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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 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
  6. 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
  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. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. 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
  17. 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
  18. News Article
    An ambulance service says it has sped up clinical review of lower-priority calls, after a coroner said the new triage process — introduced in response to recent waiting time pressures — ‘will lead to further deaths’. The coroner raised concerns with West Midlands Ambulance Service after a type 1 diabetic patient died following a long delay in deciding whether to send an ambulance. Following a pilot in July 2021, all category 3 and 4 incidents at WMAS, except for a predefined list of exceptions, are sent directly to the trust’s “clinical validation team” to triage patients, with the aim of reducing the need for ambulance call-outs. It is thought a similar approach has been introduced across England since covid, as there have been huge pressures on ambulance capacity. But coroner Emma Serrano has raised concerns about the process in a prevention of future deaths report published this week. The inquest was told that Ms Finch waited 10 hours for her call to be “clinically assessed” and an ambulance call-out approved as the validation team was “under-staffed”. The PFD report also said that there was “no time limit” for assessments to take place, and no prioritisation system. Read full story (paywalled) Source: HSJ, 14 June 2023
  19. 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
  20. 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
  21. 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
  22. News Article
    Healthcare systems across Australia are buckling in the wake of COVID waves and the flu season. Pictures of ambulances piling up outside hospitals have become commonplace in the media. Known as “ramping”, it’s the canary in the coalmine of a health system. As a major symptom of a health system under stress, state governments across Australia are investing unprecedented amounts into ambulance services, emergency departments (EDs) and hospitals. South Australia has committed to an increased recruitment of 350 new paramedics. Likewise, New South Wales has committed to 1,850 extra paramedics. Victoria, meanwhile, has committed an additional A$162 million for system-wide solutions to counter paramedic wait times, on top of the A$12 billion already committed to the wider health system. This could begin to alleviate the system pressures that lead to ambulance ramping. But what happens when the paramedics return yet again to ED with another patient? Will they simply end up ramped again? We also need to consider better care in the community – and paramedics could play a role in this too. Read full story Source: The Conversation, 21 July 2022
  23. 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
  24. 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
  25. 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
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