Ambulance shortages leaving ‘stranded’ patients, says review

Image copyright PA Image caption Ambulance crews are unable to provide 24-hour cover in many areas across the country

Ambulance services across England are at “crisis point” and have been begging for military aid amid a “significant increase” in demand, says an official report.

An NHS funding crisis and delays in referrals to hospitals are also hampering efforts to respond to medical emergencies, said the interim report on National Ambulance Service.

Acute trusts in Wales are also complaining about staffing levels in their ambulance services.

Dozens of ambulances in Wales have been involved in multiple incidents during recent months.

The report said the NHS in England, along with the military, was doing “everything possible” to support frontline staff.

Staff shortages have led to “at the minimum the reduction of available vehicles” with shortages exacerbated by a shortage of “standby staff” to cover non-emergency out-of-hours cover, it added.

Patients having to wait longer

The report, written by the ambulance service’s audit, risk, workforce, workforce policy and research board, which has been made up of representatives from all areas of the service, said there had been “significant growth” in demand for emergency services.

Increased demands have seen “huge increases” in the number of non-emergency episodes called in, it added.

Since 2010 there has been a 52% increase in ambulance demand.

An average of 61,000 patients needed an ambulance an hour in England in 2016/17, with 90% of callouts never handed back to a 999 operator for another arrival.

Image copyright PA Image caption Acute trusts in Wales are also complaining about staffing levels in their ambulance services

Able staff have had to cope with “some of the greatest demands seen in recent decades”, the report said.

“Some trusts have resorted to decreasing their numbers of ambulances to cope with demand,” it added.

“A number of trusts have told us that the cumulative effect of the day-to-day variation in demand has led to a deterioration in service and significantly increased pressure on the service.”

There has also been a growing “culture of waiting times”, with the report highlighting an increase in “rotational cover” – giving crews a day off for rest on weekends.

The report acknowledged that the ambulance service “is right to be cautious about increases in demand while an increase in productivity and demand management has taken place”.

Strained resources

The local administrations, ambulance trusts and NHS England “work tirelessly” to make difficult decisions and maintain service levels while raising operational efficiency, it added.

Richard Salisbury, chairman of the NHS board at NHS England, said the emergency services were “working tirelessly” to ensure there was “no gap” in their cover.

However, he said the service would need “significant additional funding” over the next five years if it was to remain viable.

An ambulance spokeswoman said the service did not have comment to make on the report.

It had already been conducting a wide-ranging workforce review across England in order to provide “the best possible care” for patients, the spokeswoman added.

Welsh Ambulance Service has said it is forced to put some front-line operations on hold while it considers a report from Unison

Matthew Rhodes, campaign and policy officer for the Royal College of Emergency Medicine, said: “We know from our regular work with service managers across the country that the acute ambulance services are in a severe financial crisis which is making it incredibly difficult to recruit, retain and train staff.

“We are also concerned that pressures on the ambulance service are having a much greater impact on patients. The current crisis is showing no signs of abating.”

Preliminary findings

Image copyright PA Image caption Many ambulances have been left lying idle at hospitals in recent months

The report is considered to be a preliminary analysis and there may be significant variations in the performance of the ambulance service according to its geographical areas.

The document provides specific information about seven NHS areas in England.

The areas include Gloucestershire, Norfolk and Suffolk, Bedfordshire, Cambridgeshire, Suffolk, Oxfordshire and Bedfordshire.

It also includes the London boroughs of Camden, Westminster, Islington, Camden and Hackney, as well as City of London.

The six areas which have been compared include Greater Manchester and Hull/East Riding.

The interim report will be considered to see if it needs further investigation in two months’ time by a board set up to provide advice on improvement.

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