Ambulance to A&E transfers: New data reveals the worst region in England for handover times

Patients in the South West of England are having to wait nearly three and a half times longer to get out of ambulances and into A&E compared to the national average.

Dan Whitehead news.sky.com 

Analysis of NHS data by Sky News has found in the week ending 1 January 2023, it took an average of two hours and 39 minutes to hand over patients to hospitals in the region, compared to 46 minutes nationally.

The target in England is 15 minutes.

Figures also show the six NHS Hospital Trusts with the longest handover times in England are all in the South West.

They are: University Hospitals Plymouth, Torbay and South Devon, Great Western Hospitals, Royal Cornwall Hospitals, North Bristol and Gloucestershire Hospitals.

So bad is the problem, that hospitals in the region have begun discharging patients who are well enough into local hotels, usually used by tourists, in a bid to free up bed space.

Sky News also found 55% of ambulances in the South West had handover delays of more than an hour, twice as bad as the England average of 26%.

An older population, spread more remotely, is part of the reason, but NHS England told Sky News that staff recruitment and illness, the number of sick patients and delays in discharging patients from hospital are all causes.

In Helston in Cornwall, 85-year-old Koulla Mechamikos is recovering from a broken hip.

She fell in her hallway last August – and had to wait 14 hours for an ambulance to arrive – and then another 26 hours in the back of an ambulance outside the Royal Cornwall Hospital.

‘I would have been better to die’

“They said we are just waiting for an ambulance to free up to come to you – we don’t know how long it’s going to be as we are so busy,” said Koulla’s daughter, Marianna Flint.

“It was a bit panicky because with that length of time, mum was then getting to a point of looking quite pale and was in a great amount of pain,” she added.

While she praised the care the paramedics and hospital staff gave her mother, having to wait in the back of an ambulance for more than an entire day was worrying.

“Basically the ambulances are now waiting rooms – because there’s no room in the hospital to take them – there’s no extra wing, there’s no bed space.”

Koulla told Sky News she remembers being “freezing” while on the floor. “It was scary, more scary than anything. I lost my mind completely. I would have been better [to] die…so many hours.”

The Royal Cornwall Hospital offered its “sincere” apologies to Koulla and Marianna.

Anne-Marie Perry is CEO of AbiCare, a company that has run so-called ‘Care Hotels’ since the COVID outbreak.

“One of the blockages coming out of hospital is community care provision, social care,” she said.

“So, if there’s no provision in the community, you can’t get people home, if you can’t get people home, they stay in hospital. If they stay in hospital, there’s a whole host of challenges associated to that hospital acquired dependency.”

She told Sky News the care offered can be cheaper than hospital beds.

“These are people that are deemed medically fit to get out of hospital to go home, but they can’t go home because there isn’t a package of care to wrap around them.

“We offer rehabilitation, we offer exercise classes, we offer social activity as well. So we’re a great interim.”

What the NHS had to say

Responding to the situation in the South West, a spokesperson for NHS England South West said: “There are multiple interdependent reasons for ambulance handover delays including the number of sick patients being seen at hospital, staffing recruitment and staff sickness, as well as delays with discharging patients when they are well enough.

“We are working hard with integrated care boards, hospital trusts and our ambulance service to address these delays and ensure patients are handed over at hospitals in a timely way, to ensure ambulance crews can get back on the road to help other patients as quickly as possible.”

More “tributes” to former East Devon council leader Paul Diviani

From a Correspondent:

I spotted this tribute to Paul Diviani from EDDC Chief Executive in www.devonlive.com:

“EDDC’s Chief Executive Mark Williams added: “Paul was a joy and an inspiration to work with and I have many happy memories of much fun and laughter at the various events and meetings we attended together as leader and CEO over the years that I knew and worked with him.”

