Almost 400 ambulances waited outside Kettering hospital for more than one hour last month

Almost 400 ambulances were kept waiting for more than an hour last month (December) to drop off their patients at Kettering General Hospital.

Despite putting in new measures to try and tackle the issue the acute hospital which is running at full capacity is still struggling to hit the one hour maximum government target, with hundreds of patients left waiting outside the hospital doors in ambulances for treatment.

The matter has now been escalated to the board by the hospital’s performance committee which says new measures need to be brought in to improve drop off delay.

The target for the month was a maximum of 18 one hour plus wait. The number in December was 399. The one hour waits are called ‘blac breaches’.

The hospital’s chief operating officer, Jo Fawcus, said it is not an easy problem to solve.

“We have been working hard with colleagues at East Midlands Ambulance Service (EMAS) to improve handover times from ambulance staff to our A&E team – but this remains a challenge.

“This has included working closely with EMAS staff to better understand the pattern of increased numbers of patients calling for an ambulance at particular times of day which results in clusters of patients being conveyed to A&E resulting in queues and longer handover times.

“Handover waits of more than 60 minutes can happen during these highly pressurised periods – which often coincide with periods where the hospital’s A&E department – and bed capacity- are extremely stretched.

“It is not an easy problem to solve – especially within our current small A&E department – but we have had our bid for a £46m new Urgent Care Hub approved and this, in the future, will enable us to develop better urgent care facilities to improve flow into and out of the hospital.

“In the meantime we are working on ways to improve the efficiency of handovers for both KGH and EMAS staff.

“One streaming method – called Same Day Emergency Care (SDEC) – has helped us move less seriously ill ambulance patients to an area on our main ward block where they can be quickly assessed, treated and discharged without need to be admitted to hospital.

“While this is working it is not always sufficient in times of very high demand to ensure a quick patient handover.

“Our highly skilled and experienced Acute Care Practitioners continue to work closely with ambulance crews and a more senior EMAS representative to stream patients and direct them to our relevant clinical areas – i.e. minors, SDEC, majors and resuscitation area as quickly as possible.

“In response to the continuing pressures we have also increased our physical capacity to be able to flex space and create an additional seven curtained off trolley spaces in A&E that can be used for ambulance handovers, or additional A&E capacity – supporting a better experience for patients of the handover process.”

Minutes of the hospital’s November board meeting said that ‘issues were exacerbated by the lack of physical space for handover, and daily surges in demand between 6pm-midnight. There were concerns that practitioners were not properly using their skills to refer to SDEC, with work continuing within the ambulance service to encourage different methods of community treatment.

The news comes after it was revealed this week by a BCC FOI request that in the 12 months to September 2019 EMAS had the highest number of long delays to call outs of any ambulance service in the country. The service pointed to a rise in demand and long waits outside hospitals as the reasons.

EMAS says it does not comment on individual hospitals but said: “We know our hospital colleagues have also seen significant pressures this winter,

with flu and norovirus in particular bringing big increases in A&E attendances as well as taking ward beds out of action - these and other factors have combined to mean that in many cases after taking someone to an emergency department, our ambulances haven’t been able to get back on the road quickly and into the community to respond to other 999 calls.

“Every part of the local health and care system wants to tackle these issues, and is working together to do that, but it’s clear that the NHS will need more staff and beds, and a well-functioning social care service, if we’re going to meet the needs of our growing and ageing population over the coming years.”