Ambulance crews to ‘dump patients in A&E’ if they’re left waiting 45 minutes

  • london
  • January 3, 2023
  • Comments Off on Ambulance crews to ‘dump patients in A&E’ if they’re left waiting 45 minutes
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London Ambulance Service will only wait 45 minutes before handing patients over to A&E, it has been revealed.

Crews have been told to unload patients onto hospital trolleys, point them out to a nurse and then leave, shows an email leaked to ITV News.

The aim is to tackle delayed handovers and ensure ambulances are back on the roads for 999 calls instead of sitting outside A&E departments.

But critics say it’s not safe and highlights the dire state of the NHS.

Liberal Democrat health spokesperson Daisy Cooper said: ‘This move shows the shocking reality of the NHS crisis and is yet further proof that a major incident must now be declared across London.

‘The health secretary must act now to save the capital’s hospitals from being overwhelmed.



The email in full

Due to the significant amount of time being lost to the London ambulance service when patients wait for a lengthy period before being handed over to ED staff, and the risk this poses to patients waiting for an ambulance response in the community we have been seeking further opportunities to release ambulance crews waiting to handover patients. 

National policy is that the acute trust (hospital) takes full clinical responsibility for the patient from the point of clinical handover or at 15 minutes from arrival of the patient with the LAS crew at the hospital, whichever occurs earlier. 

From January 3rd we are asking that  any patients waiting for 45 minutes for handover and are not in a cohort are handed over immediately to ED staff allowing the ambulance clinicians to leave and respond to the next patient waiting in the community. 

If the patient is clinically stable the ambulance clinicians will ensure that the patient is on a hospital trolley or wheelchair/chair and approach the nurse in charge of the emergency department to notify them that the patient is being left in the care of the hospital and handover the patient. 

If the patient is clinically unstable and/or is unsafe to be left the crew will attempt handover and if unsuccessful will contact LAS IDM. The LAS crew will continue to look after the patient until the arrival of the nurse in charge/senior clinician or handover is achieved. As the crew will have waited beyond 15 minutes to hand over the patient the clinical responsibility for the patient will already be with the emergency department. 

In addition we are asking that where LAS clinical staff are caring for a cohort of patients they are relieved by the hospitals clinical staff when the cohort has been in place for three hours allowing these clinicians also to leave and to respond to the next patient waiting in the community.

I know the operational challenges are very significant and that this is a difficult time for everyone, and thank you for all of you are doing. 

‘Corridors and waiting rooms are already full with patients coping with severe pain. The government cannot wait any longer to act.

‘London’s NHS is collapsing before our eyes. Ministers have spent months arrogantly dismissing or ignoring all warnings from senior health leaders and MPs.

‘This is now a life-and-death situation for Londoners. The government needs to recall parliament immediately, declare a major incident and above all else, pass a plan to get the country out of this health crisis before more people die.’

The leaked email, understood to be from NHS England’s urgent and emergency care lead for London and sent to hospital managers, says: ‘From January 3 we are asking that any patients waiting for 45 minutes for handover… are handed over immediately to ED (emergency department) staff allowing the ambulance clinicians to leave and respond to the next patient waiting in the community.

‘If the patient is clinically stable the ambulance clinicians will ensure the patient is on a hospital trolley or wheelchair/chair and approach the nurse in charge of the emergency department to notify them that the patient is being left in the care of the hospital and handover the patient.’

The NHS Standard Contract for 2021 to 2022 sets a target ‘all handovers between ambulance and A&E must take place within 15 minutes, with none waiting more than 30 minutes’.

But immense pressure on the NHS means patients across the country are increasingly left stuck in ambulances for hours.

The email says if the patient is not clinically stable, ambulance crews will stay until handover is achieved – but adds the responsibility lies with the hospital.

It said the current ‘operational challenges’ in the NHS are ‘very significant’ and ‘this is a difficult time for everyone’.

Figures from the NHS show 37% of handovers in the week to Christmas Day were delayed by at least 30 minutes, down from 41% the previous week but higher than the 13% recorded at that point in 2021, and 11% in 2020.

NHS palliative care doctor Rachel Clarke said on Twitter the plan was unsafe.

She wrote: ‘This isn’t safe. This isn’t a solution. There aren’t the ED beds, the ED doctors, the ED nurses, the ED spaces. Or is the proposal here merely to pile up more patients in ED corridors?’

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