Revealed: Patients kept waiting at A&E

Figures have shown that in March Scarborough Hospital had ambulances outside waiting to pass on patients for 18 hours of the day.
Patients waiting outside Bridlingtons closest Accident and Emergency DepartmentPatients waiting outside Bridlingtons closest Accident and Emergency Department
Patients waiting outside Bridlingtons closest Accident and Emergency Department

A Freedom of Information request has also revealed that in the past two years Bridlington’s closest Accident and Emergency department accumulated more than £2million in penalty fines when targets for ambulance handover times were not met.

Each ambulance has a handover target of 15 minutes - anything over is classed as excessive. In February, the average time ambulances were stuck outside Scarborough Hospital waiting to pass on patients was 16 hours a day.

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While in March that figure rose to 18 hours a day, the second highest recorded in Yorkshire, according to figures published in Yorkshire Ambulance Service’s Integrated Performance Reports each month.

April saw ambulance handover times adding up to 15 hours a day. While May has shown a drop to an average of seven hours a day.

A Yorkshire Ambulance Service paramedic, who wished to remain anonymous, said ambulances waiting to pass on patients is something that happens every shift.

“It’s constant - Scarborough and York are horrendous for it. When we get stuck in A&E it takes us off and someone can call 999 and not get a fast response - it all backs up.”

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Government funding is being “protected”, but simple changes such as the price of fuel make a huge difference to the budget, the paramedic said.

In 2014-15, Scarborough’s emergency department worked up £1,046,600 in ambulance handover fines and in 2015-16 the total was £1,007,400. The department is also fined for 12-hour breaches - if a patient is waiting to be moved to a ward for more than 12 hours the hospital is fined £1,000. Between 2015-16 there were 36 incidents, a fine of £36,000, compared to just five incidents the year before. The paramedic praised A&E staff who “are doing the best they can” but feels the public need to do more to help. It is believed there are too many people who use A&E instead of going to see a GP as they don’t want to wait. The paramedic said: “It is an emergency service for people who are really unwell and have nowhere else to turn.

“The public need to be told that yes you do pay for this, but you’re going to break it if you keep treating it like you are.”

From January to March this year, the department breached its emergency care standard 2,999 times out of 14,396 attendances - making it just 79.17 per cent, the lowest it has been in four years. Their target is 95 per cent.

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A breach of emergency care standard is when a patient waits longer than four hours to be seen to after entering Accident and Emergency.

One patient who attended the department said: “During our time in the waiting area there were people with all illnesses coming in and some showing signs of extreme pain and discomfort, some with nausea and on the verge on passing out. Unfortunately all the hospital could do was leave them sat in a packed waiting area as nowhere else was available for them to go.”

A spokesperson for York Teaching Hospital NHS Foundation Trust said: “The pressure facing our hospitals has been well documented, and there are several factors that affected our performance at the start of this year.

“A combination of growing numbers in attendance rates, delayed discharges and wards closed due to norovirus resulted in significant pressure on beds. This means that, as with many other hospitals, we have been unable to consistently achieve the expected performance levels.

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“Achieving the four-hour and ambulance turnaround performance targets are not solely the responsibility of the emergency department, and we are working with primary care, social care, Yorkshire Ambulance Service and our commissioners to reduce delays across all parts of the system.

“At Scarborough we have introduced a new role onto the wards to help reduce delays in patients being discharged, which is helping to make sure that beds are available for those who need them.

Patients attending A&E are treated according to clinical need, and those requiring urgent attention are seen promptly.

“Some patients will be directed the urgent care centre within the hospital which is a separate GP-led service, however when we are facing high demand people may find that they are waiting longer. Providing both services from Scarborough Hospital improves access to emergency care and delivers a safer service.

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“Despite these pressures, we are pleased that most of our patients give positive feedback about our emergency departments.”

Nigel Ayre, delivery manager of Healthwatch North Yorkshire, said: “Ensuring Yorkshire Ambulance Services are achieving their turnaround and handover targets avoids crucial knock on effects on A&E departments, and therefore, the patient experience.

“One of Healthwatch North Yorkshire’s five key projects for the year ahead is to research how the Yorkshire Ambulance Service currently performs in this respect, the issues it faces in doing so, and how that impacts on services across our county’s hospitals.

“We are working positively with commissioners and providers to better understand the situation across the county and Scarborough in particular.”

Healthwatch listen to experience of patients and the public and encourage anyone with something to share to get in touch on (01904) or by emailing [email protected].