Staffing shortages, covid-related absences, increased demand and lack of space for patients in the event of accidents and emergencies delaying patient transfer are some of the pressures affecting turnaround times. response for the Southeast Coast Ambulance Service.
Data released for the month of March shows that Secamb response times for patients with severe “category 2” illness, such as stroke or chest pain, averaged 39 minutes and 43 seconds. This is double the response standard which should be 18 minutes. For 9 out of 10 calls, industry standards dictate a response time of 40 minutes. For Secamb, the rate of 90% was one hour and 22 minutes.
For life-threatening calls, Secamb is closer to the target with an average response time of 9 minutes and 34 seconds compared to the NHS standard which is set at 7 minutes. 90% of calls needed to be answered within 15 minutes and Secamb achieved 16 minutes 48 seconds.
The data comes from the Ambulance Quality Indicators (AQI) which was introduced in April 2011 for all ambulance services in England and looks at the quality of care provided as well as the speed of response to patients.
The figure shows that the total of 999 calls to Secamb compared to the equivalent pre-Covid month of March 2019 increased by 21.9%, calls during the pandemic showed both peaks and more static levels.
SECAmb claims it is ahead of the national average on many response time performance targets.
A spokesperson added: “We have been extremely busy over the past few weeks and continue to experience high demand. We recognize that this means some patients are waiting longer than they should for a response and we are doing everything we can to reach those who need an ambulance response as quickly as possible while prioritizing our response to our most seriously ill and injured patients.
“The public can help us manage demand by only calling 999 in an emergency. We also urge the public to use alternatives to 999 for help and advice, including talking to their GP, pharmacist or visiting 111.nhs.uk or call 111.
But it’s not just Secamb that faces backlogs and pressures. Emergency services are also struggling. At East Kent hospitals – QEQM in Margate and William Harvey Hospital in Ashford – some 17,596 people attended A&E in March, 7,438 of whom waited four hours or more to be admitted, transferred or discharged.
At an East Kent Hospitals board meeting this month, the Trust’s CEO said there were significant operational pressures and the number of covid was falling but fluctuating, with a increase in staff sickness absences. The council also heard that there were problems with nursing vacancies, particularly at QEQM Hospital.
Over the past 12 months, there have been 1,264 new employees but 803 departures, a net gain of approximately 400 additional employees. A review of emergency services safe staffing is also underway with a focus on QEQM.
In an effort to combat staffing issues, there has been international recruitment which increased from 30 per month to 40 nurses in February and a partnership with universities and Kent and Medway Medical School (KMMS) in this regarding fee contracts and increased student placements. Incentives are also offered to ensure coverage of agency staff.
The report states: “At the time of writing (28 March 2022), it is clear that the BA.2 sub-variant of Omicron is now dominant in the UK. With societal restrictions fully lifted and immunity dwindling, this has led to some of the highest levels of Covid-19 ever seen in the community. Although community testing is now very limited, data from the Office for National Statistics (ONS) confirms this.
“This is reflected in the number of patients in our hospitals who have tested positive for Covid-19 (as well as a large number of people attending emergency departments and other outpatient areas). We currently have 201 hospitalized patients, which is more than the May 2020 peak, but less than half of the January 2021 peak.
“In the majority of cases, this is an incidental finding and the mortality, morbidity and intensive care needs remain low, but the operational pressure created is considerable. There is little scope for moving to a more “business as usual” approach to managing Covid-19 until this peak passes. »
Health campaign group Save Our NHS in Kent (SONIK) says the government must take urgent action to recruit and retain staff and must inject emergency funds into the health system.
A spokesperson said: ‘We would like to emphasize that no blame should be placed on frontline NHS staff and the ambulance service, who are struggling to care for patients in very difficult circumstances; many of them will still be trying to recover from the trauma and exhaustion accumulated over the past few years.
“Professionals point to ongoing staff shortages as a significant part of the problem. We call on our government to take urgent action. They should do everything possible to hire more staff and prevent staff from leaving, which means tackling conditions and wages, and ending toxic work cultures where they exist.
“Bed cuts in the NHS and social care are another factor – these need to be reversed. We need more beds, not fewer. Activists and unions have called on Rishi Sunak and Sajid Javid to provide emergency funding to the NHS to prevent it falling under the backlog caused by the pandemic.
“We want to emphasize that these dire conditions are not due to Covid demands alone, they are the result of years of neglect by our leadership. People need to understand that the NHS is not failing; it is failing.
“Extreme Pressure”
Dr Salwa Malik, South East Coast Regional Chair of the Royal College of Emergency Medicine, said the South East’s health system is under ‘relentless pressure’, adding: ‘The data shows the strain that southeast emergency services. Doctors, nurses, paramedics and all healthcare personnel are facing extreme pressures. It is a very difficult situation. Patients face long waits in the emergency department while waiting to be seen and in the community while waiting for an ambulance.
“Widespread staff shortages and a huge lack of beds, this is causing huge delays and problems in the emergency care system. When we don’t have beds to move patients, waiting rooms fill up and ambulances start lining up outside. Doctors and nurses have no choice but to provide care in hallways and other inadequate spaces. These are deeply uncomfortable and dangerous practices that are distressing to patients and staff.
“Morale is incredibly low among the South East workforce, they are overwhelmed and exhausted. Some shifts have fewer staff due to covid-related absences, further spreading out healthcare workers. We want to provide the best possible care, but current circumstances prevent us from providing the high quality, effective care we are trained to provide.
“For things to improve in the South East, the first step must be for our local MPs to work with councils and local authorities to improve and expand social care delivery. Good social care supports older and more vulnerable patients during their emergency room visits and ensures timely discharge once their treatment is complete.
County Councilor Karen Constantine says she asked about the Trust’s recruitment plans, in particular how the job offers for 400 new nurses will be fulfilled.
She said: “It is important to look very closely at data and plans, to avoid doing harm. I am afraid it will be very difficult to recruit 400 nurses, where exactly will they come from? I have asked Cllr Paul Bartlett, Chair of the Kent Wide Health and Overview and Scrutiny HOSC Committee, to invite Hospital Trust Chairman Niall Dixon to explain exactly how this recruitment strategy is going to be implemented.
She says there is a need to know what the current figures are, how overseas recruitment will work and what it will cost, how UK talent will be developed and how hospitals under pressure will organize training.
She added: ‘I also requested the data relating to strokes and access to treatment, particularly urgent admissions, from Rachel Jones, Executive Director of Strategy and Population Health.
“I am particularly concerned about the needle call time which, following the reorganization to provide HASU, we were assured would be less than 2 hours. I am still waiting for the details despite the writing of April 1 and the reminders. Ambulance delays have a huge impact.
August 2021 clinical outcome data (the most recent available) shows an average call-in time for the Southeast of nearly two hours. This is very different from what is used in all the documents arguing for HASU. We were specifically advised that the needle call time would be within the critical two-hour window.
The public rightly deserves this information. We need laser focus from our NHS professionals.
