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Emergency doctor called in as trust leaves patients waiting in corridors

An ambulance trust was forced to call in a senior doctor, normally on-call for serious incidents, to treat patients waiting in corridors at an A&E department after the hospital refused to admit them for an extended period of time.

West Midlands Ambulance Service dispatched a medical incident officer (MIO), a senior consultant doctor, to Worcestershire Royal Hospital on the evening of Friday 10 April when the A&E department refused to accept a number of patients brought to the hospital by ambulance staff.

The “unprecedented” move is the first time an MIO has been dispatched to a hospital in the West Midlands, and a spokesperson for the College of Emergency Medicine said that it could be the first time ever.

A statement for the ambulance trust said that the decision was “not taken lightly” but was done because some of the patients were in considerable pain and displaying serious conditions.

“The trust had repeatedly asked clinical staff within the emergency department to triage the patients so that the most serious could be given pain relief or taken to wards to receive appropriate care. This was refused on a number of occasions,” the statement continued.

“Due to the number of patients being cared for by ambulance staff in the hospital, the Trust had outstanding 999 calls in Worcestershire that we had no ambulances to send to, which potentially put those patients at risk.”

The MIO oversaw seven patients in the hospital corridor, with a further patient on an ambulance outside. 

One patient was cared for by ambulance staff on the corridor for over five hours despite complaining of cardiac related chest pains, another patient who was recovering after an epileptic fit waited over four hours and a third patient was cared for by ambulance staff despite suffering from a suspected pulmonary embolism.

A spokeswoman for Worcestershire Acute Hospitals NHS Trust, which runs Worcestershire Royal, said that both the hospital and ambulance service are working under extreme pressures at the moment, and that “regretfully these pressures have meant some patients being treated in less than ideal conditions”.

She added: “We can confirm that on Friday 10 April West Midlands Ambulance paramedics were asked to look after a number of patients in the corridor before they could be transferred into the care of the A&E staff.  Whilst the A&E department were unable to allow the ambulance staff to handover the patients, the A&E staff were aware of their conditions and we wish to assure people that no patients came to any harm.”

The ambulance trust claims the number of hours lost at Worcester while patients are turned over to the trust had increased from 1,368 lost hours in 2013-14 to 1,952 in 2014-15, the clock starts after the ambulance has been at the hospital for 30 minutes.

Delays of over an hour have increased from 103 in 2013-14 to 351 in 2014-15. 

In February 2015, the ambulance trust had to look after 434 patients on the corridor of Worcestershire Royal Hospital. In total this accounted for 687 hours of ambulance time.

West Midlands Ambulance Service said that it has now raised its concerns about the hospital with the CQC on a number of occasions. The ambulance service has also insisted that the Worcestershire Royal formally record the events of 10 April as a Serious Incident and that a full investigation be conducted.

The CQC said it was aware that West Midlands Ambulance Service took the action at the weekend and was monitoring the situation.

Worcestershire Acute Hospitals is the same trust that banned a West Midlands Ambulance Service paramedic, Stuart Gardner, after he blew the whistle on overcrowding in its hospital corridors in January.

In February, five emergency specialists left the trust claiming the "massive overcrowding" was a disgrace and caused "serious harm" to many patients.

On 23 March the BBC reported two cardiac arrests in the corridor in one week and 28 patients waiting to access the emergency department. The following day the CQC undertook an unannounced inspection and a day after that a risk summit took place involving all health parties in the county.

(Image source: Rui Vieira/PA Wire)

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