I am a health assistant in a GP practice in south Shropshire, writes Tracey Huffer. We are working flat out to get everyone jabbed and catch up with the backlog of patients who had not recognised or reported their conditions during the long periods of lockdown and shielding. Further north in the county, the situation is no different and the county is getting worse with the onset of winter pressures.
GPs are overstretched across Shropshire. Hospitals are at capacity with 93% of adult general and acute beds occupied. Ambulance arrival times and transfer times are growing. Nearly two-thirds of 999 ambulances must wait for 30 minutes or more to hand over patients outside the county’s two A&Es. On one day recently, there were no ambulances available in the county. This is much worse than elsewhere and much worse than last year.
I am getting frightened by the growing delays in ambulances picking up patients transferring them into A&E. People in Shropshire needing time critical treatment have died while waiting for an ambulance or hospital transfer.
The handover times at the Royal Shrewsbury and Princes Royal Hospital A&Es are the second longest in England. Sixty three per cent of ambulances must wait for more than thirty minutes outside our A&Es before they can handover their patients.
It can take a long time for an ambulance to get to patients in this huge county, especially since the local ambulance stations were closed in the market towns of Craven Arms, Bridgnorth, Market Drayton and Oswestry without consultation.
For months now, we have been seeing long delays in handing over patients from ambulances into the care of Shropshire’s main hospitals. The lengthening delays mean the crews are not available for the next emergency. People are lying in the streets having fallen, gasping in their homes after heart problems, and panicking as they face long waits for an emergency vehicle to attend. Every minute matters in emergency situations but at times we are talking about hours for the ambulance to arrive and hours to be transferred from the ambulance to the A&E department.
In the seven days to 5 December, nearly 100 ambulances a day arrived at the Royal Shrewsbury and Princes Royal hospitals, 698 ambulances in all. For sixty three per cent of arrivals, the handover was delayed for 30 minutes or more (430 ambulances). For forty three per cent, the handover was delayed for more than an hour (292 ambulances).
These figures are staggering and must be leading to poorer health outcomes.
Ambulance waiting times are a national problem. But it is much worse here and that is why it is such a major issue in the North Shropshire by-election. Let me put this in perspective. Across the six NHS trusts that neighbour Shropshire*, around one third of handovers from ambulances were delayed by 30 minutes or more (35%). That’s around half the delays experienced at Shropshire’s hospitals, despite some trusts using the same ambulance service (WMAS). Across England, delays are 23%. Looking back one year, delays in Shropshire were “just” 28%, two-fifths of what they are now.
Something is going badly wrong at the two main hospitals run by the Shrewsbury and Telford Hospital Trust (SaTH).
We have spent several years discussing proposals for improving health care in the county under a project known as Future Fit. Yet absolutely nothing has been done. Future Fit was never fit for purpose, never affordable, never expected to deliver the locally based urgent care we need to take the pressure off the two A&E departments.
We don’t need any more excuses from Shrewsbury and Telford Hospital Trust or West Midlands Ambulance Service. What we need is the quality of service and healthcare that the people of this county deserve.
I fear the coming winter. I fear we will lose lives because our health system is already just about broken. Of course, we need more funding for health but we also need better health management.
The worst five NHS hospital trusts for patient handovers (per cent handovers delayed by 30 minutes or more) in this period:
- University Hospitals Bristol and Weston NHS Foundation Trust: 67%
- The Shrewsbury and Telford Hospital NHS Trust: 63%
- Gloucestershire Hospitals NHS Foundation Trust: 60%
- North West Anglia NHS Foundation Trust: 54%
- Portsmouth Hospitals University National Health Service Trust: 53%.
At Shrewsbury and Telford Hospital Trust from 29 November and 5 December, 682 ambulances arrived at the two A&Es. Of these, 137 experienced transfer delays of 30 minutes of more and 293 experienced delays of one hour or more.
West Midlands Ambulance Service has so far failed to provide detailed response times for Shropshire despite being requested to do so by Shropshire Council’s scrutiny process.
* The six NHS trusts surrounding Shropshire used in this comparison are: Countess of Chester Hospital NHS Foundation Trust; East Cheshire NHS Trust; Mid Cheshire Hospitals NHS Foundation Trust; University Hospitals of North Midlands NHS Trust; Wye Valley NHS Trust; and Worcestershire Acute Hospitals NHS Trust.
This article first appeared on Lib Dem Voice.