Patients are waiting longer for ambulances to arrive and face long delays in being transferred from those to A&Es, as the NHS continues to experience high demand.
The most recent NHS England figures show the average response time for Category 1 call in April was nine minutes and two seconds. Category 1 ambulance calls are those that are life-threatening and needing immediate intervention and/or resuscitation, e.g. cardiac or respiratory arrest.
The national target is calls must be responded to in seven minutes on average, and with 90% of Category 1 calls responded to in 15 minutes. In April, 90% of calls were responded to in just over 16 minutes.
The April figures were a slight improvement on March (when the average response time for the most urgent calls was nine minutes and 35 seconds). However, while response times had improved from when records began and were mostly meeting the target response time between 2018 and 2021, response times have deteriorated over the past year.
In an interview with Health Service Journal (HSJ), Mark Docherty, nursing director of West Midlands Ambulance Service, has warned that ambulances will stop responding to 999 calls by August 17. He also told the trade title that the number of people waiting in ambulances for 24 hours before hospital admissions is increasing.
He said: “Around August 17 is the day I think it will all fail. I’ve been asked how I can be so specific, but that date is when a third of our resource (will be) lost to delays, and that will mean we just can’t respond.
“Mathematically it will be a bit like a Titanic moment. It will be a mathematical (certainty) that this thing is sinking, and it will be pretty much beyond the tipping point by then."
He added: “It would make me the happiest person in the world if everyone in the system proves to me that actually the ambulance service in the West Midlands isn’t going to fail on August 17, and I’ve got it completely wrong.”
NHS England publishes figures over the winter on ambulances delayed outside A&E departments while handing over patients. These show that numbers facing long waits were higher in the most recent year, and don't appear to have started to fall in the spring (which is what usually happens as winter pressures ease).
In winter 2021/22, 134,029 ambulances waited longer than an hour to handover their patient to the emergency department. That was triple the 45,883 ambulances facing long waits in winter 2020/21.
The data was published over a shorter period in 2019/20 (up to the start of March, rather than the start of April). However, comparing the numbers over that period, there were still more than double (89,138) handovers lasting over an hour in 2021/22 compared to the pre-pandemic winter in 2019/20 (41,903).
In the last week data was published in 2022 (the week to April 3), 9,972 patients waited more than an hour for a handover. That compared to 1,479 in the last week in 2021 (the week to April 4).
Another issue causing pressure on A&Es and ambulances is delays to discharging patients who are well enough to leave hospital or could receive care in the community. Mr Docherty said the large number of medically fit patients in hospital is “criminal ... when I’ve got teenagers dying on the street from things that are completely reversible".
On April 30, there were 12,580 patients who met the criteria for release but who were delayed leaving hospital. With around 92,000 adult general beds across England, that would suggest around one in seven beds is being used by a patient who should be able to be discharged.
An NHS spokesman told The Telegraph in response to the reporting of Mr Docherty's comments: “The NHS has been working hard to reduce ambulance delays and £150 million of additional system funding has been allocated for ambulance service pressures in 2022-23. There is no doubt the NHS still faces pressures, and the latest figures are another reminder of the crucial importance of community and social care, in helping people in hospital leave when they are fit to do so, not just because it is better for them but because it helps free up precious NHS bed space.”
