‘The system is broken’: Patients waiting 10 minutes for 999 calls to be answered

Exclusive: Staff warn there is a chance some patients are coming to harm, or even dying, due to the delays

Shaun Lintern
Health Correspondent
@ShaunLintern
Thursday 22 July 2021 19:55
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<p>West Midlands Ambulance Service has seen record levels of 999 calls this month</p>

West Midlands Ambulance Service has seen record levels of 999 calls this month

Some people dialling 999 are having to wait up to 10 minutes to get an answer, The Independent has learned.

With no way for ambulance call handlers to know if the call is a life-threatening situation or not before they answer, staff have warned there is a chance some patients are coming to harm, or even dying, due to the delays.

One paramedic told The Independent: “The system is profoundly broken.”

Leaked data from West Midlands Ambulance Service shows on Monday afternoon this week, some patients had waited as long as 29 hours for an ambulance.

And once an ambulance was sent out, 10 per cent of category three, or urgent but non-life threatening patients in the West Midlands so far this week were waiting almost 12 hours for an ambulance, with an average wait of five hours.

Separately, an email shared with The Independent revealed that staff working for the East of England Ambulance Service were told on Wednesday night that the trust had declared a critical incident with 999 demands at the highest level – what used to be called a black alert.

In the email a manager for the service told staff: “I just wanted to update you all on the trusts position to move to REAP4 as of today. This move reflects the extreme pressure the trust is currently under with a critical incident being declared.”

Reap stands for ‘Resource Escalation Action Plan’ with four being the most severe level. Declaring a critical incident means the service was temporarily unable to deliver services, patients may have been harmed or the service was not safe without urgent action.

It means eight out of 10 of England’s ambulance services are now under extreme pressure to deliver services.

The message to staff added: “The exec team are meeting daily to review actions taken and what else could be taken to improve our position and reduce the risk.”

It added that all meetings have been cancelled to make sure clinical staff are available to be on the frontline. It has also postponed training courses and other non-urgent activities.

The email to staff also revealed that the ambulance service is in the process of arranging catering for staff waiting at hospitals, “so staff should be able to have a meal and drinks during this period of increased activity and prolonged waits”.

The delays at hospitals in the Cambridge and Peterborough area were said to be “considerably challenged” with the problems being raised with the regional leadership of NHS England due to “the increased risk to our patients in the community”.

During the early hours of Sunday morning, hundreds of 999 calls in the West Midlands, were taking an average of four minutes to be answered across the region, with some calls taking nine minutes and 43 seconds or longer to be answered.

One call handler said: “It doesn’t bear thinking about what could be on the other [end] of those phones trying to get through.”

Another paramedic said: “Cardiac arrest survival drops by about 10 per cent for every minute without defibrillation, so a small number of patients may come to harm from these delays.

Some paramedics have reported patients waiting over 24 hours for an ambulance crew to reach them.

In Wales, new performance data shows one in 12 patients are facing a 12-hour delay in major emergency departments, with Welsh hospitals reporting the worst performance against the four-hour target ever seen.

London Ambulance Service declared an incident on Monday, after a surge of hundreds of 999 calls threatened to overwhelm it. The capital’s ambulance service has been at its highest ‘extreme pressure’ level since 17 June.

As the NHS summer crisis continues, and with the prolonged extreme heat, ambulance staff have spoken out over the poor care they say patients are having to endure, with some waiting up to eight hours to be handed over to stretched A&E departments.

One such eight-hour delay included an elderly patient who had a broken hip. Delays in their care are known to significantly increase mortality.

The pressure on the NHS is also being felt elsewhere in hospitals, where the number of coronavirus patients continues to rise, reaching 4,063 in England on Wednesday – a rise of 30 per cent in a week and back to levels last seen in March this year.

England’s chief inspector of hospitals on Wednesday warned that patients were not getting the care they needed and said major reforms were urgently required to address how emergency patients were treated.

One paramedic told The Independent that ambulance service staff “are good people working under the most unbelievable pressure”.

Another worker said: “We are stacking over 500 jobs, with patients waiting hours for an ambulance response. That includes elderly vulnerable people who have fallen but only merit a category three, so their calls are routinely pushed further and further down the queue. In the last few days, I've been to patients waiting 11 or 13 hours. And just to be clear: this is not the hospitals’ fault. The system is profoundly broken.”

On Tuesday, the West Midlands service received more than 6,400 emergency calls, compared to 4,000 calls on a typically busy day.

Factors causing the surge in calls are believed to include the current heatwave as well as increases of Covid in the community.

The service said callers should stay on the line until they get help but not to call back to check on ambulance response times as this was preventing call handlers speaking to other staff.

The chief executive of the West Midlands Ambulance Service, Anthony Marsh has previously warned staff that there was no doubt patients were coming to harm due to delays outside hospitals and he warned there were not enough staff to deal with the volume of 999 calls being received.

A spokesperson for West Midlands Ambulance Service, said: “We continue to see high levels of demand for our service and our staff are working hard to prioritise our sickest and most severely injured patients.

“Everyone who needs an ambulance will get one, but we are incredibly busy so if you need urgent medical advice – but it's not an emergency – go to NHS 111 online or call 111 for advice and support.”

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