Patients are waiting in ambulances outside A&E for 14 hours with demand at 'highest ever level'

Patients are having to wait in ambulances for up to 14 hours before being admitted to A&E – with paramedics experiencing the “highest ever level of sustained demand”.

The alarming situation in Bristol that is seeing ambulances tied up waiting to drop patients off to A&E departments means they are struggling to get out to calls, with reports of patients waiting up to two days.

Newly released data from NHS England reveals that ambulances were taking on average almost 54 minutes to respond to Category 2 calls, which includes stroke and heart attack in October 2021. The NHS’ official target is 18 minutes.

“When I left work tonight there were 130 people waiting for ambulances, the longest had been waiting two days and there was no one to send (to them), almost all the vehicles were stuck outside the hospitals,” a Bristol-based paramedic who wished to remain anonymous told The Big Issue on Monday.

“It’s pretty normal now for 50 per cent of the vehicles in the city to be waiting outside the hospital.”

An 83-year-old man with dementia was forced to spend 14 hours – from 7pm to 9am the following day – inside an ambulance outside the Bristol Royal Infirmary (BRI), without access to a bathroom or a proper bed.

“He’d been on a stretcher the whole night, and not well either, having to use the bathroom in the ambulance, so undignified for him,” said Nick Furneaux of said his elderly father who was suffering intimate bleeding, a knock to the head and a cut along his arm.

“When he first got into the ambulance, he knew he was going to hospital. And after 14 hours he doesn’t know where he is, he has no idea where he is,” Furneaux said. 

“He was trying to escape, he was trying to get out, he was traumatised, because of course he was.”

The ambulance crew of two that picked up Furneaux’s father were on their first call of the evening, he said, and spent the entirety of their shift caring for the man inside the ambulance, clocking off around 6am to be replaced by another two workers who continued to wait with his upset and unwell father.

“The time it takes us to handover patients into busy hospital emergency departments is longer than we have ever seen before,” a spokesperson for the South Western Ambulance Service told The Big Issue. 

“We are losing many more hours compared with recent years which causes our ambulances to queue outside hospitals and unable to respond to other patients” they continued.

The BBC has reported that 21 ambulances were seen queuing at the Queen Alexandra Hospital in Portsmouth, leading the South Central Ambulance Service to plead for people to only dial 999 in a life-threatening emergency.

And one student paramedic with the South Western Ambulance service reported being part of a queue of 25 ambulance crews waiting to enter the emergency department at the Royal Cornwall Hospital.

“Ambulance crews are continuing to queue for hours outside hospitals simply to hand over patients who’re in need of urgent medical care. It’s dangerous and unsustainable,” Colm Porter, Unison national officer told The Big Issue.

Despite the traumatic experience his father suffered, Furneaux added: “Every single member of staff who was involved with dad was superb. They were kind and dignified and professional and brilliant. I would hug them – if I was allowed.”

University Hospitals Bristol and Weston NHS Trust said in August that BRI was seeing “unprecedented queuing” in the ambulance bay and had the “worst performance in the country.”

Dr Emma Redfern, interim medical director at the trust, said like many hospitals across the country the BRI’s A&E was under “sustained pressure” due to Covid, staffing issues and infection control guidance.

Commenting on the general delays the trust is experiencing, Dr Redfern said: “We always aim to see and treat patients as quickly as possible, and all patients arriving at our emergency departments are triaged and assessed with the most clinically urgent being prioritised.

“Like other hospitals, our ability to admit patients in a timely way is also being impacted by staffing challenges, a rise in the number of Covid-19 patients needing admission, and infection control guidance which means we have separate wards for Covid-19 and non-Covid-19 patients to maintain safety but this reduces the flexible use of our beds.”

Dr Redfern added that time discharges for patients ready to leave hospital was also an issue at the BRI.

She added: “We would like to apologise to any of our patients who have experienced a longer wait at our emergency departments.”