you please tell them to hurry up or I shall be dead." Ken Shadbolt had been in good shape for his age. On the night of Wednesday, 23 March 2022, just before 03:00, he got out of bed to go the bathroom and fell, hitting a wardrobe before collapsing on the floor. He had hurt his hip - how badly he didn't know - and couldn't get up. He could reach his mobile on his bedside, though, and dialled 999 for help. The BBC has seen transcripts of the three separate phone calls he made to South Western Ambulance Service that night. The first was short and factual, covering the basic details of his injury. He seemed calm and lucid but made clear he was in pain and needed an ambulance. Internal call logs seen by the BBC show that at this point Ken was triaged as a category two emergency, meaning paramedics should arrive in 18 minutes, on average. About 15 minutes later, Ken called 999 for a second time. An internal ambulance service log seen by the BBC shows that South Western Ambulance Service was indeed busy that night. It talks about "high demand" in the Gloucester area, with more than 60 patients waiting for help, some for more than eight hours. Another hour passed before Ken made his third and final call to 999. It was clear now that he was in serious pain. He felt "terrible sick" and said his "breathing is going too". "I need an ambulance because I'm going to fade away quite quickly," he said. The same reply came back: "The ambulance service is just under a lot of pressure at the moment... we are doing our best." An ambulance finally got to Kenneth Shadbolt's house at 08:10 that morning, four hours after that final call. Ken died at 14:21 that afternoon, with the cause of death given as a "very large subdural haematoma" or bleed on the brain. His son Jerry Shadbolt said: "The doctors were saying his injuries were non-survivable but would they have been non-survivable if he'd arrived at hospital four hours earlier? I'd like an answer to that question. "He was on his own and he knew he was on his own. He must have felt abandoned and alone on his bedroom floor. That's the most troubling part of it for me." Read full story Source: BBC News, 16 June 2022
  19. 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
  20. 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
  21. 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
  22. 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
  23. 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
  24. 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
  25. 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
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