Hereford hospital under pressure amid ambulance handover delays

HEREFORD County Hospital has said it is doing all it can to avoid delays when patients arrive by ambulance, despite service bosses warning that patients are being put at “catastrophic risk” of harm.

The West Midlands Ambulance Service (WMAS) board of directors, responsible for Herefordshire as well as the rest of the region, heard at a meeting that the amount of time being lost to delays had reached previously unseen levels.

The knock on effect is that ambulances are not available to respond as quickly to people in need of urgent medical care, which has led to cases of patients dying while waiting for an ambulance.

But the Wye Valley NHS Trust, which runs Hereford County Hospital, said it was taking “every step” to prevent delays.

The NHS also warned of unprecedented demand on urgent and emergency care services.

But it admitted that demand was rising, and Mark Docherty, director of nursing and clinical commissioning, warned the situation would get worse as a result of winter pressures.

As a result, the ambulance service board has taken the unprecedented step of moving handover delays to “risk rating 25” – the highest possible level of risk.

It is the first time any risk has been categorised as “25” in the history of WMAS, writes local democracy reporter Keri Trigg.

Mr Docherty said: “Despite everything we are doing by way of mitigation, we know that patients are coming to harm as a result of delays.

“We know that there are patients that are having significant harm and indeed, through our review of learning from deaths, we know that sadly some patients are dying before we get to them.”

Mr Docherty said it was a “completely unacceptable situation”, and additional front-line resources had been deployed in an effort to get to more patients.

He said: “Some of these delays are not just an hour, some of them sadly are multiple hours.

“It’s almost like we are having to change our monitoring systems because some of the monitoring was never built to record delays in excess of 10 hours, for example, but we know there have been quite a number of them [in the] year to date.

“The impact of a 10-hour handover delay is that the crew going in won’t ever return back to their shift on the road to deal with patients that they would normally have dealt with.

“It’s massively impactful on our response times.

“The number of hours we are losing is going up at a rate where it’s going to continue to cause significant harm – and indeed probably worse harm if it carries on as it is.”

The Wye Valley NHS Trust said that the healthcare system was facing increased pressure due to the rising number of Covid-19 patients in the community and more people needing impatient care.

Visiting has been suspended at the county’s hospitals, except in limited circumstances, due to rising cases on wards and in the community.

We are working with Herefordshire health and social care partners to provide timely access to supported care in the community when that is required We have also carried out extensive work within our Emergency Department to increase capacity and help us manage the flow of patients more efficiently.

There is no single solution to this and we are taking a system approach, including working closely with local GPs, community pharmacies, optometry and other services.

A regional NHS spokesman said: “We’re extremely grateful to our staff, WMAS colleagues and local healthcare partners who are working harder than ever to improve patient experience, and reduce waiting times and delays to patients and ambulances outside hospitals, despite unprecedented levels of demand for urgent and emergency care services.

“We would urge the public to use the NHS 111 online service to get advice on the most appropriate service before attending our ED, and to only use 999 in an emergency.”

WMAS deputy chair Wendy Farrington-Chadd said it was “disappointing” that the board was left with no option but to declare the most serious level of risk.

She said that it was not acceptable for patients or staff.

WMAS chairman Professor Ian Cumming added that it was important to stress that the risk was not to patients in the care of ambulance crews stuck outside hospitals, but those people waiting for a crew to arrive.

Hereford Times