Long ambulance wait for dementia patient near hospital

An elderly dementia patient who fell and broke his hip waited five hours for an ambulance to take him to a hospital just 300m (330 yards) away.

Ted Chell was an inpatient at the Bro Cerwyn Centre, opposite Haverfordwest's Withybush Hospital, when he fell.

He was in "severe pain" while waiting and spent a further two hours in an ambulance outside the hospital.

The Welsh Ambulance Service said all its resources were committed to other patients on the day, in September 2018.

The trust said it was "very sorry" to hear about Mr Chell's experience.

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Hywel Dda health board said staff on St Non's dementia ward at Bro Cerwyn acted "in complete accordance with policy" but it apologised for the delay in getting Mr Chell from the ambulance into Withybush A&E.

Mr Chell died a few weeks after the incident, aged 90.

His son, Rob Chell, told the BBC Politics Wales programme: "I feel really sorry my dad had to go through that, I wouldn't wish that on anybody.

"I'm gutted really, (NHS staff) try so hard and it's made so difficult for them with the constraints they've got.

"I think it's appalling really."

Ted Chell, pictured with his late wife Marion, died aged 90 a few weeks after the fall

On the day of the incident few ambulances were available because of delays getting patients into A&E.

An investigation by the health board found:

• Despite the patient being close to Withybush, it is policy to call an ambulance when patients need emergency physical treatment

• A doctor attended to Mr Chell within 20 minutes of his fall, and identified a potential fracture

• Mr Chell was scored as being in "moderate pain" for the first two hours and in "severe pain" for the last three hours

• Calling 999 and waiting for an ambulance to transfer Mr Chell was the "appropriate action" and moving him before a full assessment "could have caused further harm"

• Ambulance staff advised an ambulance may take up to four hours but staff on Mr Chell's ward at Bro Cerwyn felt a response within an hour would be more appropriate

• The delay was "unusual" and "clearly a hugely distressing experience for Mr Chell"

• Mr Chell was made as comfortable as possible and supported by a member of staff until the ambulance arrived

• The treatment and care provided was "appropriate, timely and followed policy and procedure"

Official data shows that in the month of the incident ambulances across Wales spent 5,253 hours in excess of the 15 minute target waiting to discharge patients into hospitals.

Since then performance has worsened.

10,025 hours were lost in September 2019.

The latest figures, for the final three months of 2019, will be published later this month.

Rob Chell is highlighting the case because he does not want others to face such an ordeal

Research by Mr Chell's local assembly member, Angela Burns, found that on the day of his fall 13 ambulances waited longer than the 15 minute target to discharge patients at Withybush, while the three other main hospitals in the region had far fewer ambulances waiting.

She said: "There's no intelligence being applied to the system that says 'what is the point of sending an ambulance to a hospital when there's already ten waiting there, when there's a hospital down the road that's only got two?' "

She also questioned why an ambulance was needed to take Mr Chell such a short distance.

"It just seemed to be completely illogical," she said.

"We talk a lot about ambulances but where was a paramedic who should have turned up?

"I could have popped him on a gurney [wheeled stretcher] myself and pushed him over the road to that hospital and had him admitted."

Conservative AM Angela Burns says a "far more intelligent" system is needed

Welsh Ambulance Service director of operations Lee Brooks said: "We were very sorry to hear about Mr Chell's experience and would like to extend our condolences to his family.

"At the time of this call, all of our resources were committed to other patients, either in the community or at hospital emergency departments.

"We have worked closely with Hywel Dda University Health Board to investigate this incident and learn from it to reduce instances such as this one."

Health board director of nursing Mandy Rayani said: "Although St Non's is part of Hywel Dda University Health Board, and despite its close proximity, it is a separate site to the Withybush General Hospital site.

"The policy and procedure when patients need emergency physical treatment is to call an ambulance; this is because paramedic crews are best placed to transport patients safely, particularly those with suspected fractures, for hospital treatment.

"We would like to reiterate our apology to Mr Chell's family for the delay in transferring him from our colleagues in the Welsh Ambulance Service to the Emergency Department at Withybush General Hospital.

"The health board strives to provide the very best of services to patients but regrettably, there are sometimes occasions where services do not meet the standards we would aspire to achieve."

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