Daily Insight: Handover headache

Five months after NHS England told trusts and integrated care systems to take urgent action to “immediately stop” ambulance handover delays, the issue shows little sign of improving.

Nowhere is this more evident than in large parts of the South West region, where South Western Ambulance Service Foundation Trust is reporting nearly a third of all England’s handover delays.

Ambulance handover delays are complex to resolve, not least because of the current pressures on hospital emergency departments which all trusts are grappling with.

However, it is not quite clear why the South West is having particular problems with handover delays.

The region is experiencing a covid-19 surge, has an older population than elsewhere, and perhaps some more severe issues with delayed discharges. But these don’t seem to explain the major gap with other regions. The answer, short term and long term, is likely to involve more collaboration to try to make life easier for SWAST.

They think it’s all over — it’s not

Anybody who has travelled on public transport recently will have seen a much greater reluctance to wear masks (or open windows).

Many seem to have decided the pandemic is over or, at least, that it is no longer worth taking precautions to avoid infection. The media is — understandably — preoccupied with the early stages of a potential third world war.

Health ministers seem to have moved on, feeling safe to unveil visions for the future without facing awkward questions about covid.

When the latest REACT-1 survey revealed “covid-19 prevalence continues to decline across England but infection rates remain high”, the health secretary’s tweet publicising it omitted the last five words.

Trouble is the data no longer supports the idea the pandemic is receding — at least as far as its impact on the NHS is concerned.

Having peaked in early January, hospital admissions of those who test positive for covid had been steadily declining. However, at the end of the last month, that trend halted and began to reverse.

On 25 February, the seven-day total covid admissions total was 6,612. By 8 March, the latest data available, it has risen to 8,431 — a 28 per cent increase.

Every region has seen a rise, but the uptick has been the most dramatic in the South West (up 54 per cent over the same period), and the South East (up 35 per cent).

The reasons for the rise are as yet unclear, though the BA2 variant of Omicron, waning vaccine effectiveness, and behaviour changes seem the likeliest culprits.

What is in no doubt is the impact on the NHS. The need to create separate pathways for covid positive patients and observe strict infection prevention and control measures is gumming up the system as it struggles with unprecedented demand. 

Here’s hoping the war in Ukraine is halted as soon as possible, but when the public, press and politicians turn their attention homeward once more, they might be dismayed by what they find.