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Sajid Javid was today told to urgently get a grip of the escalating NHS ambulance crisis, which has left patients dying in the back of vehicles parked outside hospitals.
Campaigners have demanded an end to the fiasco, urging the Health Secretary to call in the Army, which has already been done in Scotland and Wales to bolster their struggling services.
The true scale of the issues facing the frontline were laid bare in a damning report last night which claimed up to 160,000 patients are harmed because of handover delays every year. Paramedics warn it is having a devastating knock-on effect on ambulance response times, with heart attack and stroke victims left waiting with their lives in the balance for 55 minutes.
Medics insist the ‘incredibly complicated’ problem — which has been silently brewing for years — is down to a plethora of factors, but say pent-up demand from the Covid pandemic is likely to have exacerbated the issues.
Patients who put off getting care because of strict Government ‘stay at home’ messaging through lockdowns are now flocking back to the fragile health service, which is trying to juggle routine autumn pressures with Covid and a record pandemic-induced backlog.
Critics say the ‘broken’ GP service isn’t helping, with scores of patients left feeling like they have no option but to make an unnecessary trip to A&E or ring an ambulance because of they’ve struggled to see a doctor.
The ever-worsening social care crisis is also piling extra pressure on hospitals, in a warning sign that ambulance issues will only get worse over the next few months following the controversial ‘no jab, no job’ rule that saw up to 60,000 workers effectively banned from homes overnight last week.
Care homes were already short of 100,000 workers coming into the pandemic, and industry bosses say the lack of staff has made ‘bed-blocking’ a bigger problem than before because hospitals have nowhere to discharge patients who are medically fit to leave but need further care.
However, some hospital chiefs say the challenge is not a case of ‘funding’ but ‘capacity’, vindicating critics who fear the NHS will ‘swallow’ up billions more of extra funds from the public purse.
Paramedics warn the escalating handover crisis — which has seen hour-long switchovers quadruple in a year — is worsening response times for 999 calls, with heart attack and stroke victims last month facing 55-minute waits for ambulances. And call handlers are busier than ever.
A line of ambulances were left waiting outside the Queen Elizabeth Hospital in Birmingham on Saturday night because of handover delays
In the year up to September, paramedics wasted 96,000 minutes due to delays they faced at hospital over and above the 15-minute cut off all patients should be handed over to hospital in. Comparable figures from previous years did no exceed 45,000 by September
The NHS has long struggled to meet its recommended ambulance response times for Category 2 incidents which include medical emergencies such as strokes and severe burns but the last few months months have seen unprecedented rise with patients waiting nearly an hour on average for an ambulance after calling 99.
Category 1 incidents, the most serious, life threatening emergencies, have also seen delays with patients waiting nine minutes and 20 seconds for an ambulance, well above the NHS’s target of seven minutes
Around 28,900 ambulance handovers at hospitals lasted more than an hour in October in England this year — almost four times the 7,772 recorded in the same month last year. It was also more than 10,000 more than the number seen at the height of the pandemic this January (17,137)
A record number of 999 calls were made in England in October with 1,012,143 urgent calls for medical help made. But the time it took answer these calls also increased to a record 56 seconds
Emergency admissions to A&E departments at hospitals in England stood at 506,916 in September 2021, up from around 430,000 recorded every month in 2010. And a record 5,025 people had to wait more than 12 hours at A&Es in England last month from a decision to admit to actually being admitted — the worst performance on record. For comparison, just one person had to wait that long to be admitted in the last three months of 2010
Ambulance called at 2pm…arrives at 4AM: Diabetic pensioner, 92, is forced to wait nearly 14 HOURS for paramedics to arrive
Mr Pepper celebrating a Christmas. The 92-year-old diabetic spent nearly 14 hours waiting for an ambulance after falling in his kitchen.
A 92-year-old diabetic spent nearly 14 hours lying on the floor covered in blood while waiting for an ambulance.
Cyril Pepper was left with severe back pain, damage to his arm and also banged his head during a fall at his home on Monday, November 8.
