Tag Archives: ambulances

Revealed: the damning figures that show the NHS can’t cope with patient demand

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St George’s University Foundation Trust’s A & E department Pic credit: health trust

If you thought the NHS was at breaking point and want to know why – the National Audit Office have today provided a handy fact and figures guide to the decline of the country’s most cherished service.

A new report from Parliament’s financial watchdog charts the scale of both the failure of the NHS to respond to emergencies fast enough and the unprecedented demand from the public to use its facilities in the 13 years the NHS has been run by the Tories and the coalition government.

These are the startling figures:

711,881 A&E patients waiting over four hours from arrival to be admitted, transferred or discharged in December 2022, an all-time high. Since fallen to just over 550,000 in March this year.

90,998 ambulance handovers to A&E taking longer than 30 minutes in March 2023, equivalent to 25.9% of all ambulance handovers

32.0m reported number of appointments in general practice provided in October 2022, an all-time high, compared with 27.1 million reported in October 2018

92.3% general and acute hospital beds occupied during Q4 2022-23,representing record levels

88 seconds mean time to answer 999 calls related to health issues in December 2022, an all-time high

July 2015 the last time the NHS met its target for 95% of A&E patients to be admitted, transferred, or discharged within four hours of their arrival

8.4 million 111 calls answered within 60 seconds in 2021-22, compared with 11.2 million to 13.3 million between 2014-15 and 2020-21

1.27 million full-time equivalent NHS staff in February 2023, compared with the most recent low of 0.96 million in June 2013

£21.5 billion estimated annual cost in 2020-21 of providing the services reviewed in this report

Big variations in different regions in England

Delving deeper into the figures there are big variations in different regions of the UK. For example those being admitted, treated and discharged from A&E within four hours varied between 67.9 per cent in the East of England to 75.9 percent in the South East – both noticeably lower than the standard 95 per cent treated in that time just after the Tories got into power in 2011.

Similarly among ambulance response times there were wide variations. In 2021-22, the mean Category 1 (life threatening incidents like strokes and heart attacks) incident response time for the London ambulance service was 6 minutes 51 seconds compared with 10 minutes 20 seconds for the South-West ambulance service.,

In the same year the mean Category 2 incident response time for the ambulance service in the Isle of Wight was 26 minutes 20 seconds, compared with 1 hour 1 minute 57 seconds for the South-West ambulance service.

Some other points emerge why this is happening. The growing elderly population and general population increase in the UK is increasing demands on the NHS and effects of the Covid pandemic has left its mark.

More staff recruited but more off sick from stress

The government can claim it has recruited more NHS staff, including GPs and ambulance drivers. But this has been offset by more staff going off sick and more staff leaving the NHS because they can’t cope with the workload. I should not think the government’s attitude to keeping down pay rises in the middle of a cost of living crisis has helped either.

The government is promising a great £2.5 billion recovery programme and has allocated the extra money. But the NAO report says:

“More people than ever before are receiving unplanned and urgent NHS care every day. To support these services, the NHS is spending increasing amounts of public money and employing record numbers of people. Nevertheless, patients’ satisfaction and access to services have been worsening, suggesting there is no single, straightforward solution to improving what is a complex and interdependent
system.”

The real test will come next winter -since the government is promising much better services by March 2024. If it fails it will just add to the multiple problems facing this government and increase the distrust between the public and politicians.

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Result! West Herts Hospitals Trust changes patient ambulance services after scandal of a 5 hour wait

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West Herts acted on complaint

