South Holland patient faced 23-hour ambulance wait as East Midlands Ambulance Service struggles to meet targets
A patient in the South Holland area had to wait more than 23 hours for an ambulance as stark new figures show the pressure placed on our health services locally.
East Midlands Ambulance Service (EMAS) has revealed - after a Freedom of Information request submitted by this newspaper - its response times to calls in our PE11 and PE12 postcode areas in September - months before the demands of winter truly bite.
The trust met the most serious calls (Category One) for people with life threatening injuries or conditions in the target of seven minutes just 43 times in that month but it missed the seven minute target on 103 occasions.
The longest wait for a South Holland area patient on a Category Three ‘urgent call’ - for people in the late stages of pregnancy or burns or diabetes - was 23 hours 11 minutes and 59 seconds.
East Midlands Ambulance Service, which covers patients in Lincolnshire, Nottinghamshire, Derbyshire, Leicestershire, Rutland and Northamptonshire, had previously acknowledged the ‘extreme pressure’ it faced in September and was braced for a challenging winter.
Neil Scott, Head of Operations for Lincolnshire at East Midlands Ambulance Service, said: “We are very sorry that due to a number of factors, patients in our communities are waiting longer than we would like for an ambulance response.”
September was a challenging month for the ambulance trust when a ‘critical incident’ was declared across the whole of the Nottinghamshire NHS.
This critical incident meant that hospitals - including some of the biggest in the region which deal with specialist care - struggled with the rising number of patients coming into Emergency Departments with some Nottinghamshire people having to be treated here.
Increased demand and patients staying longer in hospitals - sometimes due to shortages in social care - are some of the problems faced by hospitals.
The issue has even led to police officers filling the void where ambulances are unable to reach patients quickly.
United Lincolnshire Hospitals Trust issued a statement after a police officer spoke out after witnessing backed-up ambulances and six of his colleagues waiting with patients at Lincoln County Hospital last month due to the strain on the ambulance service.
Delays in handing over patients at hospitals are one of the key problems facing the ambulance service.
In August EMAS estimates that it lost 13,000 ‘resource hours’ in the East Midlands due to hospital handover delays.
EMAS chief executive Richard Henderson stated in his report to the October board meeting: “This is just below the total amount of double crewed ambulance hours we have available in the Northampton division and therefore losing these hours was equivalent to closing one of our divisions for most of the month.”
Our Freedom of Information request revealed that ambulances were called out to PE11 and PE12 postcodes a total of 898 times in September 2022.
This is a drop on the number of call outs to those postcodes in September 2019 when there were 1,060 calls.
Ambulances have a target to attend the most serious Category One calls in seven minutes. In September 2022, ambulances met that target on 43 times but missed it 103 times.
Nationally, the ambulance service aims to get to nine out of ten patients who are Category One within 15 minutes.
In September 2022, the longest response time for a Category 2 ‘Emergency Call’ was 9 hours 58 minutes and 55 seconds.
Emergency calls - for patients with epilepsy, stroke or burns - have a target of 18 minutes. Nationally they aim to get to nine out of ten patients who are Category Two within 40 minutes.
National standards for Category Three - for patients in the late stages of pregnancy for example - aim for ambulance trusts to meet 90% of those calls in 120 minutes.
But this was massively missed for one patient in South Holland, who had to wait 23 hours 11minutes and 59 seconds for an ambulance.
Mr Scott, Head of Operations for Lincolnshire at East Midlands Ambulance Service, said: “Handover delays are not an ambulance and hospital only issue and concern; they are a symptom of wider pressures across the NHS and social care systems, and both are working together to address staffing pressures and wellbeing whilst identifying ways of improving patient flow to reduce the negative impact on patient safety and wellbeing.
“Clinicians in our 999 control rooms continuously work hard to assess and reassess the condition of our patients who are waiting for an ambulance, to ensure people who need medical attention most urgently receive the first available ambulance.
“This means that patients experiencing less serious illnesses or injuries may experience an extended wait for an ambulance.
“Therefore, if you are asked by our 999-control room if you can make your own way to hospital, please do so – either via taxi or asking a friend or family member to drive you.”
Situation putting lives at risk
Healthwatch Lincolnshire has expressed concern about the waits experienced by some people.
Dean Odell, Healthwatch Contract Manager said: “Timing is crucial, and timely treatment could be the difference between life and death.
“Additionally, there are long hospital handover delays preventing ambulances getting back on the road out to patients which flags the wider health and social care challenges that the NHS is facing.
“With increased demand on services, gaps in workforce and lack of social care support this is not exclusively an EMAS problem but a Lincolnshire system wide one which needs addressing despite NHS and social care staff doing all they can. We encourage Lincolnshire people to continue to use services appropriately and share their experiences of health and social care with us.”
No answers from NHS bigwigs
We did approach Lincolnshire Integrated Care Board for a comment on the support it is providing to EMAS and are awaiting a response.
This newspaper also asked NHS England - which ‘provides national leadership for the NHS’ - for the support it was offering EMAS.
It pointed us to a press release on its winter plans which did not mention EMAS. It did mention a falls response service in London and Hull, care home projects in Weston-super-Mare and Essex, and a paediatric respiratory hub in Sandwell.
We also approached the Department of Health and Social Care to find out what support it is offering EMAS.
We received this response (after initially advising us to contact NHSE and EMAS - which we already had): “We are providing an extra £500 million to speed up discharge and free up hospital beds, reducing waits in A&E and getting ambulances quickly back out on the road. This is alongside NHS plans to rapidly boost capacity and resilience ahead of winter, including increasing the number of NHS 999 and 111 call handlers and creating the equivalent of at least 7,000 more beds.”
“NHS England is investing an additional £150 million in ambulance trusts to support response time improvements and £20 million to upgrade the ambulance fleet, while the ambulance and support staff workforce has grown by almost 40% since April 2010.”
Again, no mention of EMAS.
Why we're highlighting this
We did not write this story to bash the hard working paramedics on the frontline, or even EMAS as a whole, but to highlight the pressures faced in the system here.
We have every respect for paramedics, along with other frontline clinicians, who are battling to meet our needs in our darkest hours.
We have to face up to the fact that the system, as it stands, cannot cope. That’s a frightening prospect for our vulnerable residents and bosses at the top cannot continue to bury their heads in the sand.
We’re crying out for help. It’s about time someone listened.
