Paramedics in England are unable to respond to 100,000 urgent 999 calls every month because they are stuck outside hospitals waiting to hand over patients, endangering thousands of lives, the Guardian can reveal.
As the crisis engulfing the NHS intensified this weekend, figures showed ambulance crews are tied up at A&E for so long that on more than 3,500 occasions each day they are unable to respond to a 999 plea for help.
In total, there were 1,313,218 lost job cycles in the past year as a direct result of ambulance handover delays, an analysis of NHS data by the Guardian and the Association of Ambulance Chief Executives (AACE) found.
Doctors said the figures were “jaw-dropping” and called on ministers to take immediate action to tackle the handover delays.
Patient groups said it was “incredibly frightening” that paramedics were unable to respond to thousands of emergency calls because they were stuck in queues outside hospitals.
The revelations follow a Guardian investigation that exposed how more than 1,000 patients a day were experiencing “potential harm” while left in the back of ambulances outside hospitals.
In total, ambulances spent 1,641,522 hours waiting outside A&E to hand over patients in the year to November 2024.
Anna Parry, the managing director of AACE, which represents the bosses of England’s 10 regional NHS ambulance services, said the data showed how vital it was that handover delays were reduced.
“Lost job cycles have a profound impact on the resources available to local ambulance services,” she added, with “the most detrimental impact” on 999 patients with life-threatening conditions “who need us most”.
Patients who have suffered heart attacks and strokes are having to wait far too long for emergency care, and vulnerable older people are in some cases spending all night on the floor at home after falling.
The crisis is being caused by soaring demand for emergency care, staff shortages and a lack of social care beds that means packed hospitals cannot discharge patients who are fit to leave so struggle to admit patients waiting in ambulances outside.
Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation, said: “This inevitably has a knock-on effect where ambulance staff caring for patients at the hospital cannot go out to the next call.
“This desperate situation becomes all the more pressing as the NHS grapples with the huge challenges it faces this winter.”
Every minute that passes when someone has had a heart attack or stroke risked further harm and even death, she added. “No patient and their family should have to endure dramatic delays, and it’s a tragedy to see this happening on such a large scale.”
National guidance says patients arriving at an emergency department by ambulance must be handed over to the care of A&E staff within 15 minutes. However, the target is persistently missed, the Guardian investigation found.
A total of 42.2% of patients arriving at hospitals in England last week waited at least 30 minutes to be handed over to A&E teams – the highest figure so far this winter.
In the past fortnight, one crew had to wait eight hours outside a hospital to hand over a patient before they could leave for another 999 call, a paramedic told the Guardian.
Helga Pile, head of health at Unison, the UK’s largest health union, said a failure by ministers to invest properly in the NHS for years had left staff “exhausted” and “frustrated they can’t do more”.
Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said the number of 999 calls that crews could not respond to because they were tied up at hospitals, as revealed by the data analysis, was “jaw-dropping”.
“It is demoralising for my staff that we seem to have gone backwards compared to where we were last year,” Boyle added.
After Wiltshire resident Jayne Bolton, 63, was admitted to hospital last year with volvulus, a serious condition where the bowel twists and cuts off the blood supply to the organ, she was told to call 999 immediately if she experienced symptoms again.
Vomiting and experiencing severe pain again in September, Bolton called 999 but was told no ambulances were available. She made it to A&E only when a neighbour agreed to drive her, and then spent almost a week in hospital. “They need to get the hierarchy on to the frontlines to see what is really going on,” she said.
Louise Ansari, the chief executive at Healthwatch England, a patient group that was contacted by Bolton, said ambulance handover delays were “becoming the norm”.
Juliet Bouverie, the chief executive of Stroke Association, said that even patients who had suffered strokes were being left “desperately waiting for an ambulance” while crews were “parked up outside hospitals due to significant handover delays”.
The situation was “unacceptable”, she added. “Not only is this incredibly frightening for patients and their families but it also endangers their lives and chances of recovery … we cannot abandon people with suspected stroke like this.”
NHS England said handover delays had improved before winter, but accepted there was “clearly much more still to do” to reduce “unacceptably long waits for patients” in some parts of the country. It was “prioritising the sickest patients”, a spokesperson added.
The Department of Health and Social Care said its plans to “rebuild” the NHS would enable ambulances to “arrive on time again”, but did not specify any new measures for emergency care.
A spokesperson added that previously announced social care reforms and a pledge to recruit 1,000 extra GPs would help “ease pressures on ambulance services”.
However, Rachel Power, the chief executive of the Patients Association, said solutions to end the emergency care crisis were needed immediately “to ensure patients can receive the care they need without unnecessary delays”.
The Guardian investigation clearly exposed how persistent handover delays were preventing crews from picking up thousands of 999 calls and “continuing to put patients’ lives at risk”, she added.
“Every minute counts when it comes to emergency care, and the longer patients are left without help, the greater the risk of harm. The government cannot afford to ignore this issue any longer.”
Source: theguardian.com
