An elderly patient died in the back of an ambulance outside a Greater Manchester hospital as there were no beds available inside, the Manchester Evening News understands. The patient had arrived at Fairfield General Hospital and antibiotic treatment was started by hospital staff who came out from inside the hospital, before the patient went into cardiac arrest, NHS sources said.
The death on Tuesday, October 18, follows paramedics across the country raising concerns that ambulances are ‘being treated as extra wards’ as the scarcity of beds inside hospitals reaches crisis point. An investigation has now been launched by North West Ambulance Service in response to the death.
In Greater Manchester, patients are regularly being held in ambulances for hours as they wait for a rare bed inside, according to North West Ambulance Service (NWAS) paramedics.
Ambulances were pictured lining up outside hospitals as the NHS was strained by hot weather throughout the summer. That pressure is only worsening as the service heads into winter and there is more demand on A&E from seriously ill people than ever, but no capacity inside the hospitals, say multiple NHS workers from the North West.
On Tuesday, the patient was taken to hospital with a chest infection, the M.E.N. understands. The patient was still in the back of the NWAS ambulance which had been held outside the hospital as there were no available beds for the patient to be admitted to, the M.E.N was told.
However, treatment began and the patient was given drugs by hospital staff. The patient then deteriorated and went into cardiac arrest, the M.E.N. has been told.
“A patient was taken to hospital with a chest infection and held outside in the back of the ambulance,” said a senior NHS source. “Treatment began on the ambulance, the hospital started antibiotic treatment.
“The patient has gone into cardiac arrest. The patient was elderly and there was a DNAR in place, so no resuscitation was attempted.”
A ‘do not attempt resuscitation’ (DNAR) order was in place, meaning that paramedics would not attempt the action to restart the patient’s heart. The death has prompted outcry within the ambulance service, amid staff fears that the cardiac arrest could have been prevented if the patient was inside the hospital in a bed watched over by doctors.
One paramedic shared the belief that dying in the back of an ambulance compromised the patient’s dignity.
“The patient has died on the back of an ambulance,” said the paramedic. “It’s not right, it’s just insane.
“Every hospital is holding ambulances outside. I’ve had occasions where I’ve taken over from the night shift and the patient hasn’t even made it through the door.
“They’ve been in the ambulance for eight hours, treated there and sent back home. Every hospital is really struggling to get patients through the door. Some hospitals will treat us as another ward.”
The incident will ‘lead to big discussion about treatment in the back of ambulances’, another paramedic commented.
“What happened on Tuesday might put this at the forefront of what’s going on. It’s not safe.
“It’s doctor-led care when you’re outside the hospital but the doctors aren’t staying with the patients because they have others to look after inside the building. Paramedics have a limited scope of practice - there are things we’re not trained to do that are being seen in the care given on ambulances.
“That patient should not have died in the back of an ambulance. What about their dignity? “It’s not the fault of individual staff members, they’re working as hard as they can. There’s just not the capacity in the system to deal with the demand.”
The NHS remains under immense pressure as demand has outstripped capacity for months, claim its workers. NHS bosses have themselves admitted that a combination of problems.
Shortages in social care, including too few community workers as well as a lack of care home spaces, is among the chief reasons for the lack of hospital beds, causing ambulances to have to wait outside hospitals with their patients until one comes free. Patients who actually get a bed in hospital cannot be discharged, as there are not enough resources to look after them at home or in residential care.
NHS staff have also told the M.E.N. that the sheer number of people coming to A&E through the doors themselves or via ambulance has shot up in recent months. The country has an ageing population meaning people are more likely to fall ill, and patients have had their treatments delayed through the pandemic so are more sick and need more serious care.
Hospitals are also suffering their own staff shortages, dating back years. Staffing levels can often become thin in the face of such rising demand, long-time doctors have shared with the M.E.N.
A North West Ambulance Service spokesperson said: “We would like to offer our sincere condolences to the patient’s family and friends at this time. This incident was reported by our staff and will be investigated.”
The Northern Care Alliance, which operates Fairfield General, has been contacted for comment.
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