A patient waited in an ambulance for almost two days before being admitted into a hospital's emergency department, it has been revealed. The Welsh Ambulance Service's chief executive Jason Killens said handover delays are becoming increasingly frustrating for staff and the public alike but admitted there was "no quick fix".
It has emerged that it took ambulance crews 41 hours to transfer the care of one patient over to A&E staff at Princess of Wales Hospital in Bridgend on Monday, September 26. The target time is 15 minutes, however this is consistently not being met due to emergency departments being severely overcrowded, resulting in a severe lack of vacant beds.
A report by Healthcare Inspectorate Wales (HIW) found that of the 185,000 ambulance handovers to emergency departments between April 2020 and March 2021, less than half of them (79,500) met the 15-minute target. During that period there were also 32,699 incidents recorded where handover delays were in excess of 60 minutes, with almost half (16,405) involving patients over the age of 65 who are more likely to be vulnerable and at risk of unnecessary harm.
Read more: 'My 84-year-old mum spent nearly 10 hours in the back of an ambulance as A&E was full'
But the service now appears to be facing delays way beyond anything it has experienced before, with patients spending a day, if not longer, in vehicles before being taken into A&E. HIW added that these delays have consistently led to multiple ambulances waiting outside A&E departments for excessive amounts of time, unable to respond to emergencies within their communities.
In August just over half (50.7%) of life-threatened 'red' patients were reached within eight minutes by paramedics and their colleagues, a decline on the 52% in July and 50.8% in June. The target of 65% has not been reached for two years.
Commenting on the handover delays over the last few days, Jason Killens said: "Handover delays continue to inhibit our ability to respond to emergencies in the community. The issues and consequences of extended patient handover at emergency departments is deep-rooted and well-documented.
"On September 24 and 25 we lost nearly 1,800 hours of emergency ambulance cover across Wales outside hospitals. Unfortunately there is no quick fix. There are many factors impacting the delay in offloading patients into hospitals.
"This is as frustrating for our staff as it is for patients, so we continue to do all we can with our partners to ease the system-wide pressures to put a stop to long delays outside emergency departments."
A vital contributing factor to these excessive handover delays, according to experts, is the inability to discharge medically-fit patients from hospital wards in a timely fashion. The Welsh NHS Confederation said up to 1,500 people are currently ready to leave hospital but can't because of a lack of social care provision.
On Tuesday more than 50 NHS leaders in Wales described social care as in a state of crisis and have called on the Welsh Government to provide a long-term pay and funding strategy for the sector. You can read more on that here.
In response to the 41-hour wait outside Princess of Wales Hospital, Sarah James, deputy chief operating officer at Cwm Taf Morgannwg University Health Board said: "We appreciate any wait for clinical service can be difficult for patients and their families as this is not what we want for any of our patients, staff and partners who are often working in challenging circumstances.
"A significant proportion of the beds at the hospital are currently occupied by patients who no longer need to be in an acute hospital and this creates an ongoing impact on flow through our emergency departments. Social care teams are working hard trying to discharge patients from our hospitals with the right package of care for their needs.
"We want to reassure that the safety of our patients, communities and staff is a priority: we continually work with Welsh Ambulance Service colleagues and local authority partners in Bridgend, to do all we can to manage the system-wide demand regularly experienced."
The Welsh Government confirmed over the summer that a national ambulance improvement plan has been agreed by NHS Wales chief executives to deliver a wide range of actions to support better management of 999 demand in the community, increased ambulance capacity, improved responsiveness to people with time sensitive complaints and ambulance patient handover.
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