Ambulance Response Times Crisis

The NHS crisis is impacting heavily on emergency response times for ambulances serving the rural area of North Wales. Jools Payne speaks to local families hit by tragedy whose distress and trauma was compounded by waiting hours for an ambulance to arrive, and another who endured a six hour wait in an ambulance stacked outside the Maelor.

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Queue of ambulances outside Wrexham Maelor Hospital taken by Cllr Trevor Bates, Wrexham Council member for the Ceiriog Valley

The NHS is in crisis. The evidence to support this assertion is as stacked as the ambulances sitting idly outside A&E departments across North Wales. In its 70th anniversary year, the pride of Britain – a healthcare service once the envy of the world – is buckling under the strain of not enough doctors, not enough nurses and definitely not enough funding to cope with an ageing population and the advances in treatments that mean we are living longer, and expecting a better quality from that life.

Impact

Residents in our rural area of Chirk and the Ceiriog Valley are experiencing the tragic impact of this growing crisis first hand. Bed blocking, caused by a combination of lack of joined up thinking, inefficient working practices and woefully poor social care provision, means patients are unable to transition from ward beds back into the community with sufficient ease. That in turn means delays in moving urgent A&E admissions into available ward beds, which then leads to ambulances stacking up outside A&Es as patients wait to be triaged. The inevitable result of this ‘perfect storm’ of unfortunate events is that ambulances are off the road and unavailable to respond to emergency 999 calls. Trevor Bates’ damning photographic evidence (above) captured eight ambulances in a stacking queue outside the Wrexham Maelor on one sunny afternoon in April. This is the new normal.

 

Such is the depth of this crisis in North Wales, there are ambulances from the West Midlands being sent across the border, and vice versa, where there now appears to be a ‘nearest one goes’ rule in force. How on earth did it come to this? Residents in Chirk and the Ceiriog Valley are rightly asking ‘are we in peril?’ With no ambulance station in Chirk there is little hope of an ambulance meeting the eight minute arrival target on a red call.

Josie Williams, whose husband Brian suffered a fatal ruptured aortic aneurysm in March 2017, has been battling to get the Welsh Ambulance Service to provide answers for the “unacceptable delay” in responding to her emergency call when she found Brian collapsed on the floor of their home in Dolywern.

“It took the ambulance two hours to arrive. I’m a retired nurse, by the time they finally got here I knew he was gone,” she reveals. “The worst thing was being on my own when he went.”

Josie goes on to explain how the ambulance crew had followed the vehicle’s Satnav, which bizarrely, took them into the valley over the Selattyn road and down the steep narrow lanes into Stryt Pentre to her then address in Dolywern. They got lost which caused further delay.

The Williams family were, of course, devastated by Brian’s death but Josie is determined to see something positive arising from their deeply distressing tragedy. She has been actively campaigning to improve the way emergency calls are managed by the Welsh Ambulance Service in rural areas. “I was a nurse once and I’ll always be a carer,” says Josie. “I feel very strongly that something positive needs to come out of Brian’s death. We need to work together as a community to find a way of dealing with this crisis.”

In a cruelly tragic twist of fate, just days before the first anniversary of Brian’s passing, Elaine Hidden, who lived next door to Josie and Brian at the time of his death, also suffered a fatal collapse. Despite repeated 999 calls the family also had to wait over two hours for an ambulance to arrive – missing the eight minute ‘red’ response target by a country mile.

After Elaine’s tragic death aged just 51 years, Glyntraian Community Council committed to securing two public access defibrillators for the communities of Dolywern and Pontfadog through the British Heart Foundation’s Public Access Defibrillator (PAD) Scheme. One will be placed outside the Oliver Jones Hall in Dolywern and Mandy and Phil Connor have kindly agreed to fit the other at Pontfadog Post Office & Stores.

Elaine’s husband Colin, the popular character known to many locals as ‘Colin Sky Man’, has made a generous donation towards the cost of funding these life-saving devices in her memory.

Collapse

Jan Bennett, who also lives in Dolywern, attended the Welsh Ambulance Service NHS Trust’s annual meeting at Wrexham FC’s Racecourse ground earlier this year eager to give feedback on her own sorry experience. After a sudden collapse and violent fitting in December 2017, Jan also had to wait over two hours for an ambulance. She then endured an anxious six-hour delay in the ambulance as it sat outside the Wrexham Maelor A&E department behind a convoy of seven others parked up waiting to offload patients. Jan was diagnosed with a brain tumour the following day.

“I was unconscious for about half an hour I think,” she explains. “It was very alarming for my husband Ralph because it just came out of a clear blue sky.”

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Jan and Ralph Bennett

Ralph, a Councillor with Glyntraian CC, worked closely with Trevor Bates, Josie and others to collate a catalogue of evidence of disturbing delays and arranged for the Welsh Ambulance Service NHS Trust’s leadership to account for its policies and procedures at a public meeting that was held on Thursday 12th July.

Public Meeting

“I promise you complete honesty tonight, a frank conversation about what we believe we are doing well and what absolutely requires improvement,” was the opening line by Richard Lee, Director of Operations for the delivery of ambulances across North Wales. The public meeting held at Oliver Jones Memorial Hall in Dolywern saw 50+ residents of the Ceiriog Valley and Chirk come together to share concerns and personal experiences regarding the emergency response times in our rural area.

An informative presentation, reliant on overall statistics across North Wales as a whole, provided an insight into what challenges the Welsh Ambulance Service are facing and how they are working towards improvement. However, a resounding reflection on the system itself is where accountability seemed to be placed, stating that ‘lost hours’ is the root cause. Andy Long, Area Manager, explains that lost hours is the term used for the time an ambulance on duty is sat in a queue outside of A&E rather than available on the roads for emergency calls. There is a direct correlation between response times and lost hours.

We were advised the following improvements have been made:

  • A team of paramedics and nurses are situated within the control room to provide clinical assessment over the phone to avoid an ambulance being dispatched unnecessarily and freed up for ‘red’ calls
  • A concerted effort to send the right vehicle every time has been put in place. A paramedic in a car can be sent instead of an ambulance for almost any red/amber call allowing ambulances to remain available. However, an ambulance must be sent for a heart attack or stroke
  • Track repeat callers and arrange a multi disciplinary team to talk through what those patients require – this sees a significant drop in the amount of times ambulances are sent to these individuals monthly
  • Working in partnership with other organisations to provide training for use of defibrillators across communities.

Yet, as question time came around with many relaying their own distressing stories, a clear pattern emerged with each response – the Welsh Ambulance Service can not take accountability for the delays, inefficient flow and bed blocking within the hospitals. The community is still at a loss for a sufficient explanation.

An agreement was made to arrange another public meeting along with Betsi Cadwaladr University Health Board to ensure all areas of inefficiency are addressed with the local community. Estelle Hitchon, Director of Partnerships and Engagement, advised this will most likely take place in Autumn.

Double.LL will provide updates when a date has been set.

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