South West Ambulance teams under pressure

Delays becoming "intolerable"

The ambulance service in Devon and across the south west has “never experienced such a long period of sustained demand” according to one of its bosses.

Jessica Cunningham, South Western Ambulance Service’s executive director of operations, told Devon’s health and adult care scrutiny the service had “broadly” been at its highest level of “escalation” since June and that total activity in Devon is 12 per cent higher than last year and nearly 20 per cent up on April this year.

A report to the committee described handover delays at hospitals as becoming “intolerable,” with the service ranking the worst in the country for the time taken. Ms Cunningham said delays were especially bad at Derriford and Torbay hospitals.

The report said: “We are currently losing around 750 hours per day to handover delays at hospital emergency departments, compared to around 400 hours per week two years ago. This results in many ambulances queuing outside hospitals, and unable to respond to other emergency calls.

“During the week commencing 6 September, the Trust lost over 5,609 hours to handover delays in excess of the 15 minute target. That is the equivalent of 510 ambulance shifts being lost (an average of 73 shifts lost per day).

“These levels have become intolerable and it’s an absolute priority for us and for our NHS partners to reduce these delays, so crews can get back out on the road for other patients.”

Ms Cunningham said the situation was being compounded by the trust still having “quite a high” sickness rate, including from staff having to isolate because of covid, and that this was “putting quite a lot of pressure on our resourcing across the trust.”

She continued: “Obviously we’ve had the pandemic to deal with and we have a very fatigued and tired workforce and we are still experiencing the impact of the covid pandemic on our staff,” she told the meeting.

However, the trust was managing to deal with a “good number” of 999 callers through clinicians on the phone, without the need for an ambulance. Ms Cunningham said this accounted for around a quarter of calls in October.

In addition, the percentage of people being seen by ambulance crews and then taken to emergency departments has fallen to just under 40 per cent in Devon, as the trust looks to reduce the high demand also being experienced by hospitals.

“We’re trying our very hardest to not convey patients where there are alternatives available to us, to try and keep the pressure off of our emergency department colleagues.”

The service has seen increased activity since the easing of the lockdown in May. According to the report: “Weekly incidents ran at over 20,000 incidents for 25 consecutive weeks from the start of May, compared to levels prior to covid-19 which were around 18,000 incidents per week.

“To put this in perspective, during the previous two years (2019/2020) the trust has only reported 2 weeks above 20,000 incidents, both of which fell over the Christmas and New Year period in 2019 when activity is traditionally busier.”

Ms Cunningham said “quite a lot” of calls received relate to falls and mental health, and the service was targeting the two areas about how it can respond “more adequately”.

The committee agreed to conduct a review on the pressures faced by the trust and its partners.