Hospital handover delays causing '˜planned wipeouts' for ambulance service

South East Coast Ambulance Service NHS Foundation Trust (SECAmb) has seen a huge increase in the number of hours lost while crews wait to transfer patients to hospital staff.

Leaders of the ambulance service and the county’s hospital trusts appeared before East Sussex’s Health Overview and Scrutiny Committee last Thursday, June 30, to explain what was being done to tackle the issue.

Geraint Davies, acting chief executive at SECAmb, said they needed to get into ‘solution mode’ and start reversing the increase in handover delays. He added: “This will enable my organisation to stand a chance of responding appropriately to the calls and ensure my staff are where they need to be, which is in the community.”

Ruth O’Keeffe (Ind, Lewes), vice-chairman of HOSC, asked at what stage the trust would reach a ‘critical point’ with handover delays.

Mr Davies replied: “I think we have already had a tipping point at SECAmb.”

He explained that they experienced ‘planned wipeouts’ where the trust had ‘no vehicles to send to calls’ in some areas.

Tim Fellows, operational manager for the area at SECAmb, explained that in a situation ambulances crews would be responding to calls quite close to the hospitals, rather than covering the patch geographically.

He added: “In the main I do not see that patients are suffering harm, because we do still have very very good response times.”

East Sussex Healthcare Trust chief executive Adrian Bull, who is in charge of Eastbourne Direct General Hospital and Hastings’ Conquest Hospital, said: “It’s unacceptable for patients to be waiting in ambulances for periods of time just as it is for them to spend time in A&E departments.”

He said the issue was not having the funding for staff, but being able to recruit.

Jenny Darwood, general manager of urgent care services at ESHT, explained that they could use recruitment and retention payments, and were also introducing training packages to keep and attract staff.

But Dr Bull said they did not want to get into a ‘war of escalation’ on pay with other trusts. This was echoed by Steve Holmberg, medical director for the Brighton and Sussex University Hospitals NHS Trust (BSUH), who added: “Getting into a price war would be a terrible place for us to be.”

Bosses from the BSUH explained that it was hard to start the clinical process as well as maintaining the dignity of patients in open areas such as corridors rather than cubicles.

The trust had brought in a rapid assessment model, which meant that the most senior doctors were seeing patients first, rather than more junior personnel.

Meanwhile Ms Darwood explained that they had a high level of patients termed ‘medically fit for discharge’, and explained that it was ‘unacceptable’ for patients to wait in corridors. She added: “It’s not a good patient experience.”

The trust was also working with colleagues at the Clinical Commissioning Groups and adult social care teams to support a seven-day service so they could discharge patients at the weekend.

Overall across Sussex, Surrey and Kent the time lost to handover delays has increased by 63 per cent in the last two years, totalling more than 47,000 hours in 2015/16.

Over this period handover delays increased by 44 per cent at the Conquest Hospital, 21 per cent at Eastbourne DGH, and 35 per cent at Royal Sussex County Hospital in Brighton.

Mr Davies called for hospitals to put realistic systems in place at the front end of A&E departments to take patients off SECAmb vehicles.

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