I too have memories of Paul Diviani and Mark Williams, slouched in their seats, laughing and talking together (they appeared very convivial and it was just after lunch) whilst a councillor was arguing the case for EDDC to cooperate with Dorset in the bid for a combined East Devon and Dorset National Park. As a member of the public I found this behaviour between the committee chairman, Paul Diviani, and the Chief Executive to be  totally unprofessional, indeed unacceptable. It was obvious that they couldn’t care less about what was being said.

I felt so strongly at the time, but who could I complain to? All channels of complaint flow through Mark Williams!

‘Ticking timebomb’ as ageing landfill dumps threaten English beaches

Do we know where all these historic landfill sites are? Most estuaries were a soft option, some are now covered by car parks. Extraordinary that this was deemed an acceptable practice as late as the 1970s. Lyme Regis is an obvious example of erosion spewing old landfill onto the beach from the cliffs above.- Owl 

Sandra Laville www.theguardian.com 

Hundreds of ageing landfill dumps on the coast of England containing plastics, chemicals and other waste are a ticking timebomb threatening to leach pollution on to beaches and into the sea, new research shows.

The waste sites date back 100 years in some cases, and little is known about what has been dumped in them. Climate breakdown with associated rising sea levels and flooding are increasing the risk of a cocktail of pollutants entering the sea.

More than three-quarters of the landfill dumps identified in a survey by the local government association are adjacent to designated environmentally protected areas.

The survey, by the Local Government Association coastal special interest group (LGA Coastal SIG), in collaboration with coastal group network, shows that 26 coastal councils have sites already spilling large amounts of waste on to cliffs and beaches.

The councils that responded to the survey identified 195 coastal landfill sites as being at risk of tidal flooding and/or erosion. But it is thought there are approximately 1,200 to 1,400 historical coastal waste dumps in the UK currently at risk of erosion and flooding, according to the LGA Coastal SIG.

Mark Stratton, officer lead for coastal landfill at the group, said: “There are hundreds of coastal landfill sites at risk of tidal flooding and erosion. During visits to sites, I have been overwhelmed by the scale of the problem, especially the threat of waste eroding or leaching out on to the often-designated natural coastal environment.

“The landfill sites have been inherited by councils, and stretch from the north to the south of England.”

The councils are asking for government help to tackle the threat, shore up the dumps to stop the leaching of pollution from sites that are already eroding or being flooded, and carry out an investigation into what the sites contain.

David Renard, Local Government Association environment spokesperson, said: “Our coastlines need urgent support. This problem will not go away, and funding is needed to prevent hundreds of disasters on our shores. Councils want to protect their local environments but need urgent support from the government to save our coastlines from this ticking timebomb.”

A spokesperson from the Department for Environment, Food and Rural Affairs said: “We are committed to working closely with local authorities, who have the responsibility of ensuring historic landfill sites are managed in a consistent and environmentally friendly way. Findings from the LGA survey will help inform our planned national assessment on the impacts of coastal erosion and flooding at historic coastal landfill sites, which will help improve management of these sites in the future.”

1,000 excess deaths each week as the NHS buckles

The result of 13 years of Conservative government – Owl

Fifty thousand more people died last year than normal, with NHS delays blamed for one of the most deadly 12 months on record.

Chris Smyth, Kat Lay www.thetimes.co.uk

Excluding the pandemic years, 2022 brought the highest excess deaths total since 1951, according to an analysis by The Times.

There were 1,600 more deaths than usual during Christmas week as long waits for ambulances, cold weather and surging flu infections increased mortality rates by a fifth.

Covid accounts only for a minority of recent extra deaths, focusing attention on “compelling” evidence that the crisis in the NHS is killing hundreds of people a week.

Untreated health problems as people were urged to stay away from surgeries and hospitals during the pandemic are also thought to be contributing to the deaths. Experts have also cited lingering after-effects of Covid infection.

Figures from the Office for National Statistics yesterday showed the third consecutive week of more than 1,000 excess deaths in England and Wales and confirmed that last year one of the highest death totals in Britain was recorded.

Ministers say that countries across Europe had high excess deaths last year, pointing to a big increase in flu. But others pinned the blame on the government’s handling of the NHS, where there are long waits for 999 ambulances and emergency treatment in hospitals.

