A man who died coughing up blood was told it would be an 11-hour wait for an ambulance, an inquest heard.
On January 5, Charles Stephen Rothwell, 69, was diagnosed with a chest infection and given antibiotics. But the next day, his condition "significantly deteriorated", which led to him calling the North West Ambulance Service.
An inquest held into the death of Mr Rothwell, held in Warrington, heard how he made four 999 calls that afternoon - the first being at 4.26pm. But an ambulance did not arrive until 7.37pm and paramedics were unable to resuscitate Mr Rothwell.
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Mr Rothwell died in Chester on the evening of January 6, CheshireLive reports. During the first 999 call, Mr Rothwell was "correctly triaged" as category three, which is classed as an urgent call. Despite a recommended response time of 120 minutes, Mr Rothwell was told it was "likely to be a minimum 11-hour wait".
The hearing heard how a second emergency call was made at 5.26pm and he was again graded as category three. But a third call at 7.05pm when he was "coughing up blood and struggling to breathe", saw him re-graded as category two - an emergency call with an average response time of 18 minutes.
The final call was made at 7.30pm when he was "no longer breathing" where he was re-graded as category one, but when paramedics arrived seven minutes later, the 69-year-old was pronounced dead. A prevention of future deaths report was made by coroner Claire Welch.
She said the delayed arrival of paramedics did not contribute to his death, but concerns were raised over "ongoing lack of resources" across NHS services meaning there was a "risk that future deaths will occur unless action is taken".
Ms Welch said North West Ambulance Service (NWAS) "continues to experience exceptionally high demand" and that the demand "completely outstrips the capability they have got". She added: "With the approach of winter, NWAS are also beginning to see an even greater increase in demand on top of the existing demand.
"The problem is not due to a shortage of NWAS ambulances or staff but instead is the result of a wider issue linked to the lack of resources in primary, secondary and social care."
She went on to say a demand in ambulances and a backlog of ambulances waiting to hand over patients at A&E departments due to a shortage of beds was "because of shortages in social care".
The hearing heard how category two responses should respond within 18 minutes, but were seeing an average response time of 75-minutes and category three responses were seeing an average of 10.5 hours instead of the recommended 120 minutes. Recording a conclusion of natural causes, Mr Rothwell was given a medical cause of death as Lobar pneumonia.
The prevention of future deaths report has been sent to the Secretary of State for Health and Social Care, the chief executive of NHS England and the managing director of the association of ambulance chief executives. They must respond by the deadline of November 30.
A North West Ambulance Service spokesperson said: "Our sincere condolences go to Mr Rothwell’s family at this difficult time. We acknowledge the coroner’s report, and we are sorry we didn’t get to him as quickly as we would want.
“We’re working hard to ensure that everyone who needs an ambulance gets one as quickly as possible; unfortunately, emergency medical services remain under significant pressure, and while the next available resource is dispatched for life-threatening calls, some other patients are waiting longer than we would like.
"To mitigate this, we have increased the numbers of frontline ambulance crews and introduced more clinical staff into our emergency call centres to oversee all those waiting. They will call patients back to offer medical advice or recommend appropriate pathways to receive medical care and can crucially upgrade the response required if needed. We’re also working closely with NHS colleagues to reduce hospital handover delays."
A Department for Health and Social Care spokesperson added that the Health and Social Care Secretary has set out her priorities of A, B, C and D – ambulances, backlogs, care, doctors and dentists. They said: "Our Plan For Patients sets out a range of measures to help ease pressures, including an extra £500 million to speed up discharge and free up hospital beds, reducing waits in A&E and getting ambulances quickly back out on the road.
"This is alongside NHS plans to rapidly boost capacity and resilience ahead of winter, including increasing the number of NHS 999 and 111 call handlers and creating the equivalent of at least 7,000 more beds."
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