More than four hours after an ambulance was called, Richard Carpenter, 71, who had had a suspected heart attack, began to despair. “Where are they?” he asked his wife, Jeanette. “I’m going to die.”
She tried to reassure her husband that the crew must surely be close. Perhaps they were struggling to find their rural Wiltshire home in the dark. “But I could see I was losing him,” she said. She gave her husband CPR and urged him: “Don’t leave me.” But by the time the paramedics arrived another hour or so later, it was too late.
Jeanette Carpenter, 70, a stoical and reasonable person, accepts it might have been impossible to save her husband. “But I think he would have had more of a chance if they had got here sooner,” she said.
It is the sort of sad story that is becoming all too common. Across England, but in particular in the south-west, ambulances are too often not getting to patients in a timely manner.
Richard Carpenter had come out of hospital two days before, after heart surgery. On the night he died he complained of pains in his back, side and arms, and his wife called for help at 10.37pm. She rang back twice more, telling the call handlers that she thought her husband was having a heart attack. Finally, help arrived at about 4am.
“The paramedics did everything they could but it was too late,” Carpenter said. Her husband, a beloved father and grandfather with a lovely sense of humour, died after suffering a haemothorax – an accumulation of blood within the pleural cavity. “I feel so let down,” she said. “Is this the sort of country we live in now?”
‘My lips were blue. It was really bad’
Steven Webb, 49, the mayor of Truro, is paralysed and susceptible to a condition called autonomic dysreflexia that can send his blood pressure soaring. The last time it struck him, he believes it almost cost him his life.
“Blood pressure like that can lead to a stroke or death in 15 or 20 minutes,” he said. “Normally my carers deal with it but this time I was passing blood. I was sweating, my heart was pounding, I was in a lot of pain. My lips were blue. It was really bad.”
An ambulance was called. “They said it was category one, next ambulance available. Twenty minutes passed and I phoned back and asked where the ambulance was. It was very dangerous for me, frightening. They said they were sending an ambulance from Bodmin.” That was 27 miles away.
The ambulance that finally arrived, 90 minutes after the 999 call, had actually come from Saltash, 50 miles away. The paramedics stabilised him.
As a politician, Webb understands why things are going wrong – the lack of bed spaces in hospitals, the strain on the care system that means people are not able to be discharged even when they are well enough, the ongoing impact of Covid.
“The situation is getting worse,” said Webb. “People are having heart attacks and strokes and loved ones are having to drive them into hospital. People are dying because of this. The system is the problem. The ambulance crews are the heroes. They’ll soldier on through this, turn up to work, do their best.”
Why the south-west is struggling
One of those heroes, a frontline ambulance worker based in the south-west, characterised the situation as “horrendous”. Before Covid, said the worker – who asked not to be named – he would do between six and 10 jobs in a shift. Now if the first person he is called to needs to go to hospital, he expects this will be his one job for the whole shift.
“At some hospitals we are waiting outside hospitals for 10, 11 or 12 hours,” he said. “There’s nothing more demoralising than hearing a general broadcast going out for a cardiac arrest or road accident and there’s no resources to send. It’s terrible to think someone’s loved one needs help and we can’t do anything because we’re stuck at a hospital.”
There are reasons why the south-west is struggling in particular. South Western ambulance service NHS foundation trust (SWASFT) covers 10,000 square miles – a fifth of mainland England – much of it rural. It takes a long time to get around and hospitals are far apart. The trust also serves a more elderly population than other parts of the UK, and has to deal with an influx of 23 million visitors a year.
SWASFT is trying to address the situation by introducing measures such as hospital ambulance liaison officers, “fall cars” dedicated to helping people who take a tumble, and specialist mental health teams.
But a spokesperson said there had been high demand for a sustained period. “At times we experience delays in handing our patients over to emergency departments, which prevents our crews from getting back out on the road for other patients. This is because of the pressures across the entire health and care system,” they said. “We are engaging with our partners to address these delays and they are working hard to reduce the number of patients waiting to be discharged from hospital, so beds can be freed for those needing admission to a ward.”
SWASFT has asked people with non-life-threatening conditions to use other services such as 111, GPs or pharmacies where possible. But this weekend, as ever, there were ambulances parked outside hospitals – a dozen on Saturday afternoon outside Gloucestershire Royal hospital, another 12 by early evening at the Royal United hospital (RUH) in Bath.
‘Not the world we want to live in’
At the end of last month, Bath and North East Somerset council wrote to the government expressing concern about the case of a 93-year-old man who collapsed during a classical music concert in the city’s Christ church.
The priest-in-charge, Lore Chumbley, a former surgeon, knew the man had broken a bone, and someone dialled 999. “It took six and a bit minutes for us to get through,” said Chumbley. They tried to make the man comfortable, using hassocks – kneeling cushions – to prop him up, and the long, long wait began. “He lay there all night,” said Chumbley. It was almost 12 hours before the ambulance arrived. “This is not the world we want to live in,” she said.
The Liberal Democrat leader of the council, Kevin Guy, wrote to the government arguing that “unacceptable pressures” on the health and social care system were putting lives at risk. He said a quarter of beds in the RUH were occupied by people fit for discharge but who were stuck in the system, “largely due to shortfalls in domiciliary care”, He added: “It is not uncommon to see 15 or 20 ambulances queueing outside the emergency department.”
Daryl Major, 32, who has fibromyalgia, a condition that causes widespread pain and extreme tiredness, told how he was left in pain for 14 hours after falling into the gap between his bed and a radiator in his seventh-floor flat in Swindon. “I was stuck in the 2ft gap. I just couldn’t move,” he said. “I was crying in pain.”
His father, Ian, 67, a former police officer and part-time bus driver, found him and called 999. Major spent a whole night in that painful, uncomfortable position. “I phoned them four or five times,” his father said. “They were very nice but they just said they were very busy and would get to us when they could.
“It’s made Daryl feel very anxious. I know ambulance crews are doing the best they can. They just want to do the best job for their patients but they are not being allowed to do their work properly. Something has got to change.”
