Paramedic cares for just one patient in 14.5-hour shift due to hospital queues

It comes after NHS leaders said emergency care pressures have surpassed those placed on services by Covid patients.
Ambulances are being forced to queue for hours outside A&E units as they await space for their patients (PA)
PA Archive
Ella Pickover17 November 2021

A paramedic has described only caring for one patient in a whole shift due to handover delays at hospital.

Faye Shepherd, a student paramedic for South Western Ambulance Service said in a Twitter post on Tuesday that she saw just one patient in a 14.5-hour work day because her crew was “stuck at hospital for the entire duration waiting for bed space”.

In October, Ms Shepherd had described the “palpable sense of concern among staff” as her ambulance was “23rd in the queue out of 25 ambulance crews waiting to enter the emergency department”.

It comes as the head of the NHS in England said pressure on emergency care systems in hospitals are “even greater” than those caused by Covid.

Amanda Pritchard described challenges in the system including a rise in demand and difficulties getting medically fit people out of hospital to free up beds because of a “very stretched social care system”.

NHS Providers which represents NHS trusts, said ambulance services are under such pressure that a significant proportion of people are “repeat dialling” 999 asking where their ambulance is.

Ms Pritchard told the NHS Providers annual conference on Tuesday: “The number of Covid-positive inpatients is heading in the right direction at the moment, though there are still thousands of very ill patients in our hospitals receiving expert care – yesterday 6,864.

“We know though that even greater pressure is being felt in non-Covid urgent and emergency care system as people come back to our services having perhaps, for understandable reasons, stayed away during the pandemic.

(PA Graphics)
PA Graphics

“Equally, challenges at the back door – in discharging patients often to a very stretched social care system – are meaning patients are spending too long in A&E, meaning ambulances are spending too long waiting to handover patients, meaning response times are not what any of us want them to be.

“The indications suggest we are not going to get a let-up for a while.”

She added that the next few months will be a “winter like no other” for the NHS.

Earlier on Tuesday, Ms Pritchard described “demand rebound” for emergency services including the highest ever number of 999 calls in a month.

Meanwhile Chris Hopson, chief executive of NHS Providers, had said on Friday: “We think that about three-quarters of the extra phone calls that are coming in on 999 are repeat diallers trying to find out what’s happened to the ambulance they are having to wait far too long for.”

On Monday ambulance chiefs sounded the alarm over a new report which claimed tens of thousands of patients in England may have come to harm while waiting in ambulance queues outside busy hospitals.

Up to 160,000 may have come to harm, including 12,000 who could have suffered serious harm, according to analysis by the Association of Ambulance Chief Executives (AACE).

National guidance states paramedics should be able to hand patients over to A&E staff within 15 minutes of arriving at hospital.

But the AACE said that since April 2018, an average of 190,000 handovers have missed this target every month, accounting for around half of all handovers.

In October, NHS leaders stepped in and ordered hospital bosses to “eliminate” ambulance queues outside hospitals.

NHS bosses in England wrote to trust leaders highlighting the “risk to patient safety” after two deaths were linked to handover delays.

Hospitals were told to end all handover delays and stop using ambulances as emergency department “cubicles”.

Asked about current operational pressures and remarks made online by Ms Shepherd, a spokesperson from South Western Ambulance Service NHS Foundation Trust said: “We continue to experience the highest ever level of sustained demand on our service.

“Our response times are directly affected by the time it takes us to handover patients into busy hospital emergency departments, which is longer than we have ever seen before.

“We are losing many more hours compared with recent years, which causes our ambulances to queue outside hospitals and unable to respond to other patients and has an inevitable impact on the service we can provide. This is a health system problem which therefore demands a system solution.”

Meanwhile, South East Coast Ambulance Service was forced to declare a “critical incident” on Wednesday due to an IT problem.

It said: “Following a significant IT issue overnight, we have declared a critical incident this morning. Staff are working extremely hard as we continue to respond to patients. We would ask that you consider alternatives to 999, including NHS 111 online, unless absolutely essential.”

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