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GPs forced to drive patients to hospital amid 'shocking' ambulance delays

Exclusive Very young and elderly patients are dying because of worsening delays to 999 calls, claim GPs who have in some cases had to drive patients to the hospital themselves after an ambulance failed to turn up.

The stark assessment comes in a dossier with scores of recent occurrences collected by the campaign group GP Survival, and shared with Pulse, which says patients were increasingly being put at risk due to underfunding of ambulance services.

Examples include a GP in England who waited for 45 mins for a 999 ambulance, despite telling call handlers it was likely the patient had unstable angina and/or a myocardial infarction.

Another GP drove a six-month old child with severe respiratory distress due to bronchiolitis to hospital themselves after calling 999 and waiting 55 minutes for an ambulance.

And a GP in Scotland said the situation was 'very scary', adding: 'It's common for us to wait 45 minutes to an hour [although we are] only 10 minutes from [the] local hospital.'

Performance statistics for English ambulance trusts show worsening in response times, with 71.9% of all ‘Red 1’ calls receiving a response within eight minutes in 2014/15 (the latest available figures), down from 75.6% in 2013/14.

Of the 11 ambulance services in England, just five met or exceeded the 75% standard for this section, compared with eight trusts in 2013/14.

Urgent care experts say ambulance trusts have had to cope with rising demand and a national shortage of paramedics.

Rehana Azam, national secretary for GMB, the union representing ambulance service staff, said the examples were 'absolutely shocking'.

She said: 'Ambulance staff are doing their upmost best to respond to this demand but the Government is turning the other way. These horrifying case studies are the direct result of years of chronic under-funding of the NHS and Ambulance Service.

'If we genuinely want a health service we can be proud of - one that provides free, quality care for people at their time of need - we need to fund it properly and invest in the people delivering the service. By Jeremy Hunt's own admission, the NHS faces painful and difficult economies in the near future, so the problem is only going to get worse.'

The College of Emergency Medicine said the GPs' experiences were 'tragic and unacceptable'. RCEM President Dr Taj Hassan said A&E 'overcrowding', meaning ambulances cannont hand over patients, was a key obstacle lengthening response times.

Dr Hassan said this presents 'a serious challenge across emergency departments throughout England and we are concerned for patient safety'.

He said: 'These tragic stories highlight the need to urgently tackle the problem. Ambulances are having to wait too long to offload their patients due to overcrowding, and cannot get back out into the community quickly enough.

'This can only be solved by a combination of rebuilding social care capacity and the whole hospital focusing on dealing with exit block as a key priority to restore stability, efficiency and safety to the emergency care system.'

A GP Survival spokesperson said: 'If the ambulance service was properly funded, these types of events would not happen. It is without doubt that patients from babies to the elderly are dying unnecessarily in cases like these.

'Ironically those GPs in the cases [above] who took the patient to hospital themselves because the ambulance did not arrive, could probably be successfully sued. But when patients like these are in front of you, it is the right thing to do to try and save their lives. Something is very wrong when this can happen.'

According to the group, the Government has 'not listened to doctors, nurses, or paramedics about the harm that is happening because of lack of adequate NHS funding'.

The spokesperson added: 'We hope these examples will encourage patients to write to their MP, health secretary Jeremy Hunt and Prime Minister Theresa May and demand that this is addressed before more lives are lost.'

Responding to the claims, a Department of Health spokesperson said: 'Patients deserve the highest standard of care at all times. We know services are under pressure but the NHS continues to perform well across the country, with ambulance services making over 3,400 more emergency journeys every day compared to 2010.

'We've employed 2,200 more paramedics since 2010, increased training places this year by 60% to over 1,600, and invested £10bn to fund the NHS's own plan for the future.'

What GPs say about ambulance response times

'Six-month-old with severe respiratory distress due to bronchiolitis. Called 999 and 55 minutes later still no crew. Got frustrated, cancelled call and drove him to hospital'

'Blue baby brought in mother's arms. Not breathing, fitting. We rang 999  told no ambulances. First responder attended at 10 minutes, another 30 minutes for ambulance. Awful day'

'Drove a three-year-old with sepsis to hospital because no ambulance was coming and they couldn't tell me when it would come'

'We waited 45 minutes for a patient in cardiac arrest. Horrendous'

'One hour [is] standard [for] chest pain, sepsis, heart failure, meningitic child, life-threatening asthma'

'I have never known ambulance response times to be so poor in 25 years of being a GP'