Today 999 call handlers will join paramedics in a second day of strikes in the ambulance service as an estimated 25,000 staff walk out. With ministers publishing draft laws to restrict strikes in the NHS and other public services, health leaders have accused the government of using the powers to “silence workers in their hour of need”.

Adrian Boyle, president of the Royal College of Emergency Medicine, said the latest death figures were “shockingly high”. He acknowledged it was “extremely difficult to determine the causes” but pointed to studies showing deaths rose with longer waits at A&E.

“Our own analysis indicates that an estimated 300-500 patients are dying per week across the UK associated with long waiting times in emergency departments,” he said. “This is awful, distressing and completely unacceptable. The health system is not functioning as it should. Our priority should not be to quibble about the data, but to mitigate the harm of this crisis.”

Overall the 656,735 UK deaths last year were 51,159 above the pre-Covid five-year average. The figure was exceeded only in four years prior to 1951 since records began 130 years ago.

Although 2020 and 2021 brought higher excess death totals as the pandemic hit, excess deaths last year were predominantly not driven by Covid. Stuart McDonald, a partner at LCP Health Analytics who works on the Faculty of Actuaries’ Continuous Mortality Investigation, said that even looking at figures adjusted for age, 1963 was the last time deaths had jumped so much above the rate three years earlier.

“Had we not just had two years of very extreme mortality, 2022 would really stand out,” he said, adding that it was most unusual for there to be month after month of high deaths. “At the start of the year we were seeing fewer deaths among older people because a lot of those people had frankly already died [of Covid], but it was clear even then that we were seeing higher deaths among younger people. Since the spring and beyond we’ve had fairly consistently high levels at all ages”.

McDonald said “it’s undeniable that the NHS crisis is part of the story”, adding: “Access to healthcare has been a problem all year and that’s been increasing — waiting times for ambulances [and] A&E. We also know there are people who should have got diagnosed with high blood pressure or should have had a statin who missed out [when the pandemic began].”

The Times reported last year that Professor Sir Chris Whitty, the chief medical officer for England, had been raising alarm in government about an increase in heart deaths in the middle age linked to missed care during the pandemic.

Professor Sir David Spiegelhalter, a statistician at Cambridge University, said it was “very difficult to divide up the causes of the excess, but I find evidence around delayed admissions compelling”.

He said that since the summer there had been more than 40,000 excess deaths in England and Wales. Adjusting for an ageing population and subtracting Covid “still leaves an average of around 450 excess non-Covid deaths each week since June”. Spiegelhalter said “multiple factors will be contributing to this: early flu, Covid, the impact of disrupted care in the pandemic, and the acute crisis in the NHS”.

Wes Streeting, the shadow health secretary, blamed “13 years of Conservative mismanagement of our health service”, saying: “The NHS is in the biggest crisis in its history and the crisis has a cost in lives.”

The Department of Health said: “There are a wide variety of factors that may be contributing to excess deaths and the health and social care secretary continues to receive regular briefings on Covid and flu cases.”

Barratt brings in hiring freeze as UK housing market slows down

Britain’s largest housebuilder, Barratt Developments, has introduced a hiring freeze and is “significantly” cutting back on buying land as it steels itself for a further slump in the UK housing market.

Kalyeena Makortoff www.theguardian.com

Barratt said it was responding to a “marked slowdown” in the UK housing market after a rise in interest rates that had made mortgages more expensive for prospective homebuyers.

The company said the average weekly net number of private reservations of properties fell in the second half of last year, down from 259 to 155.

It was also forced to scrap building plans for 3,293 land plots, cancelling out the 3,003 plots that proceeded with construction. The net cancellation of 290 plots compares with the net addition of 8,869 a year earlier.

“The first half of the financial year has … seen a marked slowdown in the UK housing market,” said Barratt’s chief executive, David Thomas.

