Ambulance chiefs have urged NHS England to spell out to ministers how thousands of patients could come to harm during Wednesday’s strike action amid escalating pressure.
The plea was made by senior ambulance leaders in a call with NHS England leaders this evening, after their services came under an unprecedented degree of strain in recent days, heightening fears about the threat to patients’ safety, HSJ can reveal.
Data leaked to HSJ suggests average response times for category two ambulance calls, which should get a response within 18 minutes, stood at more than an hour for nine out of 10 English ambulance trusts today (Monday). For five trusts the average response time was more than two hours (see data below).
These figures have rarely been reached even over the past year of very high pressures, and suggest the situation is significantly worse than when ambulance services came under high profile and extreme pressures in March and October this year. They show hundreds of ambulance call incidents awaiting a response.
Ambulance chiefs fear that coming on top of this, the planned strike action on Wednesday, involving members of the GMB, Unite and Unison unions, is extremely high risk, with more situations in which crews will arrive too late to patients with life-threatening conditions.
Multiple sources told HSJ that ambulance chiefs sought to stress the grave situation to NHSE’s emergency care team in the meeting this evening, and called for a meeting with NHSE chief executive officer Amanda Pritchard, to urge her to lobby health and social care secretary Steve Barclay to find a way to avert the strike. This would likely require Mr Barclay to say the government is prepared to negotiate on pay, which he has so far resisted.
One ambulance source said: “Services are already in the worst state they’ve ever been in, we’ve never known it to be as bad as this.
“To have strike action hit us on top of this is such a dangerous situation. Even without strike action we are not getting to people in time…people are being harmed and some are dying. So clearly strike action is only going to make that worse.”
Another senior ambulance source said: “Going into Wednesday at this level of demand, with many many long waits will further deteriorate waiting times and significantly increase risk.”
There is a sense from some ambulance chiefs that NHSE could be doing more to free up beds and staff by cancelling elective care, to help speed up ambulance handovers at accident and emergency. NHSE has told trusts that electives should be cancelled as a “last resort”.
A further senior sector leader said handover delays to hospitals — which have a huge knock-on to response times — had also worsened in recent days, leaving very little time to recover before Wednesday morning, when it was hoped they would be eliminated to help free up scarce ambulance crews.
They said systems would have to make “difficult decisions” on Tuesday, such as cancelling planned care and pushing hard to increase discharges, to improve the situation.
Last week, HSJ revealed all 10 ambulance trusts had declared the highest level of alert, due to the extreme pressures.
Several trusts today went further, with London Ambulance Service declaring a “business continuity incident”, while North East Ambulance Service declared a “critical incident”. Later on Monday both East of England Ambulance Service and South East Coast Ambulance Service declared critical incidents. HSJ also understands South Western Ambulance Service has declared a critical incident and has 727 calls awaiting an ambulance response, with this number expected to rise.
One EEAST paramedic said that the service had had 5800 calls on Monday, against an average of 3600 to 4000.
These moves are partly about triggering additional communications to the public about the level of strain on services.
NEAS said a critical incident would enable it to seek mutual aid; cancel training to put more staff on the road; not take bookings for urgent but non-emergency transport; and increase use of private providers.
NHSE was approached for comment this evening.
Updated 7,30 20 December with details of more critical incidents being declared and 8.36 with details of South Western…