'Two hours for an ambulance for a baby with sepsis'

'Middle-aged lady with an evolving stroke. 999 called for urgent hospital transfer to nearest stroke unit at 11.30am. At 1.10pm still no ambulance. We elected to take her in the car and cancelled ambulance request'

'About 40 minutes for a baby under 12 months with a respiratory rate of 66 and heart rate so fast I couldn't count'

'Well over an hour for a man with central crushing chest pain'

'90 minutes for a lady with central crushing chest pain radiating to jaw and associated with sweating and nausea'

'Psychotic unwell schizofrenic. Very distressed, dilusional. Ambulance took 4-5 hours. A healthcare assistant and a receptionist sat with him all that time. Complete nightmare'

'The police and I waited over 45 minutes with an acutely psychotic man who was threatening himself and others. Ambulance never arrived but police decided to take him [to hospital] themselves'

'Four-hour wait for patient with neutropenic sepsis'

Source: GP Survival

 

Readers' comments (18)

  • Let's hope the media picks this up.

    Interestingly I note that the little information that has been mentioned in the on-line press regarding the huge cuts that STP will bring has had comments sections 'closed'. I wonder why... Patricia are you trying to silence the press?

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  • This contradicts NHS England's Sustainability and Transformation Plan (STP) which many fear would close down local A&E and Maternity Units (both receive urgent and emergency patients) when speed to the A&E or Maternity Unit is of the essence. I was held up for an hour on a main road here in Worthing because of a traffic accident attended by three ambulances, four Police Cars and two Fire Engines many of which we had to let through by driving up onto the kerb. When we were allowed to proceed, it was clear that the roof of a burned car had had to be cut off to free the injured passengers. That is why we need nearby A&E and Maternity Units and if the STP causes deaths or increased morbidity by delaying getting accident and emergency patients to Hospital, the politicians who authored or introduced this STP will in future be unelectable. This note is a WARNING to them. Ambulance services obviously require to be adequately served with vehicles and adequately staffed. The last Labour Government increased the funding to the NHS to near the EU average per capita funding and reduced Hospital waiting times down from 1-2 years to 2-4 weeks but this Government had reduced NHS funding so that its per capita funding is now at the bottom of the EU per capita league table which is again increasing waiting times and the time it takes to reach hospital. The Government's Austerity Programme is misdirected because the Pubic Sector did not cause the Public Deficit: the Banks did. I vote that the Banks should share the cost of deficit reduction since they caused the deficit, and we should follow Bank on Dave's advice to establish local banks offering 5% to investors and charging 7% interest to borrowers such as local businesses and giving the profits charity in order to undercut the main Banks whose reckless and criminal misconduct with their investors' money practically bankrupted their banks. They ought to have lost their banking licences.

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  • This news about NHS cuts was on the Guardian Front Page two days ago on Saturday 19 11 2106.

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  • 'a department of health spokesman says'
    we are not listening to anything nhs staff say and continue with our campaign of smokescreens ,lies and disinformation for as long as we can get away with it.
    I note the so called spokesman is never named..though it is probably a robot.
    I think the same mendacious trash is wheeled out from a tape recorder.

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  • Shocking!Some patients are helping the ambulances by going straight to A+E.

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  • This is no surprise. I can immediately think of several more examples. A colleague described waiting 2 hours when the patient had ongoing chest pain and confirmed ST elevation - of which the ambulance service was aware.

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  • Absolutely disgraceful.

    People are dying needlessly due to a deliberate funding squeeze and the staff on the frontline as usual are expected to deal with this.

    Scandalous

    I'm utterly dismayed and indeed ashamed that this can go on in a civilised country in the twenty first century without any backlash from the professionals !

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  • This comment has been moderated.

  • Feel sorry for these poor paramedics - it's not their fault they are grossly understaffed, and they are just as horrified by these stories as we are.

    The stress they are put under by being spread so thin on the ground is intolerable and more and more of them are leaving (some to become physician assistants, or equivalents in primary care)

    This is only going to get worse - we have reached the tipping point already.

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  • just had a FIVE hour wait for a child that was confused and hypoxic off oxygen

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  • Presumably the Department's response will be to require any clinician driving a patient to hospital to prove that they have an advanced driver's certificate, insurance for the patient, a second person in the back of the car to look after the clinical needs of the patient, and a certified absence of dog hairs on the back seat for those patients who may be allergic. Oh yes, and a PSV driving licence.

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