AN ACUTE lack of ambulances and paramedics has created a situation where 999 patients classed as ‘life threatening’ are waiting for up to five hours before being taken to hospital, alarming new figures have revealed.
National requirements state that 75 per cent of ‘life-threatening’ calls must be reached in eight minutes. The Freedom of Information figures show that, over a six-weeks period, more than 8,000 such cases waited more than 30 minutes for a response. The longest wait was in Portsmouth, on January 2nd, when a call to South Central Ambulance Service (SCAS) resulted in a wait of five hours five minutes for an ambulance, even though the case was classed as ‘life-threatening’.
Unions rightly insist that this situation has come about as a direct result of Tory cuts to the NHS. However NHS England, rather than deal with the source of the problem and demand more ambulances and more staff, are trying to move the goalposts. They have run a trial which re-defines what is considered a ‘life-threatening’ emergency.
This is being run in three of the country’s ten ambulance trusts: Yorkshire, South Western and the West Midlands. The scheme, called the Ambulance Response Programme (ARP), streamlines the sickest patients. But it also controversially re-classes those who would previously be considered suffering from a ‘life-threatening’ condition as ‘serious but not life threatening’.
Despite tens of thousands of cases being stripped out of the urgent category, ambulances are still failing to meet the target. Ambulance staff union GMB accused NHS England of ‘manipulating’ targets, saying: ‘At the end of the day, someone, if they haven’t already, is going to die from a lack of care.
‘The targets are being manipulated so there are fewer urgent calls – and if there are fewer urgent calls, surely you should be able to hit the targets. I don’t think reducing the number of calls classed as emergencies is the way forward. The way to deal with response times is more ambulances and more properly-trained paramedics.’
Debbie Wilkinson, chair of the union Unite’s ambulance staff committee, said staff shortages, rising demand and a lack of extra funding means the ARP trial is ‘always going to fail’. The most urgent calls in ambulance trusts are currently split into two groups depending on their severity: ‘Red 1’ and ‘Red 2’.
‘Red 1’ is used for patients who are not breathing, do not have a pulse, or in other highly time-sensitive situations such as cardiac arrest or severe bleeding. Conditions such as stroke, sepsis and major burns are in the ‘Red 2’ category, used for ‘serious but not the most life-threatening’ conditions. Both require an eight-minute response.
When the ARP was first announced, Keith Willett, national director for acute care at NHS England insisted the programme was ‘not about relaxing standards.’ However, in the trial some conditions in the ‘Red 2’ category were upgraded to ‘Red 1’ status and, alarmingly, vice versa.
Liz McAnulty, chair of the Patients Association, said the findings are a signal that the NHS is facing a major crisis. Ambulance services must respond in a timely and effective way – this can be literally a matter of life or death,’ she said.
‘We are profoundly concerned that people with life-threatening medical needs are apparently increasingly likely to face unacceptably long waits,’ she said, calling for more NHS funding.
