Health

Patients face a life-threatening postcode lottery in 999 emergencies due to ambulance wait times, report warns


  • Patients in worst performing areas stay in hospital double the time on average

Patients face a life-threatening postcode lottery of ambulance response times in an emergency, a damning report by MPs warns.

The Public Accounts Committee found how quickly an ambulance will arrive depends too much on where the patient lives.

Its new report also says that not enough is being done to tackle hospital bed blocking, meaning there is not enough capacity for new arrivals.

MPs say the NHS has more money and staff than ever before but has failed to use it properly to improve access for patients in need of urgent care.

Performance in this area has fallen ‘far below the standard the NHS says patients should expect and receive’, members added, as they called for the NHS and Department of Health and Social Care to make improvements.

People in some parts of the country have to wait more than three minutes longer for an ambulance to arrive when they are facing a life-threatening emergency, the committee said.

It highlighted that in 2021/22, average ambulance response times for the most serious incidents – including cardiac arrests – varied from six minutes 51 seconds for the London Ambulance Service to 10 minutes 20 seconds for the South Western Ambulance Service.

There is also wide variation in how the NHS performs in sending patients home when they no longer need hospital care.

The length of stay in the worst performing areas for discharging medically fit patients is more than double that of the best performing areas, the report highlights.

The number of patients staying in hospital despite no longer needing to be there averaged 13,623 across the last quarter of 2022/23 – up from 12,118 during the same period in 2021/22.

Staying in hospital too long can hamper recovery and prevent patients who need operations and other care from being admitted.

The report blames problems discharging older patients from hospital into adult social care, delays in hospitals’ own processes, transfers to NHS community settings, and the provision of short-term care packages, or nursing or residential care.

This last group can be forced to wait up to five weeks from when they are ready to leave hospital.

The MPs said: ‘Not enough is being done to address the systemic issues with discharges that lie within the gift of the NHS and its hospitals, and which cannot be blamed on external factors.’

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The NHS has not met targets for A&E waits since July 2015 and the time it takes for ambulance crews to hand over patients to doctors since November 2017.

‘Against this background, we asked how effective the (health) department has been in holding NHS England to account for the declining performance,’ the committee added.

It said investments in technology and infrastructure will be ‘critical’ to improving productivity, but the Department of Health and Social Care ‘does not appear to have budgeted for any such investment’.

The new report also identified bed blocking as a critical issue, with patients from worst performing areas staying in hospital nearly double the time of those in well performing areas (File Photo)

The new report also identified bed blocking as a critical issue, with patients from worst performing areas staying in hospital nearly double the time of those in well performing areas (File Photo)

Furthermore, NHS England’s existing plans ‘lack ambition given the scale of the issue at hand’.

The report also highlights very high levels of staff ill health and turnover rates, with the PAC left unconvinced by NHS England’s approach to address workforce shortfalls.

NHSE hopes to retain 130,000 staff who would otherwise leave over the next 15 years, an aspiration which the PAC describes as ‘highly doubtful’.

Labour MP Dame Meg Hillier, who chairs the cross-party PAC, said: ‘Patients suffering long waits and hard-pressed staff working in a system which is not delivering deserve better.

‘Excluding demand-led spending such as welfare payments, health takes up approximately 40 per cent of day-to-day budgeted spending by Whitehall departments.

‘It is vital this is delivering benefits for patients.’ Professor Julian Redhead, NHS England’s national clinical director for urgent and emergency care, said performance has since improved and staff are working hard to cope with record demand.

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