This site is intended for health professionals only

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