Some of the country’s GPs are advising patients requiring urgent hospital care to “get an Uber” or use a relative’s car due to their worst case history. ambulance service delays In England.
Patients with breathing difficulties and other potentially serious conditions are told in some cases that they are likely to be transferred more quickly from general practice to accident and emergency if they travel by taxi or private vehicle.
Data from the NHS for England shows that the average October ambulance response times for category 1 to 3 emergencies, which cover all urgent conditions, appear to be the highest since the categories were introduced nationally in 2017. Some patients requiring emergency treatment may have to wait several hours for an ambulance to arrive.
Dr Selvaseelan Selvarajah, a partner with a GP in east London, said: “If someone isn’t having a heart attack or stroke, my default advice is ‘Do you have someone who can take you or do you want to get an Uber?’
“These are patients who may have shortness of breath or have severe abdominal pain, but their lives are not in immediate danger.” He said that such patients would have previously been transferred by ambulance.
Health chiefs say the main delays in ambulance services are due to delivery delays at A&E departments, with vehicles queuing for hours before their patients are seen.
Proportion of delays of more than one hour in transfers from an ambulance to a hospital in England increased from 3% in October 2020 to 18% in October 2022, according to the latest figures published by the Association of Chief Ambulance Executives. The number of transfers of more than an hour reached around 52,000 in October, the highest number to date.
Dr Neena Jha, who works as a locum GP in Hertfordshire, said: “I have never seen ambulance services stretched to this degree due to the pressures they are under. It’s really concerning when you’re dealing with a seriously ill patient.
“If someone needs an urgent transfer to accidents and emergencies, we do not depend on the ambulance service. We call taxis or ask relatives to take them if they are going to be stable on the trip.
“I have had patients who have declining oxygen levels, who are not feeling well, and they give me an 18-hour wait for an ambulance.”
Jha said it was often a dilemma whether to keep a patient in the practice and wait for an ambulance with oxygen available, or risk them going to the hospital alone to ensure they had quicker access to the medical care they needed.
She said the ambulance service delays were highlighted when she was treating a baby this month at risk of cardiac arrest. She was initially given a two-and-a-half hour wait time and she said the baby’s life may have been saved by the fact that a vehicle was rerouted and arrived at the practice she was working at in 10 minutes.
In April it was reported that Deborah Lee, director of Gloucestershire hospitals NHS Foundation Trust, was taken to hospital by her husband after a suspected stroke because he had heard her lamenting the ambulance delays. She wrote on Twitter: “What if my husband hadn’t been there and my daughter had called an ambulance and they put me in the [Category 2] ‘stack’?”
GPs say they are increasingly concerned about the risk to patients from broader failures in the healthcare system. doctors at a conference of local medical committee representatives on Thursday he supported a motion saying “general practice in England is unsafe due to a shortage of doctors and lack of investment”.
Dr Kieran Sharrock, Chairman of the British Medical Association’s Committee for General Practitioners for England, said: “We are committed to our patients and we continue, but we know this trajectory for general practice cannot continue if we are to survive. ”
the National Health Service says that the problem of ambulance queues in emergency departments is due to hospitals being full, with delays in the discharge of patients to the community or social care. An NHS spokesperson said: “Ahead of what is likely to be a challenging winter for the NHS, services face considerable demand, with the busiest October ever for A&E attendants, difficulties discharging thousands of patients that they are medically fit for discharge, and that’s along with new data this week showing a 10-fold increase in the number of hospital flu cases compared to last year.
“NHS staff are working incredibly hard to prepare for the busy period with plans for new 24/7 system control centres, fall response services and additional beds and call controllers, so that it is vital that people continue to seek care when they need it. using 999 and A&E in an emergency and 111 online for other health conditions.”