East Midlands Ambulance Service responds to concerns about corridor care in hospitals
East Midlands Ambulance Service could start reducing how many crew members it leaves waiting with patients once they have been taken to hospitals as it tries to improve response times.
Nationally, pressures on available beds have seen ambulances queueing outside hospitals during long waits to hand over patients.
This is largely due to patient flow problems through hospitals, where there are often people who are medically fit for discharge but cannot leave because there is no space for them in the social care system.
Nottingham University Hospitals Trust, which runs the Queen’s Medical Centre, accepts most ambulance patients soon after they arrive, to allow paramedics to return to answering calls more quickly.
But a lack of space at the hospital means some patients are ending up in corridors.
Paramedics must wait with patients until they have been accepted by the hospital, which is leading to delays in ambulances being out in the community.
Greg Cox, divisional director for Nottinghamshire at EMAS, spoke to Nottinghamshire County Council’s health scrutiny committee about the issue on November 14.
He said QMC is experiencing significant pressures around ambulance handover.
He added the service is not hitting its targets for responding to category two calls, which include heart attacks.
The service covers Nottinghamshire, Derbyshire, Leicestershire, Rutland, Lincolnshire and Northamptonshire.
Category one calls are emergencies involving people with the most serious life-threatening injuries and illnesses and ‘category two’ is for other calls still classed as emergencies.
Category three is for urgent calls and category four is for less urgent calls.
Mr Cox said EMAS is mostly hitting targets when it comes to category one calls.
He added: “In category two calls unfortunately we don’t achieve either of the standards we have.
“We are about 10 minutes adrift on average.
“We’re all very aware that QMC at the moment is experiencing significant pressures around ambulance handover.
“I can give assurance that we are working with colleagues in the system to develop plans to improve that position.”
Councillor Kate Foale said: “Some of the response times clearly are worrying.
“One of the things people said to me when I was coming to this meeting is ‘tell them about the people queuing in the corridors’.
“As I understand it there is one or two paramedics with each bed and clearly that is reducing your capacity to get back out there again.”
Mr Cox said: “The work we are doing with the ICB is trying to address that.
“Nottinghamshire hospitals have been good at getting our patients in the department.
“Then there comes the difficulty about the hospital’s ability to take that patient off us.
“We effectively continue that care of those patients until the hospital can take the patient off us.
“We are trying to look at whether those two people from the ambulance could look after four patients to release some crew.
“It does seem a waste of resources but we are trying to do something about it as a system.”
Sue Saddington chairman of the committee, said: “Can you explain how you are managing to get there for category one calls but you’re not able to make the timings on the next category?”
Mr Cox replied: “We do hold some resources just for category one patients.
“There is something about how our control rooms work in terms of priority.
“It’s not ideal but these are the decisions that have to be made on a daily basis.
“If an ambulance is deployed to a category three call and a cardiac arrest comes in, if it’s appropriate they will be redirected to that more serious call.”
Gemma Whysall, system delivery director for urgent care at the ICB, said: “What we see in the ambulance service is symptomatic of what is happening in the whole system.
“We are seeing a higher demand in primary care and community services.
“We’ve got an ageing population and we are seeing people living longer with lots of multiple long-term conditions. We have a greater demand across the whole system. You will be very aware of the social care pressures.”
Heads of operations Bill Kelly said around half of all patients are currently taken into an emergency department.
He added the service had received funding for 25 new frontline staff in Nottinghamshire.