An elderly woman with suspected sepsis spent nearly 10 hours in the back of an ambulance waiting to be taken into an overcrowded A&E department, her daughter claims. Natalie Davies said she feared her mother Gillian Davies, 84, would die as a result of the "unacceptable" delays.
Gillian, a grandmother-of-two from Llanederyn, Cardiff, was suffering with a very high temperature, shaking and confusion on Sunday, August 28, so the decision was made to call an ambulance. Despite paramedics arriving at her home within 15 minutes to drive her to the University Hospital of Wales (UHW), A&E staff were allegedly unable to take the patient as there were no beds available.
It resulted in the pensioner spending nine-and-a-half hours in the back of three different ambulances outside the hospital, becoming dehydrated and increasingly upset, her daughter claims. "My father died at the same hospital in a similar situation, and I thought 'this is how it's going to end for my mum as well'," admitted Natalie.
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Natalie described Gillian, who spent many years working as a wine merchant, as a "fun-loving" and very sociable person. But she claims the ordeal has left her mum traumatised.
She said the ambulance crew who arrived in Llanederyn ran initial tests on Gillian, including an ECG and temperature checks, before deciding to take her to A&E with possible sepsis caused by a urinary tract infection. "I followed them [to hospital] in my own car. When I parked up there were at least eight ambulances queuing outside, so I pretty much knew that my mum wouldn't be offloaded at this point," she recalled.
"I managed to find the ambulance she was in, and when I went inside they still had a blood pressure cuff on her and they were still monitoring her. The paramedic went to speak to somebody and then came back on board to tell us that the A&E didn't have any beds free at all and we were looking at a five-hour wait minimum.
"Throughout the night, not one doctor or nurse came into the ambulance to assess her. As the handover hadn't been done, the hospital didn't yet consider her their patient. My mum was hallucinating, she was very confused and very unwell. Her temperature remained high and it was just a horrible situation. I always thought that time is of the essence when it came to sepsis."
Natalie claimed that the ambulance crews were visibly frustrated at the fact they were spending so long stuck outside the emergency department when they could have been reaching more life-threatened patients in the community. "They're on their knees with it because this is not the job they signed up for. It's not patient care to them. They saw one patient that evening and it was my mum during their 11-hour shift. So you've got people ringing 999 who need that ambulance just as much as my mum and they're not getting it."
Natalie, who used to work in emergency ambulance response herself, believes Covid-19 is now being used as an excuse for the way the acute end of the NHS operates. "The protocol we used to have when ambulances started queuing is we'd have one paramedic looking after between four and five patients on the trollies in the corridor in A&E. You would also have a duty officer who was medically trained. They would be looking after those patients so the crews could get back in their ambulances and go.
"When I said that to a senior consultant in A&E, they said 'Well, that's what used to happen, but we can't have them queuing in the corridor now because of Covid'. I don't buy that as none of the staff were wearing masks.
"And frustratingly, the crew were given free food and drink vouchers that they could go into the hospital and use - and yet my mother was not given any fluids at all. Luckily I had a bottle of water on me and my own paracetamol in my handbag, and that was it. I could barely get her to even sip the water because she was so ill."
Following her lengthy spell in three different ambulances due to changes in shifts, Gillian was finally put in a cubicle in A&E, given blood pressure checks and a cannula was inserted with the aim of administering intravenous antibiotics. In the end she was giving oral antibiotics and discharged home despite continuing to feel very unwell and her infection markers being high, Natalie claims.
"We probably got offloaded from the ambulance at around 6.30am, and we stayed in A&E until about 11pm that night. During that whole time there was no medication and no antibiotics given to her," Natalie added.
"Interestingly, as my mum has a metal hip they queried whether she had something called septic arthritis where the joint becomes infected. Orthopaedics came at around 9pm, they had a good look at her and they were unsure whether to discharge her or not. But by this point my mum was begging me to take her home. I think she felt she was dying, but she just didn't want to die in a hospital bed."
Gillian, who is also partially-sighted and hard of hearing, is now home and her infection levels are lowering thanks to the antibiotics, but Natalie said her mum is petrified of going to A&E again. The family has questioned why patients weren't being diverted from UHW to other emergency departments in south Wales.
Lee Brooks, executive director of operations for the Welsh Ambulance Service, said: "The issues and consequences of extended patient handover, at emergency departments is deep rooted and well-documented. On the day in question, we lost nearly 700 hours across Wales outside hospitals. This is as frustrating for our staff as it is for patients, and we sympathise with Ms Davies and her family."
A spokesperson for Cardiff and Vale University Health Board, said: “Our health and social care services across Cardiff and the Vale of Glamorgan are experiencing significant and sustained pressures, which is having an impact on patient flow within our hospital and waiting times in our emergency unit.
“Staff are working incredibly hard, often in difficult circumstances to provide the best and most appropriate care. We are unable to comment on individual cases but we sincerely apologise for the delays experienced in the emergency unit, and we would advise the family to contact our concerns department if they would like to discuss this further.
“While we are under these extreme pressures, we would ask the public that if they do have an urgent, non-life-threatening emergency, to call NHS 111 Wales free from a mobile or landline. By doing so, a call handler will assess your condition and, if appropriate, a clinician from CAV 24/7 will call you back for further assessment and access to urgent care. This is to ensure we can assess and direct patients to services appropriately, helping to reduce pressure on the system and ensuring we can support those most in need.”
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