You're focusing on the wrong problem. The real problem is that no matter when you get to hospital, the staff has NO PROTOCOLS TO GET YOU 100% RECOVERED. Focusing on ambulance time is just the latest whack-a-mole. Solving that still won't get you 100% recovered.
Ambulance response times vary wildly as new data exposes hour-long wait for stroke patients
Delays are causing causing ‘life-threatening harm’ and ‘deaths’ as emergency services in Sourth West face heaviest pressure
Stroke patients who live in the South West of England face an average wait for an ambulance of nearly an hour, new figures show.
The 56-minute wait for patients, who by definition need urgent treatment, is more than three times the 18-minute national target for such “category 2” ambulance calls covering strokes and chest pains.
It is also more than double the average 27-minute ambulance wait time for category 2 patients in the South East. And even there the new data shows that for one in 10 such cases there is a wait of at least 56 minutes.
Jacqui Cuthbert, the Stroke Association’s associate director for the South West, said: “We remain deeply concerned at the continuing delays in ambulance response times.
“Stroke is a medical emergency and getting the best treatment quickly is vital to survival and recovery.
“Every minute a stroke is left untreated, 1.9 million brain cells can die. The later treatment happens, the harder recovery can be for survivors and the more likely it is that they will be left with severe effects of stroke, including increased disability.”
The figures published this week by NHS England document both the continuing severity of the ambulance crisis and its uneven spread across the country.
Jessica Morris, a fellow at the Nuffield Trust, told i: “It’s a whole system problem at the moment with backlogs and waiting times.
“One of the reasons for this is what’s happening in emergency departments. There are increased waits outside accident and emergency (A&E) departments, handover delays have gone up, and within emergency departments, waiting times have got much worse.”
The figures come after a study by the Healthcare Safety Investigation Branch (HSIB), published on Thursday, linked the long waits for ambulances to delays in them being able to hand over the patients to hospital A&E departments.
The report said the delays were causing “life-threatening harm”, and cited an example of a patient found unconscious at home, who was taken to hospital by ambulance but then held in the vehicle for three hours and 20 minutes, before eventually being admitted to intensive care.
Some people are already dying because of the delays, HSIB National Investigator Neil Alexander warned.
“It is one of the most urgent issues facing healthcare and sadly has resulted in deaths of patients who couldn’t access the treatment they needed in time,” he said.
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Three of those five hospitals were in the South West, including Gloucestershire Hospitals NHS Foundatoin Trust, which saw 57 per cent of handovers delayed over an hour, the highest of any trust.
University Hospitals Bristol, and Torbay and South Devon, were the other two hospital trusts in the region with the highest handover times.
Nationally, Shrewsbury and Telford, and North Lincolnshire and Goole, also had more than half of handovers delayed by more than an hour.
This week’s NHS data shows that the South West had the longest average ambulance wait times for category 1 calls covering life-threatening emergencies, such as heart attacks. Ambulances in London were on average 50 per cent faster to these calls than ambulances in the South West.
While rural areas like the South West tended to struggle more with the most urgent category 1 and 2 calls, they were far better at responding to less serious calls.
London was the slowest to respond to category 4 calls, taking an average of three hours and 25 minutes compared to one hour 53 minutes for the North East, which was the fasted response time.
On average across England, while ambulance delays have fallen from the previous month, they are still considerably higher than official targets.
The NHS has pledged that ambulances will respond to 90 per cent of all category 2 calls within 40 minutes, but the true figure currently stands at more than double that, with ambulances responding to 90 per cent of calls within 85 minutes.
For category 3 incidents – less serious but still urgent calls – the Government aims to respond to 90 per cent within two hours, but is currently only managing to respond to that proportion within five hours and 22 minutes.
Only in the most serious emergencies – category 1 calls – have numbers fallen to close to the target, where average response times are only 15 seconds higher than the goal of meeting 90 per cent of calls within 15 minutes.
There are various reasons for the recent rise in delays, including a historical shortage of paramedics and a slight uptick in 999 calls. But experts believe that one of the main contributors to the surge is the lack of bed space in hospitals.
The hospital handover delays are themselves a symptom of wider pressures on the healthcare system, as the NHS faces staffing pressures while simultaneously trying to slash backlogs caused by the pandemic.
Danielle Jefferies, a policy analyst at health think tank the King’s Fund, told i: “Right now it is a very big issue. It shows that the emergency service and the healthcare system are struggling across the board. Those long waiting times are a symptom of the whole healthcare system under pressure.”
Trusts have been asked to deliver 104 per cent of pre-pandemic elective surgery activity throughout 2022, but a recent survey of NHS trust leaders showed that just 37 per cent were confident they would achieve that target, and 88 per cent pinpointed difficulties in discharging patients as one of the main reasons for this.
Staff shortages in social care have also contributed to patient blockages at hospitals. According to its interim report, national organisations told the HISB that the social care sector has had particular challenges with staff recruitment and retention, in turn making it difficult to safely discharge patients into the sector.
The increased pressure on ambulance staff may also cause more damage to the healthcare system in the long term.
Ms Jefferies said: “It’s probably having a huge effect on the morale and the well-being of the staff. I’m sure most paramedics don’t want to be stuck outside in the car park for a few hours waiting to hand over their patients.”
An analysis by the GMB union has shown that ambulance callouts have increased by 77 per cent in the last 11 years but the number of ambulance workers increased by just seven per cent.
Rachel Harrison, GMB National Officer, said: “Ambulance workers have faced more than a decade of cuts while demand has almost doubled. It’s no wonder they are leaving in droves while the service itself is teetering on the brink of collapse.”
A spokesperson for Torbay and South Devon NHS Foundation Trust said “high pressure in our healthcare settings” was leading to ambulances “waiting longer to discharge patients than we would want”.
Dr Peter Reading, chief executive of North Lincolnshire and Goole NHS Foundation Trust, said: “Staff in our emergency departments are working incredibly hard to see and treat people as quickly as possible,” adding: “This is a whole system issue, not just a hospital one, and one that is felt right across the country.”
Gloucestershire Hospitals, University Hospitals Bristol and Shrewsbury and Telford were also approached for comment.
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