Ambulances have waited for almost 67,000 hours – more than seven years – outside the region’s three main hospitals in the past two and a half years, a Freedom of Information request has revealed.
Olivier Vergnault www.devonlive.com
According to figures obtained from the South Western Ambulance Service NHS Foundation Trust (SWASFT), ambulances crews, and therefore patients, have had to wait a total of 26,448 hours outside the Royal Cornwall Hospital at Treliske in Truro between January 1, 2019, and June 30, 2021.
Over the same period of time, ambulances had to wait a combined total of 27,120 hours outside A&E at Derriford Hospital in Plymouth and 13,425 hours outside the emergency department at the Royal Devon and Exeter Hospital in Exeter. Converted into days, these figures equate to 1,102 days (three years), 1,130 days (just above three years) and 560 days (one and a half years) respectively.
The figures mean that ambulances crews have spent a combined total of more than seven years waiting outside Devon and Cornwall’s three main hospitals in the past two and a half years, up to the end of June 2021, before being able to discharge their patients.
The figures also show that ambulances waited almost 24,000 hours outside the three hospitals in the first six months of 2021 alone – almost the same at the total for the whole of last year.
Ambulances and crews tied up outside the region’s hospitals are unable to attend other incidents, even if they might be more urgent.
In a joint statement, all three hospital trusts apologised for patients having to wait longer to get into emergency departments and insisted investment was taking place across Devon and Cornwall to alleviate the pressure by creating extra capacity, with new theatres and diagnostic facilities in Plymouth and at the former NHS Nightingale hospital in Exeter and a new ward unit under construction at Treliske.
The three trusts say they are also encouraging people to embark on careers in care and trying to recruit more hospital staff, but also have to ensure their staff are not overworked so they can do their jobs properly and are looked after.
A lack of beds at the region’s hospitals, underfunding in the NHS and hospitals in general and the lack of a cohesive social and health care programme, which would allow for so called ‘bed-blockers’ to be released and cared for in the community when they no longer need hospital care, have all been blamed over the years for increasing ambulance waiting times.
Peter Levin, from the watchdog West Cornwall Healthwatch, said many patients used to be discharged from acute hospitals to recover in community hospitals, but these had been closed down.
“The acute hospitals say it’s not their job to provide rehabilitation and recovery facilities,” Dr Levin said. “They do exist in Cornwall but they are in community hospitals, and NHS Kernow has made it its mission to close such beds. We’ve already lost the only two community hospitals in Penwith. Two more – Fowey and Saltash – are on the way. That’s 40 beds gone, with some residents discharged from Treliske being sent to the other end of the county as a result.
“What is needed is ‘joined-up thinking’ that covers a patient’s entire journey from admission to hospital through to recovery and rehabilitation. It is sadly absent at present.”
In August health and care leaders issued a joint letter describing “ongoing extreme surge in demand”, which included 700 people in need of care and support that was currently unavailable in Cornwall and the Isles of Scilly.
The letter said more than 20 care homes were closed due to Covid-19, while more than 400 people had visited the Royal Cornwall Hospital’s emergency department over the weekend of August 21 to 22; the NHS 111 telephone advice service had received more than 2,000 calls during the same period, and some patients with dementia were not being treated in locations designed for their needs.
Cherilyn Mackrory, the Conservative MP for Truro and Falmouth, said she was very much aware of the situation and insisted she had been in regular contact with both the Royal Cornwall Hospitals Trust and SWASFT to discuss what steps they were taking to ease these issues and how she could help.
“It’s been an unprecedented summer in Cornwall, with record visitors,” she said. “With that comes huge demand on our NHS – particularly on the emergency department at Treliske. We’ve all seen the stories and the pictures of the ambulances queued up outside. This is not an ideal situation and to any of you who have had to wait for an ambulance, I can only apologise.
“There is a lot of hard work going on to address this. The ambulance queues, in particular, are exacerbated by Covid restrictions at the hospital, with people not being allowed to wait in corridors and therefore having to stay with ambulances, therefore causing further delays and backlogs both at the hospital itself and also with the ambulance service.
“Obviously another ongoing issue is – much as I don’t like the term – so-called ‘bed-blocking’, with people who are otherwise able to leave the hospital being kept in because of the lack of social care plans to get them home.
“This is currently being addressed by the new administration at Cornwall Council on a local level, but I would also be remiss in not commenting on the recent changes announced by the Prime Minister, unprecedented as they are, which will put a considerable boost into our health and social care system.”
A SWASFT spokesman said: “NHS services across the South West, including our ambulance trust, have been under significant pressure during the Covid-19 pandemic and especially this summer.
“We work closely with our hospital partners to manage the issue of handover delays at hospital emergency departments, so that our crews can respond to the next patient as quickly as possible.
“We treat around half of our patients over the phone or at the scene of incidents, without needing to take them to hospital. We provide clinical care to our patients until they are handed over to hospital staff, and offer welfare support to our colleagues at various hospitals in our region.”
The crisis has highlighted the lack of a holistic approach to health and social care, meaning many patients who may be medically fit to leave hospital are unable to do so because there is not enough social care provision in the community.
Only last week, it was revealed that there were 150 so-called ‘bed-blockers’ at Treliske.
Anne Thomas, chief executive of Cornwall Care, which runs 16 care and nursing homes in the county, said her industry was acutely aware of the problem.
“We are working hard with all social care and voluntary providers in Cornwall to help get people home from hospital”, she said. “An emergency ‘care bunker’ team has been set up for that purpose this week, which includes both care and voluntary sector teams working together.
“Our aim is to give people the support they need in their own homes, and to do that effectively we’re using every resource possible – regardless of whether that comes from a range of different providers.
“We’re in the middle of a health and social care emergency, and working together is vital.”
The joint statement from all three hospital trusts added: “There are no easy answers to resolving these issues, which have increased since the start of the Covid pandemic.
“Patient safety is our number one priority and people are seen based on urgency and need.
“Emergency departments (EDs) are under extreme pressure due to the rising demand for services across the health and care system in Devon and Cornwall in recent years and patients are more unwell, meaning that more of the patients coming through our doors need to be admitted to hospital.
“Some patients come to our EDs with minor conditions which could be treated more quickly and effectively elsewhere.
“Care providers also have rising demand for their services and are experiencing significant pressures due to a shortfall of people wanting to work in the care sector, which can impact on the ability to discharge people with very complex needs promptly from hospital and free beds for people waiting to be admitted from ED.
“These issues have been further complicated throughout the pandemic by the need for additional infection prevention and control measures and the need to keep patients with Covid separate from others.”
The three hospital trusts and SWASFT all reiterated the same message, urging both residents and visitors not to call 999 unless it was a genuine, life-threatening emergency and to get themselves vaccinated against Covid.