Patient handover delays ‘equivalent to taking 1,286 ambulances off Cambridgeshire’s roads’

Delays handing over patients at hospitals took the equivalent of 1,286 ambulances off the road in Cambridgeshire and Peterborough in a six-month period.

National standards say patients should be handed over from an ambulance to a hospital within 15 minutes, but the East of England Ambulance Service NHS Trust (EEAST) said it was a “significant way off that”.

Terry Hicks, head of operations for Cambridgeshire and Peterborough at EEAST, said a plan was being worked on to hand over patients automatically after 45 minutes to enable ambulance crews to respond to more emergency calls.

A report to Cambridgeshire County Council’s adults and health committee on 12 December said 15,435 hours of patient-facing time was lost between April and October due to handover delays, up from 8,448 hours in the same period last year.

This is the equivalent of 1,286 ambulances being taken off the road.

Average response times have also increased, with a rise in the time taken to reach the most serious Category 1 cases from nine minutes in 2023 to nine minutes and 19 seconds this year.

Average response times for Category 2 incidents, which include serious medical emergencies such as chest pains and strokes, increases from 35 minutes and eight seconds in 2023, to 40 minutes and 56 seconds in 2024.

Discussing work to improve the statistics, Mr Hicks noted some patients do not need to go to hospital and there was an “awful lot of work” going into preventing unnecessary trips.

He added: “The emergency department teams are working really hard to make sure they get their flow, but we do know as well that there are many patients that are in our hospitals that don’t necessarily need to be there.

“They are fit for discharge, but the social care is not necessarily as reactive and responsive to allow that patient flow to happen as quickly as possible.

“There are many bottlenecks in the patient journey that will end up meaning that a patient can’t be offloaded from an ambulance in a timely manner.”

And he said: “We are working very hard with the collective teams, with the emergency department, the wider hospital teams and the community care teams, to implement a transitional period where at 45 minutes we will automatically hand a patient over into the hospital to release a crew to respond back into the community.

“That is no easy feat and I don’t underestimate the impact that is going to have for the hospital teams, but we have to make a significant shift change in trying to make sure we get to our patients as quickly as is reasonably possible, recognising that there is a lot of work that has got to go in behind that.

“Regionally, we have implemented that across a number of our other [integrated care system] colleagues, but we haven’t yet done that across Cambridgeshire and Peterborough. We are looking to do that over the next few weeks, but to do it safely I think it is really important that we manage to do that.”

Cllr Richard Howitt (Lab, Petersfield) said the 45 minute handover proposed “has its own risks associated with it”.

Cllr Simone Taylor (St Neots Independent Group, St Neots Eynesbury) asked: “How would it work? The department is not ready for the patient, ambulances are waiting outside: ‘By the way we are dropping a patient off for you to deal with’. Is that patient sitting in the corridor on a bed or in a wheelchair? That is a massive concern.”

Mr Hicks recognised the plans were “not ideal”, but said the ambulance service had to make sure it was responding to patients in the community.

He said people who have called 999 and have not had a face-to-face assessment were at the “greatest risk”.

He said corridor care was already happening and not a “new phenomenon”, but stressed it was done safely.

He added that ambulances would not “just drop patients” at the hospital after 45 minutes, but work with emergency departments to make sure patients could be handed over safely.