West Herts acted on complaint

My complaint about the appalling situation that left my wife, recovering from a stroke, waiting five hours for a privatised patient ambulance at Hemel Hempstead Urgent Care Centre to take her back to Gossoms End rehab centre in Berkhamsted has yielded results.
The West Herts Hospitals Trust, which manages the contract for Medical Services Ltd, the private company providing the ambulances, ordered an investigation into the incident and a review of the service.
The inquiry confirmed that my wife, Margaret, had in fact, waited 5 hours 15 minutes for the ambulance.
It then found the following damning facts:
The excessive delay was caused, as I expected, by the company supplying insufficient numbers of ambulances to do the job. They had only two vehicles – an ambulance and a seven seater minibus – on that Saturday afternoon and evening – to supply the entire needs of West Hertfordshire.
The company did not manage the call -indeed it appears it disappeared off their radar because they didn’t have proper management controls to check why nobody had turned up.
Neither the company nor Hemel Hemsptead Urgent Care Centre even reported the delay – which amounted to a big breach of Medical Services Ltd contract – until days after the event. Indeed there is a hint in the report they may not have bothered – if I had not publicly raised it in this blog and with the Berkhamsted and Tring Gazette.
The report is honest enough to admit that both Medical Services and the West Herts Health Trust have let my wife down. West Herts admit ” it could have been avoided with closer controls and proactive management of the activity levels.” The investigators also found “no examples of good practice ” in managing this contract.
The good news is that West Herts and Medical Services Ltd have pinpointed deficiencies in the service and are taking action to put things right.
The main changes are:
Medical Services will contract some patient ambulance services to a taxi firm where people are mobile enough to get in a taxi.This will mean that people like my wife who couldn’t get out of her wheelchair to get in a taxi will get priority ambulance treatment.
Medical services Ltd will review ambulance rosters to put more on at the weekend and employ an additional member of staff at Watford.
The senior management at Medical Services Ltd will take direct charge for a trial period of their control room and take action if anybody is waiting for more than an hour.
West Herts are also strengthening their management procedures and using the information to change the procurement of new contracts. This includes financial penalties for breach of contract – all patients not to wait for more than two hours is written into current contract.
There are two lessons to be learned from this. Far too many people are happy just to grumble rather than complain if the NHS service is not up to scratch. this shows if you do complain you can get something done.
Second, West Herts Hospitals Trust are to be congratulated for taking the complaint on the chin and doing something about it. They have also been honest and open in releasing the report to me without having to go to the trouble of putting in a Freedom of Information request.
The proof of the pudding will now be whether the services does improve – but I see Medical Services Ltd contract is up for renewal next May. They had better step up to the plate.

New Privatised NHS: Medical Services Ltd broke patient ambulance contract

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The 5 hr wait ambulance: Picture taken by me at Hemel Hempstead Urgent Care Centre

The 5 hr wait ambulance: Picture taken by me at Hemel Hempstead Urgent Care Centre

Following my personal exposure of Medical Services Ltd appalling provision for weekend patient ambulance services, my local newspaper, the Gazette, took up the story. the experience onvolved waiting five hours for an ambulance to come and pick up my wife, Margaret, who recently had stroke, from Hemel Hempstead Urgent Care Centre.
Their report reveals that not only were the company at fault but it is clear that the people responsible for managing and overseeing the contract on behalf of the NHS were also to blame.
It is now revealed that Herts Valleys Clinical Commissioning Group require Medical Services Ltd ( gross profit £7m a year) to collect all patients within two hours. The contract says:
“The Contractor will collect patients from clinics within 60 minutes of being requested by the Department in 90% of cases and within 120 minutes on 100% of cases.”
So this amounts to a blatant breach of contract and if as staff at Hemel Hempstead Urgent Care Centre, say they are regularly leaving patients for up to four hours, this is not an isolated case.
There are also a serious questions for the West Herts Health Trust who are supposed to manage this contract.
Were they asleep when Medical Services Ltd were providing just one ambulance for patient transport and collecting patients from Bedford, Luton, Letchworth and Hitchin hospitals. Or were Medical Services Ltd two timing the authority by using the same ambulance for contracts with other health trusts? Did they allow Medical Services Ltd to close their Watford depot at weekends so all ambulances will have to travel from Luton to pick up patients at Watford General. Great guardians of taxpayers money and patients interests, I don’t think.
Why should the public put up with shoddy providers who flout contracts and complacent NHS supervisors who don’t check up on them?
If you’ve had a bad waiting experience with a private or public ambulance taking you back from hospital you can always use the contact me point on this website or contact the Gazette series of papers to complain. Just give me the details, day, time and wait.
Or you can now go one better. Samantha Jones, the chief executive of West Herts Hospitals Trust, has promised an inquiry after the publication of this blog and would like to hear from anybody who has had a bad or good experience using the patients ambulance service from watford, St Albans and Hemel Hempstead hospitals. Her email is samantha.jones@whht.nhs.uk.

