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07.04.17

A&Es turned away ambulances twice as many times last winter

A&E units have been forced to close their doors to ambulances twice as many times this winter compared to the previous three years, research conducted by the Nuffield Trust has revealed.

The think tank found that units closed to ambulances 478 times in just three months this winter, and urgent response time targets were only met nationally in six out of the last 49 months.

Today’s report, called Winter Insight 3: The Ambulance Service, will deepen the concerns of NHS organisations that increased demand, staffing problems and harsh funding cuts have meant trusts had to deal with a ‘winter crisis’ over the past few months.

The news follows a similar warning, reported by NHE at the start of the year, that NHS England figures showed a growing number of patients being turned away from emergency departments due to a lack of capacity.

It was also found that the number of most serious category A calls resulting in an ambulance arriving at the scene had increased by 7.4% year on year, whilst there had been an annual increase of 2.1% in the number of emergency admissions to hospital.

This growth in admissions has created an unprecedented strain on ambulance trusts, and the think tank’s findings have now confirmed that targets are largely not being met across the country.

Last month, NHE reported that the director of acute care at NHS England, Professor Keith Willet, had warned MPs in the Public Accounts Committee that wildly unrealistic A&E response targets were causing major inefficiencies that forced emergency call-handlers to make decisions too quickly about sending an ambulance to the scene of an incident or not.

Report lead author Prof John Appleby, Nuffield Trust’s chief economist, said: “There’s rightly been a lot of focus recently on the delays ambulance crews face in being able to hand over their most seriously ill patients at A&E – but what our research today has uncovered is the huge increase in the number of times this winter ambulance trusts have been told that they must take patients to another hospital altogether, because an A&E unit simply doesn’t have the capacity to accept any more patients.”

Appleby argued the effect of pressures on the service on ambulance staff was particularly striking. 

“Even allowing for the inherently stressful nature of the job, our analysis of the results of this year’s NHS Staff Survey shows they feel significantly more pessimistic than other staff in the health service about their ability to do their job properly and provide a good service,” he added. 

“Managers in the NHS and politicians need to make improving the ambulance service’s poor morale and its ability to meet targets an urgent priority”.

And Anna Crossley, Royal College of Nursing professional lead for acute, emergency and critical care, said the report should make ministers sit up and take note of the chronic pressures that emergency departments are being put under.

“Ministers must understand how critical ambulance response can be – with every extra minute the chances of surviving a potentially life-threatening incident such as a heart attack or stroke decrease,” she stated.

“The government must stabilise urgent and emergency care services in England. If people struggle to see a GP or do not have confidence in the advice given by the 111 line, they turn to A&E and add to the pressure and overcrowding there. It is encouraging that 111 is becoming increasingly nurse-led but further steps need to be taken to give people alternatives to England’s A&E departments.”

NHE contacted the Department of Health for comment but had not received a response at time of publication.

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