Ambulance and A&E performance drop to lowest levels on record

[JC544D]

Ambulance and A&E performance drop to lowest levels on record

Are I being unreasonable in saying that this is the worst that we can ever remember it?

I used to think that if you called an ambulance in an emergency, that they would come rushing. That's what the emergency services are for.

Sadly, I don't think that this is any longer the case. It feels that today, you are just going to have to wait, if they even turn up at all. The same applies to the other emergency services.

What happened?

I've had the misfortune to need 999 twice in the last year. Once for my dad, collapsed on the floor with possible stroke symptoms for over an hour (turned out to be a brain stem stroke and he was left paralysed and is now in a care home having previously been fit and healthy).care home called 999 last week as he was vomiting, high temp - he has a tracheostomy - call placed at 2pm, ambulance came at 11pm. His nurse was actually crying with frustration on the phone to my mum because they couldn't help him and he was getting worse. He had aspirated and subsequently got pneumonia.

July last year I was hospitalised overnight with a severe water infection having been let down by GP, Pharmacist (didn't have my antibiotics) and 111. 999 said I wasn't unwell enough for ambulance. By the time my poor mum had all but carried me to the car and then hospital, I collapsed. I reluctantly put in a complaint about that and they found in my favour, that even though they were at full capacity I had tried all available avenues prior to becoming seriously unwell and the call handler had handled the situation incorrectly.

I am really angry about this, not at the individuals who are working their arses off - I felt so guilty about the complaint I made but it had to be made because I knew they were in the wrong and it was dangerous. Its all so fucked up.

@Iggly

The Tories have for the last 12 years steadily under funded it. 12 years!

They’ve also cut local authorities funding so they can’t afford to pay for adult social care. This is closely linked to the nhs so also crumbled.

Then came Brexit. Which meant a significant loss of work force.

Then came covid which was the shit on top.

See having worked both in a hospital and in the ambulance service i don't agree with you. The general public need to take a long hard look at themselves and start treating the NHS with respect. It's completely taken for granted, people demand a gp appointment for things that could easily be sorted at the pharmacy. When they don't get that gp appointment they then go to A&E or call an ambulance. The service was never designed to be used the way it is used and by so many people. You can throw money at it until the cows come home and it will still be the same! The whole system needs ripping apart and starting again. Maybe if people were charged a nominal fee for appointments, A&E and ambulance call outs they would start asking themselves if they actually need it!! I would estimate that at least 60-70% of my call outs on a daily basis were things that didn't even need a GP let alone an ambulance!

For people going on about health issues, the public are to blame etc, it's not just the NHS though, all the other so called 'Emergency Services too' that are failing to turn up.

Yeah
Don't expect the police to turn up either!

wanttomarryamillionaire

How do explain the delay and failure of the other 'emergency services'? Are you going to blame the public for that too?

Sometimes people phone ambulances when in theory they could make their own way to hospital because they wouldn’t be able to afford parking charges in the hospital, especially knowing they’re likely to have to wait for hours to be seen.

The whole thing is a vicious cycle where the over stretched service can’t deal with thing efficiently causing people to need it even more than they already did which leads to even more pressure, and so it goes on.

@wanttomarryamillionaire

Well they have under funded it. And no, I don’t think it needs ripping up and starting again. That’s just silly. It needs funding properly and with certainty.

The problem is that politicians keep tinkering with it and it can’t settle down as someone keeps thinking they know best.

GP services have been stretched and given that’s the main entry into nhs care, it’s no surprise that people turn to A&E instead.

I once called an ambulance for an asthma attack, it took them over 25 minutes to arrive.
And was once involved in a resus situation when an ambulance was called, it took them over 10 minutes to arrive - in a city - and there was no rush for them to take over. I was shocked at how they strolled in with no urgency.

[quote Iggly]@HardbackWriter

Actually plenty of people have had covid and it was neither 1 or 2. Plenty of people who’ve been laid out for a couple of weeks absolutely exhausted! Unable to work.[/quote]
Sorry, maybe I wasn't very clear - I absolutely agree that it very often isn't 1 or 2, but I do think that's what a lot of people expect so if it's worse than 2 they think they're becoming a case of 1. So they panic and call 999, completely unnecessarily.

@Steelesauce

My friend also works for the ambulance service and states if their first job is a hospital job, they aren't doing another job all shift as they will be sat in the hospital ambulance bay waiting to be let into a&e. They are often doing shift change in the ambulance bays.

Even worse is that we get sent from station to outside A&E to take over the patient from the last shift so they can finish their shift (an hour or 2 late as it's a rural area so long distances involved) and then sit there until that patient goes in.

Then outside A&E next to where we are sat in our ambulance is the queue to get inside A&E, whatever to weather, due to covid rules, with patients collapsing in the queue before they even make it in to the building, or cars pulling up in the ambulance bay carrying patients that are sicker than the ones waiting on the ambulances. We then get caught up dealing with these patients on the floor or in their cars with whatever wheelchairs or trolleys we can get our hands on and equipment that we can spare off are vehicles that isn't already in use with our existing patient, because ED is rammed and the staff can only be in one place at once.

It's a f**king disaster zone.

