Ambulance transfer delays in England could harm 1,000 patients a day | NHS

More than 1,000 patients a day in England are experiencing “potential harm” due to ambulance transfer delays, the Guardian can reveal.

Over the last year, 414,137 patients are believed to have suffered some degree of harm because they spent too much time in the back of ambulances waiting to be hospitalized. Of these, 44,409 – more than 850 per week – suffered “potential serious harm”, with delays causing permanent or long-term harm or even death.

In total, ambulances spent more than 1.5 million hours – the equivalent of 187 years – stuck outside emergency rooms waiting to unload patients during the year through November 2024, according to the Guardian investigation.

Experts said the figures were “staggering” and showed how the NHS was in a more “fragile” state than ever before, amid a “perfect storm” of record A&E demand, with numbers increasing number of 999 calls and an increasingly sick and aging population. .

Analysis of NHS data by the Guardian and the Association of Ambulance Chief Executives (AACE) highlights the scale of the challenge Keir Starmer faces as he prepares to outline how he plans to save the NHS.

Anna Parry, chief executive of AACE, which represents bosses of England’s 10 regional NHS ambulance services, said the data “speaks for itself”.

She added: “These figures underline what the ambulance sector has long said: thousands of patients are at risk of harm every month as a direct result of hospital transfer delays. »

Ambulance transfer delays occur when ambulances arrive at A&E but are unable to hand over patients to staff due to busy units. It also means paramedics cannot return to the road to care for other patients.

Delays mean patients are forced to wait in the back of ambulances outside or are transferred to the emergency room, but hospital staff are not available to complete the paramedic transfer.

National guidelines state that patients arriving at the emergency department by ambulance should be released to the care of emergency department staff within 15 minutes.

delays in handing over ambulances – graph

However, the target is constantly missed, according to the Guardian investigation. Crews often wait for many hours, sometimes a full 12 hours, outside hospitals, with queued ambulances unable to respond to other emergency calls.

Last week, almost a third of patients arriving by ambulance at hospitals in England – 32.1% – waited at least 30 minutes to be handed over to A&E teams.

The Guardian’s analysis is the first time a media outlet has examined an entire year of data on ambulance transfer delays and the potential damage caused.

Ambulance crews lost 1,641,522 hours waiting to hand over patients to emergency staff due to delays exceeding 15 minutes in the 12 months to November 2024. This figure is up 18.5% from the same period of the previous year, according to the survey.

The AACE estimates that 414,137 patients may have been injured due to delays of more than an hour in the last year – more people than the population of Coventry, England’s ninth largest city. This figure is up 18.7% from the previous year.

Of the patients who suffered potential harm, 44,409 were reported to have suffered serious harm. This figure also represents an increase of 18.7% from the previous year.

Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said the findings of the Guardian investigation were “staggering” and reflected the “lack of capacity” in NHS emergency services.

“People are waiting for ambulances, waiting in ambulances and waiting on ambulance trolleys in hospital corridors because emergency departments are too full, which can cause harm.

“There is an urgent need to focus on the ‘exit block’ – an increase in the number of beds to be able to move people from emergency to wards, and appropriate social care options to ensure that those deemed medically well enough to return home can do so. .

“Only then will we see significant changes at the doors of our hospitals. »

NHS Cornwall and the Isles of Scilly declared a critical incident on Friday due to long ambulance queues outside the Royal Cornwall Hospital in Truro and high numbers of A&E patients, with many people medically fit being discharged but waiting for appropriate care.

Rory Deighton, director of the acute care network at the NHS Confederation, said the Guardian revelations exposed a crisis in emergency care.

“As these figures show, patients unfortunately often have to wait too long for an ambulance and when they arrive at hospital, as we have seen in recent days, transfers can also be delayed, with many emergency services being forced to resort to temporary solutions like corridor care in an attempt to meet demand.

Deighton said tackling “social service deficits” would be crucial to reducing ambulance transfer times by speeding up the discharge of hospital patients and helping more older people avoid admissions in the first place.

“But the reality is that years of underinvestment in the NHS and social care, alongside rising levels of poor health across the country, mean our local health and care services are more fragile than ever. »

Adam Brimelow, director of communications at NHS Providers, said the figures were “very worrying”. A “perfect storm” of very high numbers of calls from the most urgent category of 999, on top of record emergency attendance, has led to “real capacity challenges”, he said. he declared.

“Recent months have seen some of the busiest ambulance responses on record and overworked crews face an uphill battle when demand soars and exceeds available resources.

Parry said it was vital to focus “as a priority” on reducing transfer times to ensure ambulances were available to those who needed them most. The crisis is “not insoluble,” she added.

The Department of Health and Social Care said long delays in handing over ambulances were “totally unacceptable” and that its plans to “rebuild” the NHS would improve emergency care.

A spokesperson added: “This includes the investment and reform we have announced in social care and the 1,000 extra GPs we are recruiting, which will help reach patients sooner, keep people healthy and ease pressure on ambulance services. »

An NHS England spokesperson said that although transfer times had improved ahead of this winter, there was “clearly still more to be done” to reduce “unacceptably long waits for patients” in some parts of the country.

The NHS “prioritized the sickest patients” and did everything it could to avoid avoidable admissions, including treating patients at home where possible and only admitting them to hospital when possible. necessary.