Mr Pepper, of Silverdale, Staffordshire, who also suffered a stroke six years ago, managed to alert friends after by pressing a care alarm button at his home.
He said: ‘I was lying on my back in so much pain. It was horrendous.’
Mr Pepper’s friend and carer Debbie Austin, 59, arrived at his home at around 3pm after she received a message from Carecall – a personal care service.
She found the pensioner lying against a radiator on the floor near his kitchen, with blood marks from where he had tried to catch his fall.
The Patients Association, which represents patients across the UK, said Mr Javid should ‘immediately’ call in the military to support the health service.
Rachel Power, chief executive of the organisation, told MailOnline: ‘Military personnel could offer support as additional medics and drivers — but A&E departments could consider if they could be of support in hospitals where there are staff shortages.
‘At least two health boards in Scotland have asked the military to help in several operational roles. In Wales, the military have come to the assistance of the NHS.
‘It would be up to individual trusts to consider if and how military support could best help them deal with current pressures and reduce the risk of serous harm to patients.’
More than 100 soldiers were brought in to drive ambulances in Scotland in September. A similar number of troops were deployed in Wales last month to work as ambulance drivers until the end of November.
The College of Paramedics also told MailOnline the Army could be utilised in the short-term to support ambulance services, with figures showing the industry was already short of 18,000 before the pandemic struck.
A spokesperson for the college said: ‘Whilst the use of other agencies, such as the military are of enormous help, the unique skills and experience of paramedics within the ambulance sector attending the public should remain best practice.
‘However, our colleagues from the military, particularly paramedics and combat medical technicians could be utilised well in the interim to support services and provide them with some wider exposure during this challenging time.’
The Department of Health declined to comment on whether the Government was considering calling in the Army to support the health service.
It comes after official figures on Friday laid bare the worsening state of the NHS in England, with the waiting list for routine treatment standing at 5.83million in September.
And ambulance response times soared to triple the national target in October — the latest dates the figures are available for.
The average response time to Category 2 calls, which includes stroke and other emergencies, was nearly 55 minutes in October, compared with the target time of 18 minutes.
The most serious Category 1 calls for an ambulance, where patients have a life threatening event such as a cardiac arrest or severe allergic reaction, also had an increase in delays. These incidents should be responded to within seven minutes but patients had to wait an average of nine minutes and 20 seconds in October.
The NHS waiting list for routine hospital treatment in England has reached 5.83million, official data shows. Some 1.6million more Britons were waiting for elective surgery — such as hip and keen operations — at the end of September compared to the start of the pandemic
While the NHS budget and its workforce has been growing, the number of hospital beds available across England has fallen 14 per cent in the last decade. In the first quarter of the year, there were 123,707 beds to treat patients, down from 144,455 at the beginning of 2010. NHS England said the Department of Health is responsible for the drop in beds. The UK has fewer beds than other European nations and the vast majority (96,998) are kept for general and acute care, such as treating illnesses and injuries or performing surgery
Grandfather, 89, left in ‘absolute agony’ for ‘several hours’ while waiting for ambulance
Jim Rotheram suffered a hip fracture after falling over his pet dog
An 89-year-old grandfather was left in ‘absolute agony’ for several hours whilst waiting for an ambulance.
Jim Rotheram suffered a hip fracture after falling over his pet dog while opening the door to greet a workman at his Runcorn home in July, 2021.
‘I was waiting for hours in absolute agony,’ the former factory worker said.
Mr Rotheram, who lives with heart failure and Parkinson’s, added: ‘Oh God, it was painful.’
The father, grandfather and great grandfather faced a seven hour wait before he was finally picked up by an emergency ambulance which took him to Warrington Hospital.
Mr Rotheram, who spent several weeks in hospital following a successful hip operation, was recovering at home when he unfortunately suffered a second fall in August, fracturing his femur with another wait of several hours for the ambulance to arrive.
He is again recovering at home with the support of his wife Jean, 87, and carers.
Hospital handover delays ‘harming 160,000 patients’ every year
Delays handing patients from ambulances over to A&E departments is thought to be one of the main triggers of the worsening response times.