Some of it is down to under funding, some of it is down to over use. People want to "get checked out" for every little thing "just in case".

@JC544D

wanttomarryamillionaire

How do explain the delay and failure of the other 'emergency services'? Are you going to blame the public for that too?

I can't comment on the other services as I don't work for them!

@Porcupineintherough

Some of it is down to under funding, some of it is down to over use. People want to "get checked out" for every little thing "just in case".

Most definitely true, they know all their rights but none of the responsibilities.

There's so many reasons. I worked for the service from 2006-2017 ish

When I started, we covered one county. Then more got added in. It got busier, and busier, and busier
When I started, a stabbing would have everyone gasping and around your desk, shootings unheard of. When I left, stabbings were every day/night and shootings becoming more common
Lack of first aid. I never had anyone think of putting water on a burn. Not one
Basic first aid in primary schools would go a long way - CPR, stopping bleeding, burns as a v v basic. If there is blood spurting out, don't just look at it! Lack of knowledge/common sense
Social care. I've spent months trying to get care in place for a parent. It ended up with them being on the floor, having to ring 999 to get an ambulance to get her to hospital so we can refuse to have her home so she is forced into the care she needs
Not enough ambulances/staff + higher demand + hand over time + not enough beds + demand on hospitals
People ringing because they can't get GP appointments

I could go on!

@HardbackWriter maybe that’s because of Dr Google and the lack of easily accessible information on covid.

Take for example the nhs claiming for 2 years that there were three main symptoms of covid, yet plenty of other evidence that this wasn’t the case. People lost trust in what they were being told and saw what was happening via Google/mums et/the internet. Then they probably don’t know how to filter out was it and isn’t sensible and then resort to 999.

It’s such a shame that the government failed to provide sensible steady advice on covid and the likely passage of symptoms and when to call 999.

I had covid recently and have to admit I got worried - because my heart starting doing funny things. I don’t trust my GP to actually investigate properly - but if I ended up with say bad chest pains, I’d probably end up calling 999 🤷🏻‍♀️ When it may be something else less serious.

"Sidhdbej
My neighbour is 80 had a stroke in his garden, his wife found him completely paralysed down one side and couldn't get him up. Ambulance wait 3 hours"

This seems like common place. What can we do?

Rather surprising that no one has posted any of the public quotes, letters and articles from frontline medics, society for emergency medicine etc, pointing out that the government's failure to provide any infection control measures against Covid in the community has inevitably led to the current situation in hospitals.

Eg this article from 23 Mar when Chris Whitty gave warnings

www.theguardian.com/world/2022/mar/23/nhs-under-pressure-from-new-covid-wave-across-england-says-chris-whitty

JanglyBeads

I think it was sadly going on pre covid though.

@Steelesauce

Someone waited 13 hours on the floor with a broken hip in my service last week. Disgusting and I put in a safeguarding referral. It's not right that this is happening at all.

Same here. It's a regular thing, my heart and my colleagues hearts sink when we've got to attend a call with someone who has fallen and injured. We are trained to lift though so will do so if they aren't injured. And it's been agreed now that if we can get a triage call back from the ambulance service to discuss, we can lift someone if they are injured and it's agreed it's safe to do so. The effects of overnight lie or equivalent is much worse than an upper body injury.

Yes I know that things were bad and worsening pre-Covid. But if we had protections we might stand a fighting chance.

Are a lot of GPs doing private appointments which is why people who go through the NHS route can't see a GP and and end up in a & e.

I had an e consult with a GP privately and when I googled her, I saw that she worked for a local NHS practice in London. But yet I knew that the only way to see her was to go privately

www.theguardian.com/society/2022/apr/10/appalling-waits-for-ambulances-in-england-leaving-lives-at-risk

I don't know what we can do its so scary. People are scared they lash out, nurses are over worked and under paid, the quit the situation gets worse, money is pissed up the wall with agency nurses (which I am not questioning are essential) why would a nurse work for 25k when she can get double that on an agency, bed rentals cost millions, why not buy them? Because the budget doesn't cover it. Everything is going to shit. Even saying go private doesn't help, last time I checked there were no private ambulance services. Add in to that the difficulty to see a GP, stupidity of people abusing the service they don't need and inability to use over the counter medicine. Honestly, imo all the money in the world couldn't fix it now it needs rebuilding from the bottom up and that's simply impossible to do.

This with bells on. The number of social cases in the hospital I work at that could be discharged is mental.

GoadyToady

Dickheads ringing 111 with chest pain is a factor, they get escalated almost every time to 999.

Who then arrange an ambulance when someone could have took the patient to A&E in the first place. I had someone moan to me recently, “we waited 3 hours for the ambulance so I drove him to A&E myself”

Why didn’t you just bloody do that in the first place?

I’m not defending the whole system, handovers are a nightmare I know.

But no doubt someone will be along to mention the Tories soon. It’s like MN bingo.“

Because if you drive the patient to A&E yourself, they sit in a waiting room awaiting triage. On a busy day, this can take several hours. Once assessed, there is a further wait until they are seen by a doctor.
If a patient arrives by ambulance, they receive medical attention by qualified staff immediately on arrival and are under the care of the paramedics until they are handed over to A&E staff.

It’s really not difficult to understand.