Exclusive: Leak reveals urgent care patients face 30-hour waits because of covid pressures

Slides presented by London Ambulance Service Trust at a webinar with NHS London this week showed “category three” patients faced long delays at all stages of the process.

The length of each stage was said to be as follows: having calls answered at 111 centres (20 mins); the “revalidation” of the call before it is passed to 999 (two hours); 10 to 12 hour waits for an ambulance; and similar waits in emergency departments before being admitted to a bed.

Category three calls are considered urgent, but not immediately life-threatening. The calls could involve abdominal pain, uncomplicated diabetic issues and some falls. Category three patients are among those the NHS is encouraging to call first, rather than going straight to accident and emergency, as part of the flagship “111 first” drive designed to produce pressure on emergency care. 

Normally, the pathway from a 111 call being made to a patient being admitted to a bed would take nine hours with a faster response at all stages, the slides suggest. But the pressure across the NHS from covid cases is leading to much longer waits.  

On the day the slides were shown, the LAS had 547 people waiting for an emergency ambulance and more than 1,000 staff — 17 per cent of its frontline capacity — off sick or self-isolating. This has now reduced to 13 per cent. 

The service is now receiving between 8,000 and 8,500 calls a day. Its chief operating officer Khadir Meer tweeted on Tuesday that the previous week had been the busiest ever. This week, some London calls were being answered by West Midlands Ambulance Service Foundation Trust.

Other ambulance trusts are also coming under increasing pressure. On Monday, WMAS had its busiest ever day, with 5,383 calls — including some from London. South East Coast Ambulance Service FT has been regularly declaring business continuity incidents — an indication of extremely high pressure on its services — since before Christmas, with one this week lasting 61 hours. 

HSJ has seen figures showing SECAmb is taking over eight hours to reach one in 10 category three calls. On more serious category two calls — which include strokes and heart attacks — it was taking more than half an hour on average to reach patients, and in 10 per cent of cases it was taking over an hour.

Data released by NHS England yesterday showed ambulance handover delays of one hour or more hit their highest point this winter in the seven days to Sunday at 5,318. This was nearly 6 per cent of all ambulance journeys compared with 3 per cent last week.

Among London trusts, three accounted for nearly 10 per cent of the national one hour plus waits. Barking, Redbridge and Havering University Hospitals Trust had 199 one-hour waits, the Royal Free London Foundation Trust 152 and London North West University Healthcare Trust had 150. University Hospitals Birmingham Foundation Trust — one of the biggest trusts in the country — had 337.

A London Ambulance Service spokesperson said: “Our frontline ambulance crews and call handlers are working tirelessly to help an unprecedented number of patients as they respond to more 111 and 999 calls than at any time in our history.

“We are continuing to prioritise the most seriously ill and injured patients, and our team of trained clinicians in our control rooms are working hard to monitor and maintain contact with many other patients as needed while they are waiting for ambulance crews to arrive.”

A SECAmb spokesman said:: *Our ambulance crews and call handlers both in our 999 and 111 operations centres are working hard to respond to help patients and respond to them as quickly as possible if they require an ambulance. We are very proud of the ongoing efforts of everyone at SECAmb,  whatever their role, as we face this increased pressure. We are continuing to prioritise our response to our most seriously ill and injured patients and urge the public to only call 999 in the event of a serious or life-threatening emergency.”.

Updated: 14.50 8 Jan with comment from SECAmb and 15.39 with details of current absence rate.