A report by the Association of Ambulance Chief Executives (AACE) today set out the the problem is not new, but both the number of patients affected and the length of the delays are rising.
The AACE said up to 160,000 patients each year could be affected due to long periods waiting to be admitted. Of these, 12,000 suffer ‘severe harm’.
National targets set out that all handovers should be completed within 15 minutes and none should exceed more than 30 minutes. But since April 2018, an average of 190,000 handovers have missed the 15-minute target, with the figure rising to 208,000 this September — the most recent date figures are available for.
The delays are caused if hospitals are busy, if people who don’t need emergency care show up at A&E and if the patient flow into and out of hospital is disrupted, the report states.
And the College of Paramedics told MailOnline the ‘consistent deterioration of response times’ and ‘lengthening handover times’ are at the heart of the current crisis.
This leaves insufficient numbers of ambulances free to respond to emergency calls in the community, meaning patients ‘routinely wait several hours’.
The college said: ‘This problem is not new… We can show reports going back over a decade where ambulances queuing has made the headlines, but now the scale is so enormous that it can no longer be ignored.
‘We appreciate that this situation is incredibly complicated and the pandemic is still playing a part in the wider landscape, but this is truly unacceptable.’
It added: ‘With winter just around the corner, it is imperative NHS leaders take urgent action to turn this situation around and protect patient safety and give paramedics a sense of hope and tangible action.’
It called for discharge of patients from hospital to be sped up, ‘either through urgent targeted funding or support to prevent exit block which stagnates the movement through the front door of the hospital’.
Some London hospitals have trialled airport-style ‘arrival lounges’ in recent weeks as a place for ambulances to drop off patients waiting to be admitted into A&E as an alternative to keeping them stuck in the back of the vehicle.
But Dr Linda Dykes, an A&E consultant, said the plans were ‘beyond stupidity and verging on insanity’, adding: ‘Expanding emergency departments without a magic staff tree will result in dead patients.’
A report by the Association of Ambulance Chief Executives (AACE) today set out the delays in handing patients over to hospitals is not new, but both the number of patients affected and the length of the delays are rising. The graph shows that in 2021, ambulance staff lost 35,000 minutes by September due to the time they spent waiting to offload patients over and above 60 minutes. Comparable figures from 2018 to 2021 did not exceed 5,000 minutes. Some 15,500 patients were forced to wait over an hour to be passed from paramedics to emergency staff in the 12 months to September
A 92-year-old diabetic spent nearly 14 hours lying on the floor covered in blood while waiting for an ambulance. Cyril Pepper was left with severe back pain, damage to his arm and also banged his head during a fall at his home on Monday, November 8
Donna Gilby (pictured) was left stranded on the pavement outside her Cwmaman home as she waited around six hours for an ambulance. She later died from a heart attack while in hospital
Dylan Brown (pictured) said it took two days for medics to reach his father’s home in Glasgow after he rang 999 complaining of breathing trouble and his father died before they arrived
Dr Kailash Chand (right) with his son Dr Aseem Malhotra who says his father died after having to wait too long for an ambulance when he was suffering from chest pains earlier this year
Billions more funding for NHS will be wasted without hiring thousands more nurses and doctors, says former Health Secretary Jeremy Hunt
The NHS will gobble up billions more in taxpayers’ cash if ministers don’t address its staffing crisis, Jeremy Hunt warned today.
The former Health Secretary said the idea that throwing money at the health service to clear backlogs and treatment delays had ‘poisoned intelligent debate’ about how to fix the problems.
Despite record funding for the NHS, waiting lists for routine and emergency care are currently at their highest level ever following the pandemic, with growing reports of patients dying in ambulances and hospital corridors.
At the same time, NHS England was estimated to be short of up to 100,000 staff heading into the pandemic, including 44,000 nurses and 9,000 doctors in nearly every specialty.
In September, NHS bosses were given a £30bn handout and the Government has pledged to generate billions more each year by hiking National Insurance.
