A paramedic emerged from the ‘worst shift’ he’d ever had to report one patient waiting six hours in the back of an ambulance as the NHS suffers ‘New Year’s Eve’ level pressures. ‘The NHS has collapsed’, warned the paramedic, as hospitals, ambulance services, GP practices and more face crippling pressure across the country.
He said he waited outside Stepping Hill Hospital's emergency department for hours. “I’ve never seen it this bad in my life,” he told the Manchester Evening News .
Meanwhile, some '100 patients’ are stuck in the hospital waiting to go home but are unable to be discharged due to shortages in social care, according to the paramedic. He added that crews would normally have been directed to take patients to other hospitals in the region facing less demand, but are instead being told ‘all hospitals in Greater Manchester are in the same position’.
Hospitals running out of beds
A patient waited in an ambulance outside A&E for 370 minutes, while ‘multiple patients’ were waiting up to three hours in the queue of 15 ambulances outside Stepping Hill’s A&E on Tuesday evening, said the paramedic. A patient with severe sepsis, on oxygen, waited some 20 minutes.
Huge waits have also plagued patients arriving by themselves into emergency departments because there is 'no movement of people from beds back into their homes’. On Friday, July 22, the Royal Bolton Hospital’s A&E had a sign reading: "There is currently a 40+ hour [wait] for a medical bed. There are six beds only left throughout the entire hospital.
"We have no beds/cubicles in A&E due to no movement. If you are waiting for a ward, you will be in our waiting room for numerous hours. If you require food, drink, medication or wish to leave, please go through to speak to medical staff."
There are currently high numbers of patients in hospital beds who are medically fit to go home, yet cannot be discharged due to chronic staffing shortages in social care. This includes patients waiting for spaces in care homes, but also people who may need visits from a carer in their own homes.
In Stepping Hill this week, the paramedic said there are ‘100 patients’ stuck because there is nowhere to go in the community. NHS chiefs in Greater Manchester tell the M.E.N. there is simply not enough social care to go around.
This is also paired with short staffing inside hospitals. People have left the NHS in the midst of the pandemic or are off sick with Covid, meaning there are also not enough people to look after the sheer volume of patients coming through the A&E doors as demand has risen post-lockdown, claim NHS workers.
'I've never seen it this bad'
“I’ve never seen it this bad in my life. This time of year is usually quiet with the school holidays and people going away but it’s like New Years Eve,” the paramedic said.
“They would normally put on a divert to other hospitals but we’ve been told that all hospitals in GM are in the same position.
“The NHS has collapsed and the government doesn’t give a damn. Hospital staff are trying their best and most patients and families are understanding, but never in my life have I seen anything like it.”
This is the second time this month that a paramedic has told the M.E.N. that the number of 999 callers waiting hours for an ambulance is hitting ‘New Year’s Eve’ levels on a daily basis, while North West crews are dealing with 21 per cent more urgent and life-threatening calls compared to last month. A consultant also admitted earlier this month that all hospitals in Greater Manchester have been facing the same pressure .
A national crisis
During the heatwave, the boss of the NHS has written a letter to trusts urging hospitals to take ‘immediate steps’ to reduce ambulance waiting times outside A&E departments to under 30 minutes amid warnings of ‘high risk to patients’.
In the letter to the hospital trusts, Stephen Powis, national medical director of NHS England, said that ‘timely discharge’ - to facilities including care homes - should be a priority. Meanwhile, clinicians should make ‘risk-based decisions' about ‘use of estate’ and ‘deployment of workforce’.
Medics should also be ‘creating capacity’ in acute hospitals, as Mr Powis urged staff to move patients out of emergency departments and into ‘observation areas’ as soon as possible to create space. ‘Additional beds’ should be found elsewhere in hospitals.
But paramedics and doctors alike have warned that long waiting times and lengthy handovers - where patients find themselves stuck in ambulances while waiting for ward beds - has been an ingrained problem for years. And it’s only got worse over the last year, they say.
The solutions, according to NHS staff on the ground
“It needs to be recognised that many beds are occupied by patients awaiting a social care placement,” said one consultant. “Even if we had the estate to open extra wards, our ability is limited because there are not enough staff. At the moment most wards are operating on less than the recommended number of staff.
“We can’t offload ambulances because the emergency department is full and overcrowded. We can’t admit to beds because there aren’t enough because they are full of patients who completed their acute hospital care but can’t go home because there’s no package of care or nursing home placement.
“That’s because there aren’t enough social care staff and resources,” added another paramedic.
“This is a problem that has been there for seven years. I’m sick of saying it. It’s hospital blocking that’s causing the problem. I wrote to NHS England myself about it seven years ago.”
Several paramedics and doctors the Manchester Evening News has spoken to say the solution requires major commitments from the government to create a workforce plan sufficient for the growing demands on the NHS and social care - more skilled staff are needed and they cannot be created overnight. They have also said a major financial investment is needed to add beds and space in social care - otherwise the NHS will ‘collapse’, they fear.
What do NHS and government bosses say?
In response to the paramedic’s concerns around the scenes outside Stepping Hill Hospital, the North West Ambulance Service said: "We are continuing to work closely with hospitals and the wider health systems to mitigate the challenges created by rising pressures on the health and care system including challenges discharging patients into social care, and have implemented a package of measures to ensure patients are seen quickly and safely.
“Patients waiting to be admitted in the ambulances are closely monitored by the crew and should they significantly deteriorate, they would be immediately taken into the hospital and it remains important that the public continue to access service sin the usual way including calling 999 for life threatening conditions and using 111 for other health problems.”
A Department of Health and Social Care spokesperson said: “We absolutely recognise the pressures ambulance services are facing – with call handlers answering nearly 900,000 emergency calls in June alone. The NHS is providing enhanced monitoring and intensive support to the most challenged hospitals to free up A&E and ambulance crews, so we can get patients seen quickly and ambulances back on the road.
“The NHS is investing £20 million in the ambulance fleet this year, alongside making £3.3 billion available to trusts to support them to discharge patients to wider care. The number of ambulance and support staff has also risen by almost 40% since April 2010.
“The Health and Social Care Secretary recently met with ambulance trust Chief Executives and we continue to work closely with them to improve care for patients.”
The Manchester Evening News has contacted Stockport NHS Foundation Trust, which operates Stepping Hill, and Greater Manchester NHS for comments.
Read more of today's top stories here
READ NEXT:
- Dealer found in 'drugs workshop'... just SIX DAYS after release on bail following 100mph chase
-
"We've been left in limbo land": Frustration and anxiety for buyers on stalled housing site
-
Mum-of-three left with £9 to look after family for a week after bank suddenly froze her account
-
Inside abandoned Manchester theatre left empty and decaying for decades
-
Travel disruption across Greater Manchester as rail workers strike - latest updates