The New Privatised NHS : Wait five hours for a patient transport ambulance

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Discreet logo of Medical Services on" NHS " ambulance. Pic taken by myself

Discreet logo of Medical Services on” NHS ” ambulance. Pic taken by myself

Medical Services Ltd is not a name instantly recognised by the general public. Their website claims they are the nation’s leader in the providing integrated patient transport and is bulging with testimonials from a grateful public.
The Anglo- Danish company (Falck a Danish private fire and ambulance company has just paid for a 45 per cent stake and put a director on the board) claims to be Britain’s biggest private ambulance provider, operating in London,Hertfordshire, Bedfordshire and North West England.
It is well placed to make a lot of money as the NHS is progressively privatised,having according to its latest company accounts,a turnover of £29m, gross profits of £7m, and operating profits of £577,000.
However its PR appeal does not live up to reality. I am in the position of caring for my wife Margaret, who suffered a stroke while we were on holiday.
As previous posts on this site show, she received amazing treatment from the NHS when it happened on the Isles of Scilly and is receiving very good loving care and physio at Gossoms End rehab unit in Berkhamsted.
At the moment she can’t stand up or walk unaided and can only travel in ambulances.
Last weekend she had to get an X-ray – after toppling over – to make sure she had not broken her wrist. She received a speedy transit to Hemel Hempstead urgent care unit in an NHS staffed ambulance and was seen, X rayed,and sorted by the doctor’s co-operative who run the centre.
But then things went wrong. We were told we had to wait two hours. Two hours became three and then four. We pressed staff at the centre to find out whether this ambulance would ever turn up. Finally nearly five hours later it did, the driver saying it had only heard about the job half an hour ago when he started work on the night shift
Checking with staff I discovered that the ” nation’s leader in integrated patient transport ” is regularly leaving vulnerable disabled people for four hours before it picks them up.They said the Luton centre was rude to NHS staff and was fairly callous about patients having to wait in distress.
Later I discovered that Medical Services Ltd had just ONE patient transport ambulance on duty on Saturday evening covering the whole of Hertfordshire and Bedfordshire from Letchworth to Watford and Dunstable to Bedford. They have a depot in Watford, with ambulances there, but they close it at weekends. No wonder it took five hours.
Next day I penned a pretty angry e-mail to one Joe Sheehan, managing director of Medical Services ( salary £120,000 last year – a 20 per cent rise). I suspect it caused him a bit of indigestion over Sunday lunch at his Kent home but I will credit him that he did respond to me -including sending me his mobile phone number.
Also to his credit he investigated it, admitted it happened and apologised for a ” sub standard service”.
He has also promised short-term action to remedy some of my complaints by rostering extra staff at the weekend so people won’t wait so long and raise the issue with the NHS commissioners who contracted him to do the work.
I have also sought an explanation from the East of England Ambulance Trust. They pointed out, see their comment on this blog, that they don’t commissioned his company. But they have got in touch with the Herts Valley Clinical Commissioning Group who are now contacting Medical Services Ltd about the delay. I hope to find out when they let contracts for patient transport whether they specify standards of service or staffing cover. They could have a share of the blame if they don’t.
I suspect however most people would never have thought of even finding out who owned the ambulance that came to pick them up – they would have assumed as a member of the public did when I was photographing the ambulance – that it is the NHS.
This is why I am told NHS staff at hospitals, urgent care centres, and the front line drivers ( this one was courtesy himself) bear the brunt of public anger for shoddy services while I fear the management of these private companies just collect the money and never have to face the public or be hauled to account.
This managing director – to be fair to him – seems to have smelt the coffee. He had better. The public deserve better.