Mr Hunt told the BBC Radio 4 Today programme: ‘The argument about money has poisoned intelligent debate about the NHS.
‘The system is geared up to say to ministers ‘give us more money and we’ll give you the things you want’.
‘When in reality, unless you expand the capacity of the system to do things, principally by training up and recruiting more doctors and nurses, it doesn’t matter how much extra money you throw at it, you wont get the improvements you’re looking for.’
Lack of face-to-face appointments with GPs ‘to blame’
Mr Javid has already pointed to problems with GP services as fuelling the current problems, as well as patients who ‘stayed away’ from the NHS during the pandemic now wanting to be seen.
He told MPs earlier this month: ‘[A] significant portion of people are turning up for emergency care when they could have actually gone to their GP.
‘That is not the fault of those people at all.
‘They have stayed away from the NHS when they were asked to, they now want to be seen and that is right.
‘But part of the reason I think people are turning up in A&E perhaps when they don’t need it is because they’re not able to get through to their primary care services in the usual way.’
David Huckin, a paramedic working in Northampton, told the Sunday Times that the ‘broken primary care system’ means patients are hanging up when they face long waits to get through to their surgery.
He said: ‘We’re getting reports of receptionists telling people ‘if you want to be seen face to face, you’ll have to call an ambulance’.’
The Health Secretary’s comments added fuel to the growing row between the Government and family doctors over access to face-to-face appointments, with England’s top doctor Professor Martin Marshall dismissing his comments.
Professor Marshall, chair of the Royal College of GPs, said: ‘There will be many reasons for mounting pressures in A&E but we’re unaware of any hard evidence that significantly links them to GP access.
‘Indeed, GPs and our teams make the vast majority of patient contacts in the NHS and in doing so our service alleviates pressures elsewhere in the health service, including emergency departments.’
In a letter to the Health Secretary he said the college’s 54,000 members were ‘dismayed and disappointed’ that he suggested a lack of in-person consultations placed ‘additional strains’ on A&E.
Dr Jonathan Griffiths, a prominent GP, last month blamed Britons’ ‘Amazon Prime mentality’ for a surge in demand for emergency NHS care.
He said an increasing number of patients were turning up at A&E with non-urgent symptoms that could be managed by a GP.
He likened the situation to Amazon’s same-day delivery service, adding that people had ‘high expectations’ and an ‘inability to wait for anything’.
HM Treasury data shows the NHS received £100.4billion in 2010/11 and its budget had grown steadily until 2019. In 2020, the NHS was given £129.7billion of core funding for its usual services, which was topped up with an extra £18billion to help with the pressures from the pandemic. For 2021/22 the Treasury said the health service is set to receive £136.1billion pounds of core funding, as well as £3billion to help with the Covid recovery
More than 5,000 people waited more than 12 hours in A&E before being seen by a doctor in September, a record high
There are questions about whether the current Covid situation is to blame for the NHS crisis, given that there are half as many Covid inpatients now than this time last year (shown)
Social care crisis
OAP with broken hip cried in pain after waiting nearly NINE HOURS for an ambulance
Joy Lewis, 76, cried in pain after having to wait eight-and-a-half hours for an ambulance
An OAP with a broken hip cried in pain after having to wait eight-and-a-half hours for an ambulance.
Joy Lewis, 76, then had to spend three-and-a-half hours queuing in the back of a vehicle outside casualty before being admitted.
The ambulance came from Wolverhampton, almost an hour’s drive from her home at Ford in Shropshire.
Her son Les Cheley said: ‘There should be more resources. It’s disgusting.
‘There are more people coming into this world so we should be building and expanding our health service, not killing it and selling off our NHS. It’s a sick world – a complete and utter joke.’
Ms Lewis fell in a bedroom at around 6.10am on October 28, and her partner immediately called an ambulance.
Her son, who rushed over, said: ‘She couldn’t move her leg. She was crying in agony and doubled up in pain.
‘At about 10.30am the ambulance control rang again. I said she had broken her hip. They said it would still be about five hours.