“Political and economic uncertainty impacted the first quarter; this was then compounded by rapid and significant changes in mortgage rates, which reduced affordability, homebuyer confidence and reservation activity through the second quarter.”

Barratt is warning that the outlook for the first half of 2023 is “uncertain”, adding that the health of the UK housing market would depend on homebuyer confidence and the availability of competitively priced mortgages.

Lenders have increased mortgage borrowing costs in response to rising UK interest rates, which have increased nine times in the past year. Lenders raised mortgage rates even further in the wake of the government’s disastrous mini-budget in September, as the resulting market turmoil led some lenders to pull their mortgages off the shelf, while others raised the costs of borrowing in response to the uncertainty.

The turmoil has increased costs for those needing to remortgage their homes, and depressed appetite among homebuyers, with the latter pushing down house prices across the UK.

Halifax, which is part of Lloyds Banking Group, the UK’s biggest high street bank, reported last week that the average UK house price had fallen for the fourth month in a row in December.

Last month, the lender predicted that rising interest rates as well as the broader cost of living crisis would dampen house prices by about 8% over the course of 2023.

Soaring interest rates have already had an impact on the construction sector, which contracted in December as housebuilders took on fewer projects.

However, Barratt said the group was still in a strong financial position. “This provides us with a robust platform and gives us flexibility to continue to respond to market conditions as they evolve throughout the coming year,” the company said.

Boris Johnson air brushed out of history

“This government will have integrity, professionalism and accountability at every level.” – Rishi Sunak

This is the sort of thing you expect from dictatorships, but is now happening in Tory Britain. A “Secretary of State”, no less thinks, this behaviour is OK. Nothing “bizarre” about it. What next? – Owl

Boris Johnson bizarrely photoshopped out of picture Grant Shapps tweeted about space launch

Poppy Wood inews.co.uk 

Grant Shapps has denied doctoring a photograph of himself on a visit to Spaceport Cornwall in which former prime minister Boris Johnson appears to have been digitally deleted.

The Business Secretary shared a picture of himself visiting the rocket site in June 2021 ahead of Virgin Orbit’s unsuccessful satellite launch last night.

It showed Mr Shapps speaking to Virgin Orbit chief executive, Dan Hart, and another member of the space team in front of the LauncherOne rocket.

But canny observers on Twitter noticed that an almost-identical picture previously shared by No 10 had also featured then prime minister, Mr Johnson, standing in between the space scientists and Mr Shapps.

The pair visited the Spaceport site in Cornwall almost two years ago to discuss how Virgin Orbit would “help boost the UK’s incredible space industry, inspire the next generation, and enable vital environmental monitoring”.

The Business Secretary shared a picture of himself visiting the rocket site in June 2021 ahead of Virgin Orbit’s unsuccessful satellite launch last night

An almost-identical picture shared in June 2021 showed Mr Johnson standing between Mr Shapps and the space scientists (Photo: Grant Shapps/Twitter)

Mr Shapps has since deleted the tweet in which Mr Johnson appears to have been erased.

A source close to Business Secretary said: “Grant wasn’t aware anyone had edited the picture. He removed it as soon as it was pointed out. Obviously he wouldn’t endorse anyone rewriting history by removing the former PM from a picture.”

It comes as senior Tory MPs continue to distance themselves from the former prime minister as they attempt to rehabilitate the Conservative Party’s reputation following a slew of scandals embroiling Mr Johnson.

A Labour Party source said: “The Tories might want to erase their own leaders — but the country is stuck with the consequences of their appalling record: a crashed economy, a broken health service, and an asylum system that doesn’t work.”

The debacle comes after Virgin Orbit’s first space launch from UK soil ended in failure last night despite a promising start.

The evening had started out successfully with LauncherOne taking off at around 10pm while operators at Spaceport Cornwall blasted out the Rolling Stones hit Start Me Up.

But shortly before midnight, the US space company announced there had been an anomaly which meant the rocket containing nine satellites was heading back down to Earth. The rocket is assumed to have burned up on reentry, destroying all the satellites on board.