Ambulances outside the Accident and Emergency department at St Thomas’s hospital in central London
(Picture: PA Wire)London paramedics are spending their entire shift taking care of patients who are waiting to be discharged into A&E, the head of the London Ambulance Service (LAS) has said.
Dr John Martin, chief paramedic at the LAS, warned that an increasing number of paramedics were becoming “really frustrated” at having to spend hours waiting to hand patients over to emergency departments rather than responding to calls.
The latest figures show that crews had to wait more than 30 mins in 29 per cent of arrivals to London hospitals in the week up to December 11. The target is 15 minutes and long waits can cause a patient’s condition to significantly deteriorate.
The NHS said that the delays have arisen as hospitals are struggling to discharge patients and free up capacity in A&E, with many beds occupied by patients in need of adult social care who have nowhere else to go.
Dr Martin told the Health and Social Care Committee that handover delays were having a devastating impact on morale amongst paramedics.
“Hospital handover delays are at the top of the list of issues for our members… they can spend a whole shift outside hospital waiting to hand over a patient. That has a huge impact on paramedics, families and the patients themselves.
“We pride ourselves on having great paramedic education. It’s really frustrating when you can’t use that on patients on your shift.”
Health Secretary Steve Barclay will meet with union leaders on Wednesday afternoon to finalise details on which incidents will be covered during the strikes. The most serious Category 1 calls will be answered but there is uncertainty over the coverage of Category 2 calls, which include strokes or chest pain.
Ambulance response times are likely to worsen when paramedics stage industrial action on Wednesday, Dr Martin said, even though patients currently face long waits.
“On Wednesday, even with the derogations, delays are likely to be worse. But with this life and limb cover, paramedics up and down the country will absolutely want to keep patients safe.
"I think the important bit to note in that though is that the Category 1 calls will get a response and the unions are working very hard on how that will occur.
“It's the group in Category 2 and below who maybe don't start off as life or limb, and this is what we're seeing today and (likely on Wednesday), who will deteriorate over time and eventually they will become a life or limb emergency and obviously at that point they do fall into (Category 1).”
Rachel Harrison, National Secretary at GMB, which is taking part in Wednesday’s strike, said that cover will vary by service.
But she insisted: "Life and limb cover will be provided."
Ms Harrison told the Committee that ambulance workers have the highest level of sickness out of NHS staff because of the "terrible conditions" they are working in.
“This isn't just the frontline paramedics, technicians, emergency care assistants. This is the call centre - people who are having to deal with this influx of calls and screaming families and friends who are frustrated,” she said.
NHS figures show that more than one in ten (11 per cent) ambulances arriving at Barts Health NHS Trust on December 11 waited longer than an hour to hand a patient over to A&E.
On Tuesday, the Trust effectively declared a major incident and urged expectant mothers to “make plans in advance for getting themselves to hospital” during the ambulance strikes.
Guy’s and St Thomas’ said routine procedures had been postponed due to the nursing strike. While maternity services will continue to run, ambulances may only respond where there is an immediate risk to life tomorrow.
Royal Free London said emergency departments and urgent treatment centres will be “incredibly busy” and said people should only attend if their condition is urgent or life-threatening. Maternity services will not be affected and Lewisham and Greenwich NHS Trust urged patients only to call 999 in a medical emergency.
Mr Barclay insisted: “The NHS remains open and Londoners should continue to come forward for emergency and urgent medical care. They should also continue to turn up to appointments unless they have been contacted by the NHS.”
