“Dreadful” ambulance handover delays

Nearly 4,000 hours have been lost due to delayed patient handovers at Shropshire’s main hospitals so far in 2021 – part of a region-wide picture the ambulance chief calls “dreadful”.

Between New Year’s Day and July 14, transfers exceeding 30 minutes have amounted to 2,245 hours at the Royal Shrewsbury Hospital and 1,560 hours at Telford’s Princess Royal Hospital.

In a report for the West Midlands Ambulance Service’s governing trust, nursing, medical and commissioning chiefs write that the situation has “shown a significant deterioration” across the region and warn that, if trends continue, by December the effect could be equivalent to losing 46 ambulances altogether.

Chief Executive Anthony Marsh says WMAS is working with other organisations, including the trusts governing the region’s 22 acute hospitals, to improve handovers.

Statistics in a “Quality Report”, co-authored by Nursing and Clinical Commissioning Executive Director Mark Docherty and Executive Medical Direct Alison Walker, say handovers over 30 minutes have totalled just under 24,374 hours across the whole West Midlands so far this year. Birmingham’s Heartlands Hospital has the highest individual total, with 3,468 hours.

Mr Docherty and Dr Walker write: “The issue of patient handover delays has shown a significant deterioration over the last few months and this is causing significant serious patient concerns.

“The current trajectory for July would suggest there will be in excess of 7,000 lost hours due to handover delays over 30 minutes. This is the highest number of lost hours ever experienced by WMAS at a time when patient handover delays would normally be at their lowest.

“Action is being taken with individual hospitals and NHS England and NHS Improvement to address this problem.

“The WMAS Medical Director has raised this issue directly with the Regional Medical Director of NHSE/I.

“We continue to work to minimise the risk, including setting standards for our staff to adhere to when handovers are delayed and patients are kept for prolonged periods in an ambulance.

“If the patient handover delays continue at the current level of deterioration, we will potentially be experiencing over 17,000 lost hours per month by December due to handover delays. The same effect would be experienced if we took 46 fully-staff ambulances off the road every day.”

In a separate report for the board, Mr Marsh writes: “The trust has been pushing hard to try and improve the dreadful level of handover delays currently being experienced in some areas across the region.

“By doing so, we will improve the safety and wellbeing of our patients as well as for staff.”

The West Midlands Ambulance Service University NHS Foundation Trust will discuss the reports when it meets on Wednesday, July 28.

In a performance report for the Shrewsbury and Telford Hospital NHS Trust’s last board meeting, earlier this month, Chief Operating Officer Nigel Lee wrote that “volumes of patient arrivals at peak periods continue to cause challenges”.

He added: “Joint work continues with West Midlands Ambulance service and our local system partners to promote alternatives to accident and emergency and alternate admission routes.

“Of note, the activity at the urgent treatment centres alongside both A&Es has risen, with the centre at PRH up 26 per cent above May 2019 levels.”

In a separate section of the same report, Chief Executive Louise Barnett said A&E attendances in May 2021 had exceeded pre-coronavirus levels and were higher than the winter of 2019-20, with ambulance handover times one of the targets “adversely impacted” as a result.

“We remain focussed on our transformation work which aims to improve patient flow and experience,” she added.