Patients at risk as A&E handovers delayed for hours

Guidelines say patients should be handed over within 15 minutes of arriving at a hospital, but almost 300 ambulances a day ended up queuing for more than an hour last winter because accident and emergency wards were too busy to take in patients, new figures obtained by this programme show.

One crew was forced to wait nine hours to hand over a patient at Wrexham Maelor Hospital, Wales, in December last year, while an ambulance team at Treliske Hospital, Cornwall, was delayed for eight hours and seven minutes.

Crews are not allowed to leave until patients are signed over to the care of hospital doctors.

Delays mean paramedics are not available to respond to fresh 999 calls. Ambulance trust chiefs have repeatedly warned that patients’ lives could be at risk in letters to hospital trusts obtained by Channel 4 News.

‘Extreme risk’

In December, Will Hancock, Chief Executive of South Central Ambulance Service, wrote: “…we are placing patients at extreme risk who are dialling 999”.

The trust’s Operations Director Mark Ainsworth wrote in February: “This has had an impact on our ability to respond to life-threatening calls…” And Sue Byrne, Chief Operating Officer, warned: “We are seriously concerned about patient safety.”

At South East Coast Ambulance Service, an email from December obtained by Channel 4 News said: “This is now having a detrimental ability to deliver a safe service to the patients we serve.”

Yvonne Ormston, chief executive of the North East Ambulance Service, wrote: “I am becoming increasingly concerned… the ambulance service is struggling to cope.”

The warnings were sent to hospital chiefs last winter at the peak of the NHS crisis as a surge in patients overwhelmed the system.

40,000 ambulances delayed

New figures obtained by Channel 4 News reveal 40,479 ambulances waited for over an hour with patients at struggling A&E departments during 2014.

It marks an 18 per cent increase on the previous year, where 34,315 queued for 60 minutes or more.

The delays peaked over the winter, with 8,246 ambulances stacking up at A&E wards in December – the equivalent of around 270 each day.

A further 7,023 suffered lengthy delays trying to hand over patients in January this year.

The figures were compiled from ten of the ambulance services that provided data.

At the time, photographs emerged of ambulances parked outside emergency departments, with 18 at one stage lined up outside Royal Blackburn Hospital, in Lancashire.

‘That’s 28 crew sitting there waiting’

John Clayton, 42, was forced to wait after he arrived by ambulance at the Royal Blackburn Hospital on 27 December struggling to breathe.

The former Navy weapons engineer suffers from a chronic lung condition, and was taken to the hospital with suspected pneumonia.

After arriving, the ambulance crew were forced to wait with him inside the hospital for 1 hour 52 minutes before he was able to see a triage nurse.

Mr Clayton says a total of 14 ambulance crews were queuing with patients at the time.

He said: “Fourteen ambulances were waiting to book in. Each ambulance had two people on it, so that’s 28 crew sitting there waiting.

“During the time we were waiting, the ambulance manager turned up, and he’s trying to get the staff to do the handover in the corridors.

“He wanted to get his team back on the road. They were drafting ambulances in from outside areas just to cover the areas that his team were doing.”

National figures published by the NHS also show, at the peak of the delays in handover times in December, ambulance 999 response times fell sharply.

Only 66 per cent of “Red 1” calls, where patients are not breathing or do not have a pulse, were reached within the eight-minute limit, an only 61 per cent of “Red 2”, which are still serious but less critical, were responded to within limits. The national target for both is 75 per cent.

‘Unprecedented demand’

Dr Damian Riley, medical director of East Lancashire Hospitals NHS Trust, which covers the Royal Blackburn, said in a statement: “Last winter, our A&E department experienced unprecedented high demand and our staff worked extremely hard to keep patients safe.

“Every patient we receive is always transferred on a trolley or in a wheelchair into the hospital by the ambulance staff – no-one is ever left inside the ambulance, or outside of the hospital building.”