Dr. Kathryn Henderson, president of the Royal College of Emergency Medicine, said the pressure on the NHS was now so severe that it violated its “basic agreement” with the public for the timely treatment of the sick. In an emergency, Henderson said emergency care was in a “deeper crisis than ever” and for the first time in its history the NHS could no longer abide by its “contract” with the nation to reach seriously ill people immediately. patients. calling 999. Patients with life-threatening conditions, such as heart attacks and strokes, have to wait too long for emergency care, he said, and vulnerable seniors in some cases spend all night on the floor at home after falling. The rapidly escalating crisis is being fueled by growing demand, huge NHS staff shortages and social care exacerbated by Covid-related absenteeism and a drastic shortage of hospital beds and hospitals. “The real obstacle to tackling this crisis is political reluctance,” Henderson said. “The current situation is cracking the workforce and cracking our hearts.” Hospitals are facing record demand from patients who appear two years after the pandemic, while struggling to discharge patients due to the crisis in social care. As a result, Henderson said, doctors are struggling to find space for patients arriving at A&E. This causes record delays in ambulances delivering patients, leading to up to 22 hours of waiting for 999 callers. In an interview with the Guardian, Henderson said she had no choice but to ring the alarm bell for “shocking” and “incredibly bad” delays in emergency care because the growing crisis was dangerous and endangered lives. “It is not acceptable,” Henderson said. “It’s a very, very important loss for this basic NHS public agreement, which is that if you call 999 and you need an ambulance – which an elderly person who has fallen down needs – you will get one in a timely manner. “And we broke this contract with the public. It is a shame for me that we are in this situation. “We have elderly, vulnerable people at home who need an ambulance; and we can’t bring them.” The results of a study conducted by the Royal College of Emergency Medicine, which was reported exclusively to the Guardian, reveal the magnitude of the crisis. Eighty percent of clinical guides in emergency departments nationwide reported holding ambulances every day for the past week, a 15% increase from the same survey in December. More than half of potential clinical clients (55%) reported the longest stay of their patients in A&E in the last three days to more than 24 hours, the survey shows. Nearly a quarter (23%) said their patients’ longest stay was over 48 hours. “The fact that there is someone in this category is shocking, but the fact that more than 50% of the departments have people over 24 hours; that’s surprisingly bad,” Henderson said. “There is no clinical reason why a patient should really be there for more than six hours. “The fact that there is someone in the category of more than 48 hours is just incredibly disgusting.” Delays in moving 999 patients from ambulances to A&E and then into the ward have a devastating effect on ambulance response times, Henderson said. Ambulances in the South West have the worst record of any of the 10 UK ambulance trusts for the most urgent calls in four of the last five months, according to a Guardian data analysis by NHS England. In February, the month for which the latest data are available, the average response time to the most urgent Category 1 calls – patients in life-threatening situations – was 11 minutes and 39 seconds, the second highest since The NHS began publishing data in 2017. In contrast, ambulances in the Northeast, which had the best record in February, reached the average Class 1 call in six minutes and 37 seconds. A South Western Ambulance spokesman said she was experiencing a period of high demand and hospital delivery delays were preventing her crews from getting back on the road. Unison Deputy Chief Health Officer Helga Pile said: “The colossal requirements for ambulance service in the south-west are being reflected across the UK. “Dealing with repetitive pressure peaks with an exhausted workforce comes at a huge price.” National Category 1 response times have also been increased from one year to February. In the most recent month, the average Class 1 response time in England was eight minutes and 51 seconds, above the NHS targets that all ambulance trusts must respond to Class 1 calls in seven minutes on average. Even after 999 patients were picked up by ambulance, transported to A&E and decided to be admitted to hospital, many then face further waiting while staff try to find them a bed in a ward, Henderson said. In addition to being “incredibly indecent”, waiting in trolleys in the corridors can lead to a worsening of the patients’ condition, while the A&E staff proceeds to the next patients who come to the ward. The corridors are so crowded with patients waiting for beds in the wards that staff are resorting to desperate measures, Henderson said. “We have all started to have to use office space and storage space that you can quickly turn into a cabin.” Some patients receive all of their care in the back of an ambulance outside a hospital. “It’s surreal,” Henderson said. “We have almost transported the emergency medicine to the car park.” He said he could not remember an April when the pressure on the NHS was as severe as it is now. Liberal Democrat MP Daisy Cooper said: “Record waiting times for ambulances lead to heartbreaking stories of people waiting hours for an ambulance to arrive, with devastating consequences for their patients and families.” He said ministers had “turned a blind eye” to the crisis in ambulance services and the emergency care that leaves many patients “waiting in pain and agony”. NHS England said staff were working “steadily” amid a growing number of Covid patients, high A&E visits and tens of thousands of Covid-related absences, while still dealing with the backlog of care. One spokesman said patients should “come in for care” if they needed it.
