Ambulance Service Delays leading to Unnecessary Injury and Death - by Andrea Ribchester-Hodgson
At Clear Law we have experience of dealing with such cases as the article states below and it is clear the level of claims arising further to this type of delay can only increase in the current climate. In cases of heart attack and stroke for instance, the time taken to access hospital care is a critical factor in survivability and whether a patient will suffer long term debilitating effects. It is therefore essential that delays in an ambulance attending a patient and delays in that patient being assessed by A & E clinicians upon arrival at hospital by ambulance are minimised; where they are not and injury or death occurs, it is only reasonable for their families to seek legal redress.
If you or a family member have suffered harm as a result of such delays Clear Law’s clinical negligence team are more than happy to discuss this with you and answer any queries you may have without any obligation to proceed further.
In a very startling recent article on 14/11/2021, The Guardian stated that it had been reported that “NHS patients were dying in the back of ambulances stuck outside A & E”.[i]
The report, referenced by the Guardian was drawn up by the Association of Ambulance Chief Executives (AACE), representing England’s 10 regional ambulance services. The Guardian noted their conclusion that “ ..When very sick patients arrive at hospital and then have to wait an excessive time for handover to emergency department clinicians for assessment and definitive care, it is entirely predictable and almost inevitable that some level of harm will arise.”
The AACE report[ii] itself confirmed that over eight in ten of those whose ‘handover’ (from ambulance to hospital) was delayed beyond 60 minutes were assessed as having potentially experienced some level of harm; 53% low harm, 23% moderate harm and that 9% (one patient in ten) could have been said to have experienced severe harm.
Whilst no exact figures were given for deaths whilst awaiting admission to A & E, it is frightening to realise that this can occur at all and the position many readers would take upon seeing this headline, would be that surely such it could not be correct. This is however, just one of a number of recent articles and news items which have highlighted difficulties with ambulance handovers and increased ambulance response times. The Clinical Negligence Team here at Clear Law have also seen such delays reflected in enquiries coming through to us.
In a BBC online article dated 11/11/2021,[iii] the “intolerable” level of ambulance transfer delays within the South West Ambulance Service was reported to be leading to the loss of 750 hours per day in hospital handovers and had led to the service recording the longest response times for life-threatening and emergency incidents across England in September, which was repeated in October 2021.
A further BBC article dated 11/11/2021[iv] confirmed that the College of Paramedics stated lives were at risk because patients were facing unacceptably long waits for a 999 response, and that NHS data showed callouts for problems such as heart attacks and strokes were taking nearly three times as long as they should in England. The article gave examples of delays which included that of an 82 year old woman, who had waited nearly six hours for an ambulance to arrive following suffering a stroke, and then waited another three hours outside hospital. When she was finally admitted, her family was told it was too late to give her the drugs needed to reverse the effects of the stroke.
In the heavily advertised previous FAST campaign to improve stroke outcomes, which was relaunched by Public Health England and the Stroke Association in March 2021[v] following data suggesting people were putting off seeking help for symptoms during the pandemic, it was stressed urgently calling 999 was vital in saving lives. It was confirmed that stroke is time sensitive, which means any hesitancy or delay in getting treatment kills brain cells and unnecessarily has proved to be fatal in the early phase of the pandemic.
The nine hours of consecutive delays suffered by the 82 year old referenced in the BBC article above is therefore even more difficult to comprehend in light of such clear warnings of the consequences of delay, and the damage suffered by patients as a result cannot be justified.
The Chief Executive of the NHS Confederation, Matthew Taylor, commenting upon the AACE report[vi] on ambulance handover delays stated; “We are clear that the situation will get worse over the winter unless we take action now … We are seeing record levels of 999 calls and major increases in ambulance handover delays. These pressures are slowing ambulances down when it comes to responding to immediate life-threatening calls”.
A recent Birmingham Mail article[vii] on 26/10/2021 confirmed that an investigation was being launched by a local NHS Trust following the death of patient who had been “queuing” outside the hospital in an ambulance for 5 hours. Having initially been described as stable, the patient deteriorated during the prolonged wait to be handed over to the A & E Department. Upon ambulance staff raising the alarm the patient was rushed to resuscitation but died soon after.
In West Bromwich, an Express & Star online article dated 17/11/2021[viii] quoted Richard Beeken, Chief Executive of Sandwell and West Birmingham NHS Trust, as saying this winter would be “the toughest ever seen”, whilst ambulance service bosses had warned already-long delays were likely to deteriorate further as demand surges. The paper had noted in an earlier article on 27/102021[ix] that the West Midlands Ambulance Service had already moved to its maximum risk rating for the first time ever after warning that patients were dying due to soaring demand and lengthy delays in handing over patients to hospitals.
It is evident from the ongoing delays being reported in both ambulance call outs and in handovers once a patient is outside A & E in an ambulance in what is essentially a “holding pattern”, that serious injuries and unnecessary deaths are occurring and will continue to occur until this issue is addressed. In the meanwhile, this is having a devastating effect upon patients and their families across England and Wales.
At Clear Law we have experience of dealing with such cases and it is clear the level of claims arising further to this type of delay can only increase in the current climate. In cases of heart attack and stroke for instance, the time taken to access hospital care is a critical factor in survivability and whether a patient will suffer long term debilitating effects. It is therefore essential that delays in an ambulance attending a patient and delays in that patient being assessed by A & E clinicians upon arrival at hospital by ambulance are minimised; where they are not and injury or death occurs, it is only reasonable for their families to seek legal redress.
If you or a family member have suffered harm as a result of such delays Clear Law’s clinical negligence team are more than happy to discuss this with you and answer any queries you may have without any obligation to proceed further.
[ii] https://aace.org.uk/news/handover-harm/
[iii] https://www.bbc.co.uk/news/uk-england-cornwall-59246574
[iv] https://www.bbc.co.uk/news/health-59237935
[v] https://www.gov.uk/government/news/relaunch-of-the-act-fast-campaign-to-improve-stroke-outcomes
[vii] https://www.birminghammail.co.uk/news/midlands-news/worcestershire-patient-dies-after-five-21971213
