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Twice as many ambulances turned away from A&E last winter due to bed shortages, figures show

'This is not the quality of care that anybody is comfortable with providing or patients deserve'

Friday 28 April 2017 12:07 BST

None of the three main ambulance targets for responding to calls have been hit since May 2015 (Getty Images)

Almost twice as many ambulances were turned away from hospital A&E departments this winter because no beds were available, new figures have shown.

Between December and February, 478 ambulances had to be diverted to another hospital, compared to an average of 249 times over the same period for the previous three years.

Health campaigners said the figures, published in a Nuffield Trust report, revealed a “systematic denial of safety at an unprecedented scale”.

January was the worst month on record for A&E departments in NHS hospitals, with more patients than ever waiting more than four hours to be seen.

Doctors said overwhelming demand caused by an ageing population and limited resources caused chaotic scenes over the winter.

Severe bed shortages resulted in nurses seeing patients in corridors, and emergency departments closing their doors to seriously ill patients.

The think tank said ambulance crews were being prevented from responding quickly to other urgent calls when they were turned away by A&E departments.

None of the three main ambulance targets for responding to calls have been hit since May 2015.

The numbers behind the NHS crisis

Of the 233,472 most serious calls, classed as “category A”, received in January this year, at least 95 per cent should have had a response within 19 minutes.

However, the data showed that 29,000 calls did not receive a response within this timeframe. Just 88 per cent of responses met the target.

The Royal College of Nurses said ministers “must understand how critical a category A ambulance response can be – with every extra minute waiting for it to arrive, the chances of surviving a potentially life threatening incident such as a heart attack or stroke decrease.”

“Nursing staff report patients coming through the ambulance doors only to be forced to treat them in corridors due to lack of capacity in the hospital, leading to stark comparisons with war zones.

“This is not the quality of care that anybody is comfortable with providing or patients deserve.”

Saffron Cordery, director of policy and strategy at NHS Providers, said the sharp increase in the number of ambulances being diverted was “very worrying”.

“Demand is rising fast, particularly the most urgent calls, far outstripping any increase in staffing,” she said. “The report shows how diverting ambulances to other hospitals is disruptive for paramedics and bad for patients.

“The sharp increase in the number of diversions is very worrying. Further steps will be needed across health and social care to address these pressures.”

Five NHS trusts accounted for more than half of all the 493 ambulance diverts reported this winter, with four in the North of England.

These were Pennine Acute Hospitals, Northumbria Healthcare, County Durham and Darlington and South Tyneside. Worcestershire Acute Hospitals in the Midlands also accounted for a high number.

Everyone the Government blames for the NHS crisis – except themselves

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1/6Everyone the Government blames for the NHS crisis – except themselves

Everyone the Government blames for the NHS crisis – except themselves

The elderly

“We acknowledge that there are pressures on the health service, there are always extra pressures on the NHS in the winter, but we have the added pressures of the ageing population and the growing complex needs of the population,” Theresa May has said. Waits of over 12 hours in A&E among elderly people have more than doubled in two years, according to figures from NHS Digital.

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Everyone the Government blames for the NHS crisis – except themselves

Patients going to A&E instead of seeing their GPs

Jeremy Hunt has called for a “honest discussion with the public about the purpose of A&E departments”, saying that around a third of A&E patients were in hospital unnecessarily. Mr Hunt told Radio 4’s Today programme the NHS now had more doctors, nurses and funding than ever, but explained what he called “very serious problems at some hospitals” by suggesting pressures were increasing in part because people are going to A&Es when they should not. He urged patients to visit their GP for non-emergency illnesses, outlined plans to release time for family doctors to support urgent care work, and said the NHS will soon be able to deliver seven-day access to a GP from 8am to 8pm. But doctors struggling amid a GP recruitment crisis said Mr Hunt’s plans were unrealistic and demanded the Government commit to investing in all areas of the overstretched health service.

