Thursday, 4 December 2014

Critically ill patients left waiting as London ambulance response times hit record low

Ambulance response times have plummeted to a modern-day low Picture: Nigel Howard
Emergency ambulances are reaching less than half of critically ill people in parts of London within NHS target response times, it can be revealed today.
Performance has plummeted to a modern-day low, with up to seven boroughs a month seeing the eight-minute national target missed on more than 50 per cent of 999 calls.
These include the highest-priority patients who have stopped breathing and do not have a pulse, and those who have suffered a suspected stroke or fit.
Today the London Ambulance Service said it was receiving more calls than at any time in its history - about 35,000 a week - as it pleaded with Londoners not to abuse the service.
It has been hit by a spate of “unnecessary” calls, ranging from a patient demanding help because the buses had stopped running, a cat with a broken leg and a woman with period pain.
NHS England warned that the LAS’s response to the second highest priority of emergencies was the worst ever recorded across the entire health service.
The scale of the challenge facing LAS was highlighted this week when cyclist Angie Cook, 63, was left lying injured in the road for 90 minutes due to the shortage of ambulances after colliding with a car in Teddington.
Today an Evening Standard investigation found the number of priority calls receiving a response within eight minutes fell to 44 per cent in Redbridge in September.
It was one of seven boroughs that month - others included Haringey, Barnet and Waltham Forest - and three in October where less than 50 per cent of “category A” calls were reached on time. The NHS minimum is 75 per cent.
Across London, response rates to the the most serious “life threatening” calls within “category A” crashed from 81 per cent in March to 64 per cent in October, with July the worst at 61 per cent.
A LAS spokeswoman said that 80 per cent of “category A” calls received an ambulance within 11 minutes.
At the same time, the capital has fallen below the national average for the percentage of cardiac arrest patients discharged alive from hospital, and for those arriving at a hyper-acute stroke unit within an hour.
Malcolm Alexander, chairman of the London Ambulance Service Patients’ Forum, feared increasing pressures and staff shortages were causing a breakdown in relations between LAS executives and front-line staff.
Mr Alexander said: “I think they are not coping. We have been monitoring the London Ambulance Service for 10 years and it’s never been down to anything like this. If it went down to 70 per cent we would consider it to be a disaster.
“We keep saying to the commissioners: ‘What are you doing about this performance?’ Everybody seems completely stunned.”
Problems were exacerbated by crews being forced to keep patients in the back of ambulances for more than an hour on hundreds of occasions, due to A&Es being full.
At one hospital, Queen Elizabeth in Woolwich, 209 patients waited more than an hour in an ambulance between July and September. Over the same period across London, 5,852 patients waited in an ambulance for more than 30 minutes - double the 15-minute maximum.
Last week the Standard revealed that Boris Johnson had written to Health Secretary Jeremy Hunt warning of the pressure facing LAS as it entered its toughest time of year.
The LAS treated 10,187 seriously ill and injured patients last week - 10 per cent more than last year. About 3,500 of the 35,000 calls it receives each week receive phone advice rather than an ambulance.
A national shortage of paramedics has resulted in more than 400 LAS vacancies. It hopes to recruit 1,000 new front-line staff by next year, including 175 Australian paramedics in January.
LAS director of operations Jason Killens said: “We will continue to prioritise our ambulance crews so we get to the most seriously ill or injured patients first. Our highly skilled clinicians respond to life and death situations daily but we also receive many calls from patients who don’t need an emergency ambulance.
“Recently Londoners have called us to ask for an emergency ambulance for a cat with a broken leg, a person with a tissue in his ear and a woman with period pain.
“We’re very busy, please only call us in a genuine emergency and at all other times call NHS 111, visit your GP or pharmacist or alternatively make you own way to hospital.”
In June, only 5.7 per cent of cardiac arrest patients - 17 out of 296 - on whom resuscitation was commenced were subsequently discharged alive from hospital, compared to national average of 8.5 per cent.
The number of suspected stroke patients arriving within 60 minutes at a hyper-acute stroke unit was 1.6 points below the national average of 61.4 per cent.
However 93 per cent of heart attack patients received angioplasty in hospital within 150 minutes, four points above the national average.
A spokesman for Lewisham and Greenwich hospitals, which runs Queen Elizabeth hospital, said: “We knew we needed to make sure we improved in this area, so at the beginning of November we made 46 extra beds available, alongside opening a new clinical decision unit for the A&E, a bespoke discharge unit and a new dedicated area for ambulance handovers.
“This has resulted in a reduction in the number of ambulance delays and the trust is now one of the better performing trusts for ambulance handovers. With further improvements planned we are confident our rate will reduce even further.”
Published: 04 December 2014 Updated: 11:05, 04 December 2014

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