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Lincolnshire Talks: Why are so many ambulances having to wait outside our hospitals?

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East Midlands Ambulance Service (EMAS) lost the equivalent of more than four days last Saturday alone due to handover delays at hospitals across Lincolnshire.

On Saturday, February 18, EMAS reported that 102 hours were lost due to handover times at hospitals in Lincoln, Boston, Scunthorpe and Grimsby.

Ambulance crews also waited between two to four hours eight times at Diana, Princess of Wales Hospital in Grimsby on the same day.

Put into perspective, this process should take just 15 minutes.

One patient, who was left screaming in pain after breaking his ankle during an ice hockey match in Grimsby on the same day, had to wait two hours for an ambulance to arrive.

Photo: Emily Norton for Lincolnshire Reporter

What a handover entails

When an ambulance crew has arrived and assessed a patient they decide on the most appropriate place to continue their care, this may be A&E and if so they take the patient to hospital.

On arrival, ambulance crews must go through what is called a clinical handover, in which the ambulance crews pass on relevant information to clinicians at the hospital.

This information would include details such as the name and age of the patient, what is wrong and what medication that patient has taken/been given.

This should take no longer than 15 minutes according to government guidelines.

Ambulance crews then have an additional 15 minutes to do any necessary paperwork, clean the ambulance and replenish any equipment or medication before going to their next call.

“Challenges cannot be fixed alone”

EMAS said that hospitals need to help in shortening the handover waiting times.

Blanche Lentz, paramedic and general manager for Lincolnshire at EMAS said: “We have to prioritise patients based on their illness or injury because patients who are unconscious and not breathing are experiencing a life threatening emergency and need help fast.

Queues of ambulances outside Lincoln County Hospital. Photo: Trev Green

“When our crews are waiting at hospital supporting the patient they are delayed in getting to new 999 calls that are waiting in the community.

“There is a direct correlation between hours spent at hospital and our performance, on Saturday we lost 102 hours due to hospital handover delays at hospital across Lincolnshire (figures from Scunthorpe, Boston, Grimsby and Lincoln).

“The challenges we face cannot be fixed alone, we continue to work with the hospitals in our region to monitor handover delays, and together with our Clinical Commissioning Groups (the people who fund our service) we recognise that there is a financial and resourcing challenge for our service.”

Hospital pressures

Hospitals in Lincolnshire have said that they are doing their best to combat handover waiting times, which they say are caused by significant pressure in A&E departments.

Steve Vaughan, interim chief operating officer for Northern Lincolnshire and Goole NHS Foundation Trust, told Lincolnshire Reporter: “We have been working closely with EMAS to look at where improvements to handover times can be made and have made progress with this in recent months.

“However, there are times when our services are under significant pressure leading to delays within the A&E department. This unfortunately has a knock-on effect to ambulance handover times with crews experiencing delays.

“Patients with life threatening injuries or illnesses are brought into A&E as soon as the ambulance arrives so that emergency treatment can start straight away.”

Interim director of operations at United Lincolnshire Hospitals NHS Trust, Michael Woods, added: “In common with many other hospitals across the country, all three of our hospitals have been under an increased level of pressure.

“It is unfortunate that we cannot always release the ambulances as quickly as we would like.

“The quality and safety of patient care is the trust’s number one priority and we urge patients to continue to think carefully before attending A&E as we are continuing to see high numbers of patients.

“We know that around 30% of people who visit our A&Es (Boston, Grantham and Lincoln) could be seen or treated by services outside of hospital and often could have been seen quicker.”