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Everyone the Government blames for the NHS crisis – except themselves

Simon Stevens, head of NHS England

Reports that “key members” of Ms May’s team used internal meetings to accuse Simon Stevens, head of NHS England, of being unenthusiastic and unresponsive have been rejected by Downing Street. Mr Stevens had allegedly rejected claims made by Ms May that the NHS had been given more funding than required.

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Everyone the Government blames for the NHS crisis – except themselves

Previous health policy, not funding

In an interview with Sky News’s Sophy Ridge, Ms May acknowledged the NHS faced pressures but said it was a problem that had been “ducked by government over the years”. She refuted the claim that hospitals were tackling a “humanitarian crisis” and said health funding was at record levels. “We asked the NHS a while back to set out what it needed over the next five years in terms of its plan for the future and the funding that it would need,” said the Prime Minister. “They did that, we gave them that funding, in fact we gave them more funding than they required… Funding is now at record levels for the NHS, more money has been going in.” But doctors accused Ms May of being “in denial” about how the lack of additional funding provided for health and social care were behind a spiralling crisis in NHS hospitals.

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Everyone the Government blames for the NHS crisis – except themselves

Target to treat all A&E patients within four hours

Mr Hunt was accused of watering down the flagship target to treat all A&E patients within four hours. The Health Secretary told MPs the promise – introduced by Tony Blair’s government in 2000 – should only be for “those who actually need it”. Amid jeers in the Commons, Mr Hunt said only four other countries pledged to treat all patients within a similar timeframe and all had “less stringent” rules. But Ms May has now said the Government will stand by the four-hour target for A&E, which says 95 per cent of patients must be dealt with within that time frame.

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Everyone the Government blames for the NHS crisis – except themselves

No one

Mr Hunt was accused of “hiding” from the public eye following news of the Red Cross’s comments and didn’t make an official statement for two days. He was also filmed refusing to answer questions from journalists who pursued him down the street yesterday to ask whether he planned to scrap the four-hour A&E waiting time target. Sky News reporter Beth Rigby pressed the Health Secretary on his position on the matter, saying “the public will want to know, Mr Hunt”. “Sorry Beth, I’ve answered questions about this already,” replied Mr Hunt. “But you didn’t answer questions on this. You said it was over-interpreted in the House of Commons and you didn’t want to water it down. Is that what you’re saying?” said Ms Rigby. “It’s very difficult, because how are we going to explain to the public what your intention is, when you change your position and then won’t answer the question, Mr Hunt”. But the Health Secretary maintained his silence until he reached his car and got in.

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“Every one of these diverts delays swift access to emergency care, and potentially puts lives at risk,” said John Lister, secretary of health campaign group Keep Our NHS Public.

“The closure of so many acute hospital beds since 2010 as a result of the frozen NHS budgets and desperate search for cash savings has reduced bed numbers to a dangerous low point that leaves too many hospitals under permanent strain.”

And Alan Taman, of Doctors for the NHS, added: “Ambulances have always had to go where they can to get their patients to a safe place – but this is systematic denial of safety at an unprecedented scale.

“But this Government’s entire health policy is one of denial: of service, of culpability, of even the existence of a massive problem, caused by deliberate under-funding.”

Philip Hammond announced a £2bn funding boost for social care in this year’s Budget, promising it would help ease pressures faced by the health service and saying: “We are the party of the NHS”.

A damning report from the House of Lords said the NHS was in a state of “crisis”, with cross-bench peer Lord Patel saying: “There is a shocking lack of long-term strategic planning in the NHS.”

The Lords report called for increased funding in line with GDP and the renaming of the Department of Health as the Department of Health and Care to address bed blocking caused by an elderly population and poor levels of co-operation between health and social care services.

This article was updated to say there were 478 diverts this winter, not 493 as previously reported, after the Nuffield Trust said NHS England had an error in their spreadsheet

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