Meanwhile, a lack of capacity in social care is expected to further exacerbate problems in the coming months. Up to 60,000 workers were effectively barred from the sector last week because of No10’s ‘no jab, no job policy’.
The Institute of Health and Social Care said eight in 10 care homes will lose at least one member of staff, while 43 per cent will lose three or more workers. This will make it hard to care for patients, and mean some will have to be looked after in NHS hospitals instead, it said.
And the sector — which employs around 1.6million people — already had around 100,000 vacancies before the policy was implemented.
Matthew Taylor chief executive of the NHS Confederation told MailOnline: ‘All parts of the NHS and social care [should] work together to reduce handover delays.
‘Whilst ambulance crews are working flat out and hospitals are working hard to improve efficiency in their emergency departments, we would urge the Government to urgently provide extra funding and support to social care services to ensure that medically fit patients can safely be discharged into the community.
‘A properly funded social care system will in turn free up capacity in the NHS, help to reduce ambulance handover and other delays in A&E, and reduce pressure on community and primary care services.
‘The Government needs to mobilise all the resources it can to help the NHS through what we expect will be the most challenging winter on record.’
Ms Power, of the Patients Association, said extra funding is needed for social care to ensure hospitals can ‘safely discharge medically fit patients into the community, freeing capacity in the NHS’.
She joined a growing chorus of experts calling for Plan B — which would see the Government ordering people to wear face masks in certain settings and calling for people to work from home — should be implemented ‘immediately’ to protect the health service.
Independent Sage, a pressure group of eminent experts, said last week that the Government’s back-up strategy was ‘urgently’ needed to ‘save the NHS and Christmas’. It claimed the ‘very high levels of Covid’ were putting ‘extreme pressure’ on the health service.
But other experts argue the current Covid situation doesn’t justify moving to Plan B, given that admissions for the virus have fallen for nearly a week straight and are projected to fall even more in the coming weeks.
Meanwhile, East Suffolk and North Essex NHS Foundation Trust, also pointed to social care staffing problems as behind the ambulance crisis. Bosses at the trust claimed around ‘two wards worth’ of patients were ready to be discharged every day but social care staffing problems means beds that should be free for emergency admissions are blocked.
But the Ipswich Start reported Sarah Noonan, interim director of operations at Ipswich Hospital, said: ‘The challenge is not of funding. It’s of capacity.’
The Prime Minister also last month announced an extra £12billion a year would be invested in the NHS and social care through a 1.25 per cent national insurance hike — which Britons will start paying in April. But almost all of the extra cash will go to the NHS over the next three years.
Former Health Secretary Jeremy Hunt today warned against throwing money at the health service because it will be wasted on the salaries of locum doctors and agency nurses without an official plan to increase staffing levels.
He told the BBC Radio 4 Today programme: ‘The argument about money has poisoned intelligent debate about the NHS.
‘The system is geared up to say to ministers ‘give us more money and we’ll give you the things you want’.
‘When in reality, unless you expand the capacity of the system to do things, principally by training up and recruiting more doctors and nurses, it doesn’t matter how much extra money you throw at it, you won’t get the improvements you’re looking for.’
A Department of Health and Social Care spokesperson said: ‘We are committed to supporting ambulance crews who work tirelessly responding to emergencies every day.
‘NHS England and Improvement has given ambulance trusts an extra £55million to boost staff numbers for winter, helping them to bolster capacity in control rooms and on the frontline.
‘We are supporting the NHS to meet the unprecedented pressures it is facing, with record investment this year including an extra £5.4billion over the next six months to support its response to Covid and £36billion for health and care over the next three years.’
And an NHS spokesperson said: ‘Staff have gone above and beyond over the last year treating hundreds of thousands of seriously ill covid patients in hospital and most recent data shows record levels of A&E attendances and the highest ever number of 999 calls and life-threatening ambulance call outs in a single month.
‘NHS services are working collaboratively – including with AACE’s members – in line with actions set out for systems to prevent ambulance handover delays with immediate effect, so the public should continue to come forward through the appropriate route so staff can help you with the best option for your care.’