Fred Pring ambulance wait inquest: Call for service improvement

A man who lay dying at home waiting more than 40 minutes for an ambulance would probably have survived if it had arrived within its eight-minute target time, a coroner has said.

Fred Pring, 74, of Flintshire, died 42 minutes after his wife Joyce had first called 999, an inquest in Ruthin heard.

North East Wales coroner John Gittins said changes must be made to help reduce the risk of future deaths.

The ambulance service and health board said improvements have been made since.

The coroner said Mr Pring had died of heart disease and pulmonary disease.

"Although it cannot be established with certainty that Mr Pring would have survived if help had reached him sooner, it is probable that if an ambulance had arrived promptly after the first call (within the target response time of eight minutes), he would have lived long enough to be transported to hospital where further medical treatment would have optimised the prospects of his survival," said Mr Gittins.

Joyce Pring: '... it is essential they [paramedics] get to the patient as quickly as possible'

But he said it was not his role to apportion blame.

Gill Pleming of the ambulance service told the inquest on Friday that on the day Mr Pring died in March 2013, there were seven ambulances and one rapid response vehicle to cover Flintshire and Wrexham.

But, she said, at the time of Mrs Pring's first call there were no ambulances available.

After issuing his narrative conclusion, the coroner said he would send his report to the health board and ambulance service advising them of "concerns that unless action is taken, circumstances creating a risk of other deaths will continue to exist".

Mrs Pring said she had felt "let down" by the ambulance service and also called for improvements.

The Welsh Ambulance Service and Betsi Cadwaladr University Health Board said they had deep regret regarding the case and its effects on the family of Mr Pring, from Mynydd Isa, near Mold.

In a joint statement, they said they had made a "number of improvements since March 2013".

'Deep regret'

"We extend our condolences to the Pring family at what is a very sad and difficult time," they said.

"It is with deep regret that on this occasion there was no ambulance available to send to Mr Pring in a timely manner.

"It is our responsibility to ensure we have a safe, effective and high-quality urgent care system, and together we are working hard to reduce any delays in transferring patients to hospital."

Mr Pring, who had been receiving treatment for chronic obstructive pulmonary disease, was crying in pain as his wife, Joyce, phoned for help, the hearing had been told.

She called 999 three times but was told the service was "very busy" in her area. She called a fourth time to say they were "too late" and he had died.

During the hearing the court was told one ambulance had spent nearly five hours waiting at Wrexham Maelor Hospital to drop off a patient.

Another ambulance had been at the same hospital for more than an hour-and-a-half.

In his report, the coroner said the handover of patients at an emergency department "far too often results in wholly unacceptable delays with patients being kept waiting for long periods in ambulances, and ambulance resources consequently being unavailable for allocation to other calls".

He added: "Whilst I fully appreciate that this is a multi-factorial problem, improvements must be made so as to reduce the risk of future deaths."

After the coroner's conclusion, Mrs Pring issued her own statement saying she felt "particularly let down that I was led to believe that help was on its way when it so obviously wasn't".

She said the ambulance service needed to "review its policies" regarding the questions asked by the 999 operators.

She added: "Until the medical personnel are with the patient, it is not possible to know what the outcome will be, therefore it is essential they get to the patient as quickly as possible.

"I sincerely hope that my husband's death will lead to improvements in the way the Welsh Ambulance Trust and the hospitals manage their services especially in respect of the handovers of patients to A and E departments."