Ambulance service boss: Bed shortages harming patients

Patients in the West Midlands are suffering as hospital bed and staff shortages mean ambulances cannot unload patients, a senior ambulance boss says.

Steve Wheaton, of West Midlands Ambulance Service, said nearly 2,000 ambulances had waited more than an hour this month to hand over an A&E patient.

In one case, a paramedic in Dudley waited more than six hours, assistant chief officer Mr Wheaton said.

He said the situation was the worst he had known in his 20-year career.

The service covers Shropshire, Herefordshire, Worcestershire, Warwickshire, Staffordshire and the West Midlands conurbation.

The ambulance service is regularly leaving paramedics with patients in corridors - called cohorting.

'Increasingly hard'

Occasionally, vehicles are answering emergencies without a stretcher because the patient is still lying on it in hospital.

"Patient safety is our number one priority and we do our best to make sure that we look after patients, but it is becoming increasingly hard to maintain a 999 service and a service to patients in a corridor," Mr Wheaton said.

"Corridors are not the best place for patients to be nursed."

The Queen Elizabeth Hospital in Birmingham is to open two wards on its old site to cope

Mr Wheaton said hospital delays were impacting on 999 response times.

The West Midlands has consistently had among the best response times in the country.

But calls are literally stacking up, with patients who dialled 999 having to wait more than an hour because there are no vehicles available.

Mr Wheaton said: "I am sure that if you looked through some of the cases, that we have seen patients where their chances of survival would have improved, or the outcome of their care could have been better, had we got there faster."

This year, ambulance activity has increased by 6%, but the trust said it had recruited 60 extra paramedics to cope.

Documents reveal the worst turn-around times are at Heart of England NHS Foundation Trust, University Hospitals Coventry and Warwickshire and Russells Hall Hospital, Dudley.

'Highest volumes'

Dr Aresh Anwar, Good Hope Hospital medical director, from Heart of England NHS Foundation Trust, said: "We are experiencing unprecedented levels of demand and our clinical teams are working hard with ambulance colleagues to ensure that all handovers are as fast and as safe as possible as well as making sure critical patients are cared for and receive the best possible treatment in a timely manner."

He said A&Es at the trust's three sites received "the highest volumes of ambulances" by far across the region and he urged people to only use A&Es in emergencies to help cope with "unprecedented" demand in the region.

Dr Anwar added it was working with outside agencies to resolve the shortage in rehabilitation beds and elderly care provision which was affecting hospital discharges.

A spokesman for University Hospitals Coventry and Warwickshire said all hospitals across the West Midlands had been facing "huge pressure on services" recently and added that norovirus outbreaks had also added to demand.

"The whole health economy, including clinical commissioning groups, local hospitals and the West Midlands Ambulance Service, is working together to reduce these pressures and high quality patient care remains a priority," he said.

The other trusts involved have also been contacted and are considering their responses.

From April, hospitals will start being fined for not releasing ambulances quickly enough.

Mr Wheaton said, on present levels, the fines would cost Heart of England £17m a year.

Documents also show that this week six hospitals across the region declared an internal emergency due to a shortage of beds.

The Queen Elizabeth Hospital (QE) in Birmingham is not one of them, but despite moving recently into a new purpose-built facility, it is about to reopen and re-equip two wards in its old, mothballed hospital to try to cope with unprecedented demand.

'Not tailing off'

Dame Julie Moore, the hospital's chief executive, said there had been a 10% increase in A&E attendances across Birmingham and the QE had borne the brunt of it.

Government policy since 2008 has been to discourage hospitals from treating patients in A&E by only paying part of the cost if trusts treat more than an agreed number.

Joanne Basketfield said weekend surges in patient numbers were not tailing off

Trusts are also penalised if patients wait more than four hours in accident and emergency.

Joanne Basketfield, assistant director of nursing at the QE, said: "In years gone by, we would suggest that on certain days of the week we would have an increased demand.

"So, on Monday for example after GP practices have been closed for the weekend, we would see a surge, but that's not tailing off now.

"It's almost like we need to rip up what went before and start again."

Mr Wheaton said New Cross Hospital in Wolverhampton had recruited two corridor nurses and Russells Hall Hospital in Dudley was currently advertising.

He believes that patients leaving hospital too early are also having to be readmitted by ambulance a few days later.