999 crews wait 9,000 times at casualty when they could have been out saving lives

During the peak of the winter pressure crisis, one crew ended up waiting more than four hours at Worthing Hospital instead of the expected 15 minutes.

Others found themselves forced to stay at the Royal Sussex County Hospital in Brighton for almost three hours before being able to pass patients into the hands of under-pressure staff.

This put pressure on paramedics and 999 control staff who needed to provide cover in areas where crews were delayed.

Figures obtained by The Argus reveal crews were delayed by more than 30 minutes at the Royal Sussex more than 4,000 times between November and the end of last month. One in eight of these actually waited more than an hour.

There were 1,384 long waits at the Conquest Hospital in St Leonards and 879 at Eastbourne District General Hospital.

Hospitals came under exceptional pressure in January following a rise in the number of – mainly elderly – patients needing a lot of care and a shortage of available beds.

Dozens of patients ready to be discharged were also stranded on hospital wards because there were no nursing home or rehabilitation beds available in the community.

Others had to wait for arrangements to be made for the care they would need once they got home.

The shortage of beds had a knock-on effect on other departments, including A&E, with ambulance crews and patients facing long waits.

A spokesman for South East Coast Ambulance Service said: “Delays at hospitals are an issue and do have an impact on our service. We work hard across our region to ensure that those patients who call 999 but don’t need emergency hospital treatment are dealt with outside of A&E departments.

“This may be by providing advice over the phone, ambulance crews treating patients at the scene of a call without the need for hospital treatment or referring a patient to an alternative clinical pathway.

“It is vital that we balance the needs of the patients who are delayed in being handed over to hospital, and who are ultimately in the care of a hospital, with those patients out in the community who have called 999 for emergency medical assistance.

“We will continue to work closely with our hospital colleagues at all times, and especially during periods of high demand, and would ask for the public’s support in remembering that calling 999 and visiting A&E should be reserved for serious and life-threatening conditions.”

Western Sussex Hospitals NHS Trust runs Worthing Hospital and St Richard’s in Chichester.

Medical director George Findlay said the situation had improved at the trust’s two hospitals since the crisis in January.

He added: “We work very closely with the ambulance service, as well as other healthcare providers, to ensure patients are seen as quickly as possible and to the highest-possible standards.

“It is thanks to this co-ordinated approach, and the hard work of all our staff, that Western Sussex was one of the few trusts which met the A&E four-hour waiting time target after a winter of unprecedented demand for NHS services.”

Health and council officials across Sussex have been working to find a solution to ease pressures on hospitals but the problem is still continuing at some hospitals.

On Wednesday morning this week the Royal Sussex had 25 bed-blocking patients on its wards while a further 22 were waiting in A&E for a bed.

One of these was 77-year-old Brenda Chappell, of Whitehawk, Brighton, who spent 22 hours in A&E from 1.30pm on Tuesday until 11.30am on Wednesday.

Her family said they understood that hospitals were busy but the length of time Mrs Chappell had to wait was “unacceptable.”

A spokesman for Brighton and Sussex University Hospitals NHS Trust, which runs the Royal Sussex and Princess Royal Hospital in Haywards Heath, said: “We are working hard to improve the flow of patients through A&E and the hospital as a whole, as well as with our partner health and social care organisations to create more capacity out in the community that will allow patients to be discharged from hospital quicker.”

General manager for urgent care at Eastbourne District General Hospital and the Conquest, Jenny Darwood, said: “We work closely with colleagues at South East Coast Ambulance to ensure patient safety and the timely handover of patients into our care.

“In general, longer handover times reflect periods of significant operational pressure on the hospital which reduce the flow of patients throughout the hospital and affect our ability to admit patients in a timely manner.

“We are working in partnership with our GP colleagues and adult social care to find better alternatives to bringing some patients to an acute hospital and ensuring that patients stay in hospital no longer than they need.”

Brighton and Hove Clinical Commissioning Group, the city council, ambulance service and other groups are drawing up plans in a bid to avoid the crisis that hit this winter and details are due to be published at the end of next month.

LEFT IN A&E FOR 22 HOURS

Brenda Chappell

Brenda Chappell

AN elderly patient spent almost a day in a hospital accident and emergency department because of a shortage of available beds.

Brenda Chappell was taken by ambulance to the Royal Sussex County Hospital in Brighton at 1.30pm on Tuesday but was not transferred on to a ward until 11.30am the following morning.

The 77-year-old’s angry family said they understood the hospital was busy but the delay was not acceptable.

Mrs Chappell, from Whitehawk, Brighton, had been discharged from the Royal Sussex a few days before after spending two weeks on a ward with suspected shingles.

When she came home the pain became worse and her family called for an ambulance.

Mrs Chappell’s daughter Brenda said: “We were told by a consultant she would be admitted but she ended up staying in A&E for hours.

“She was upset and distressed and it was not the right place for her.

“I understand they had a lot to do and they were busy but she should not have been hanging around for that length of time.

“It was upsetting and uncomfortable for her.”

A hospital spokesman said: “We are sorry this patient’s relative has had cause to raise concerns but we are currently extremely busy and unfortunately this means that some patients have to wait longer than we would like in the emergency department to be admitted into a hospital bed.

“All patients who do have to wait in A&E are seen by a clinician within an hour of arriving in the department, are made as comfortable as possible and are regularly monitored in a safe environment.

“We are working hard to improve the flow of patients through A&E and the hospital as a whole, as well as with our partner health and social care organisations to create more capacity out in the community that will allow patients to be discharged from hospital quicker.”

ANALYSIS: ‘THERE'S A SERIOUS UNDERLYING PROBLEM’

THERE is no single solution to dealing with the long delays in hospital accident and emergency departments and the length of time ambulance crews are having to wait to hand over patients.

The NHS in Sussex, in common with the rest of the country, experienced a winter of unprecedented demand as it battled to cope with a high demand from patients while managing a lack of available beds.

The situation has eased a little since January but hospitals are continuing to struggle, with one patient spending 22 hours in A&E at the Royal Sussex this week waiting for a bed.

In previous years it was believed that as long as enough preparations were made in advance, health services would be able to cope with “winter pressures” during their busiest time of the year.

But it is increasingly clear these pressures do not go away in the spring, summer and autumn and this is a year-long issue.

Ambulances facing delays before being able to get back on the road and patients spending hours in A&E are the physical and obvious symptom of a serious underlying problem that is the responsibility of not just the hospital but the rest of the NHS and councils.

A lot of work has already been done to tackle the issue – ranging from extending the opening hours of GP surgeries to ease pressure on A&E to opening up extra rehabilitation beds for patients not quite ready to go home. But more needs to be done.

Ideally, hospitals should be able to discharge patients on any day of the week but if the necessary staff – whether NHS or social services – are not available at weekends or bank holidays for whatever reason, then this adds to the delays.

Extensive plans are now being drawn up by the authorities responsible, which may mean a radical new approach with every organisation working together.

Whether it is making sure enough of the right services are in the right place to deal with whatever comes up or whether it means seven-day working, a consensus needs to be found.

There is unlikely to be any significant extra government funding so authorities will have to make the best of what they have if they are to avoid a repeat of what happened last January.