Deadly wait for treatment grows as ambulances stuck in a loop of delays

Data reveal more than half of patients stranded in hospital despite being well enough to leave

Koulla, aged 85, was screaming in pain in the back of an ambulance with a broken hip. The grandmother from Cornwall had waited 14 hours at home for the ambulance to arrive following a fall. She then endured a further 26-hour wait in the vehicle outside the Royal Cornwall Hospital before she was eventually taken inside. “It’s not really a state that anybody should be left in for that period of time,” her daughter, Marianna Flint, said. “She was in agony, [they said] she was screaming, I can’t calm her, I can’t console her, I can’t make the pain go away.”

Koulla is one of thousands of patients across England facing record waits for ambulances to arrive and hand them over to emergency care.

The latest data show more than three in 10 ambulances were delayed outside hospitals last week by at least 30 minutes.

More than 11,000 – 15 per cent of the 77,054 total arrivals – waited over an hour, the highest on record.

In some regions, half of patients were left stranded in ambulances outside accident and emergency departments for at least 30 minutes.

The highest proportion of patients queuing at least 30 minutes was at East and North Hertfordshire NHS Trust – 81.7 per cent.

More than three-quarters of patients (76.3 per cent) arriving by ambulance at the Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust, in Norfolk, were delayed more than half an hour. But at University Hospitals Plymouth more than half of patients waited at least an hour to be handed over (57 per cent), which is the highest proportion for any trust in England.

Health chiefs warn that ambulances have now turned into “wards on wheels” with staff treating patients in the vehicles queuing outside.

Images of ambulances stacked outside NHS hospitals are, tragically, no longer an unusual sight in England.

One video posted on social media this week showed 14 ambulances queuing outside Blackpool Victoria Hospital, while, in October, a pensioner died in an ambulance outside Fairfield General Hospital, Bury, Lancs, after waiting three hours to be handed over.

When Koulla eventually arrived at the Royal Cornwall Hospital in August there were around 30 other ambulances waiting to hand over patients.

The hospital has since written to apologise to the family for the care she received. Examples of patients enduring long waits in agony at home after calling for an ambulance have also become commonplace.

In August, the family of an 87-yearold erected a shelter over the pensioner as he waited 15 hours in the rain for an ambulance following a fall.

As part of its winter crisis plans, NHS England has called on local regions to expand services to help people who have fallen in their home or in care homes, rather than unnecessary trips to hospital.

The expansion is hoped to alleviate 55,000 ambulance trips a year.

But ambulances are currently stuck in a loop of delays, leaving them unable to respond to urgent calls.

Delayed discharges of patients who are fit to leave hospital are causing blockages in the system, meaning there is a lack of available ward beds to admit A&E patients into.

When this occurs, ambulance crews are unable to transfer patients into hospitals, leaving them queuing for hours outside.

The latest data, published by NHS England, show 57.5 per cent of patients were stuck in hospital last week, despite being well enough to leave.

On average, 13,364 beds were occupied every day last week with patients no longer meeting the criteria to reside.

Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), said handover delays have not been this bad since the 1990s and warned a significant proportion of the current excess deaths in England could be due to delays in emergency care.

“The ambulances become wards on wheels, it’s not a great area for people to be waiting outside, [but] the bigger problem are the people the ambulance can’t go to because they’re stuck outside the emergency department,” he told the BBC’S Radio 4 Today programme.

Separate figures, uncovered by the Liberal Democrats through Freedom of Information requests, reveal a postcode lottery when it comes to ambulance response times.

In Mid Devon, patients waited an average of 15 minutes and 20 seconds for Category 1 calls, including heart attacks, compared to five minutes and 48 seconds in Hammersmith.

The average Category 1 call should be responded to in seven minutes, according to NHS standards.

West Devon has the second slowest response time for such calls at 15 minutes 12 seconds, followed by the South Hampshire at 14 minutes 44 seconds.

However, suburban areas are also experiencing significant delayed response times, with ambulances in Sevenoaks, in Kent, taking an average of 13 minutes and nine seconds on to respond to calls.

Professor Sir Stephen Powis, NHS national medical director, said they show the NHS is facing a “perfect storm”, with flu cases rising and ongoing emergency care pressures.

He said: “We have already said we expect this to be the NHS’S most challenging winter yet, which is why we started preparing earlier than ever.”