East Anglian Daily Times 20 January, 2018 Michael Steward firstname.lastname@example.org @MichaelReporter
One patient is said to have gone into cardiac arrest at Colchester General Hospital after taking themselves to A&E due to ambulance delays. Picture: LUCY TAYLOR
A damning dossier compiled by a senior whistleblower from the region’s ambulance trust has claimed at least 40 patients died or were harmed due to delays over Christmas and New Year – including one person who froze to death.
The damning dossier has been compiled by a senior whistleblower at the East of England Ambulance Service. Picture: SIMON FINLAY
The region’s NHS came under intense pressure in less than three weeks between mid-December and early January, with ambulances queuing outside A&E departments and patients reporting they were treated in corridors.
But the whistleblower, who wants to remain anonymous, revealed 19 people died in the east of England during the period and they expected the total number of patients harmed or killed due to delays to soar to around 80 when all cases had been reviewed.
A copy of the dossier seen by this newspaper included a man who waited 16 hours for an ambulance in Lowestoft on December 27.
The man was outside and no ambulance was sent when the first call was made by police.
Suffolk Police made a second call when they found the man, who apparently appeared to have frozen to death.
East of England Ambulance Trust (EEAST) said when the call was first made they were told the man was conscious and breathing and had no obvious injuries. Therefore the call was categorised as a non-emergency call.
When they received the second call a paramedic arrived within eight minutes but the man was dead.
In north Essex and Suffolk the whistleblower’s document claimed six people died and one was harmed as a result of the delays in that period.
• December 19, in Newmarket, a patient waited four hours and 20 minutes and there was evidence of harm due to the delay.
• December 25, in Maldon, it took six hours, 39 minutes for back-up to arrive to assist with a sepsis patient.
• December 26, in Stowmarket, a call for an ambulance was made on Dec 24 and no ambulance was sent. The patient died on Dec 26 after a cardiac arrest.
• December 26, in Ipswich, a sepsis patient waited four hours and 43 minutes.
• December 29, in Clacton, a patient with a serious spinal injury waited seven hours and 56 minutes.
• December 29, in Thetford, a patient died after going into cardiac arrest and waiting one hour and 12 minutes.
• December 30, in Walton on the Naze, an ambulance was called to a fractured ankle with an obvious deformity – a limb threatening injury – and took six hours 11 minutes.
• December 31, in Maldon, a patient arrested on arrival to hospital after waiting six hours and 46 minutes with asthma-related symptoms
• January 1, in Bury St Edmunds, a patient who had a seizure waited three hours and 41 minutes.
• January 2, in Tiptree, a patient died after going into cardiac arrest and waited for 47 minutes.
• January 2, in Clacton, a patient died from a cardiac arrest after waiting three hours and 45 minutes.
• January 2, in Chelmsford, a patient having a stroke waited 16 hours 49 minutes.
• January 2, in Colchester, a patient went into cardiac arrest after self-presenting at Colchester hospital A&E due to ambulance delay.
After years of missed targets EEAST changed its response programme last year, but in the most serious cases crews are expected to arrive within seven minutes.
The whistleblower also accused senior executives of being on holiday during the crisis, and said some of the trust’s £2.5m surplus should have been spent on hiring extra staff.
EEAST denied this was the case and a spokesman said: “The trust absolutely refutes claims that there were no senior managers in over the Christmas period. In line with all ambulance trusts, this trust operates a gold command system, which consists a 24/7 on-call rota of the most senior operational managers who are highly experienced and well trained.”
He added: “The trust is on the public record stating that it has a gap between funded capacity and demand. It is good financial planning to ensure that the trust is in a position to hire any additional resources that may become available across the months of January, February and March. The trust is well placed to buy such resources where available. We are aware of the claims made by MPs but note no complaints have been received from patients or their families at this time. Nor have any concerns been expressed internally through our line management, whistleblowing or freedom to speak up processes.”
Trust had ‘plans in place’
A trust spokesman added they “had plans in place however experienced extreme levels of demand over the new year period in particular.
“The trust was unable to respond to a very small number of the 50,000 calls we handled over a 15-day period as quickly as we would like. The trust is undertaking a rigorous analysis of that small proportion of calls.
“Where any suspected cases of potential harm are identified, then the trust will exercise it’s duty of candour to notify patients or their families. It is worth noting that any cause of death not certified by a doctor can only be established if there is a coroner’s case. It is best practice to always review the effectiveness of any plans and the trust will be doing that.
“Depending on any preliminary insight, the trust will invite an independent review of our decision making process. The trust has also requested a system wide review of these periods of high demand and lost capacity.”
Call for independent review
Former health minister Norman Lamb said the whistleblower had raised “very serious issues” with him.
Mr Lamb, the MP for north Norfolk, said: “It’s really shocking in my view, these are all suggestions which have been put to me but they are things which have to be fully investigated. I think there needs to be a urgent review by someone outside the trust.”
Sandy Martin, MP for Ipswich, said: “It is almost impossible to prove that anyone may or may not have died as the result as a result of an ambulance delay.
“However, it is clear that a better resourced ambulance service would lead to less unnecessary death and life-changing situations.
“It is time for the government to get to grips and to give our NHS the £30billion that the practitioners themselves say that the service needs.”
Giles Watling, MP for Clacton, said: “I shall be calling for an inquiry. If it is a question of funding then I shall be calling for more funding but I will wait for the findings of the inquiry.
“But we do need to get to the bottom of this.”
Suffolk health watchdog responds
Andy Yacoub, chief executive of Healthwatch Suffolk, said: “Healthwatch Suffolk is fully aware of the severe pressures all our health [and social care] providers have faced together this winter.
“I believe that at times the ambulance service has looked after and transported well over 4,000 patients a day, which would put a strain on any service. That said, each and every patient that requires an ambulance in an emergency, should rightly expect a service that is responsive and of a good quality.
“Planning and the best use of resources, in collaboration with hospitals and other providers, is essential, especially for the pressures that winter periods bring.
“For example, at a time when our hospital’s A&Es are as busy as they have been, ambulances can at times be held up, before their patient can be safely moved into the care of the hospital staff.
“The best use of what limited resources there are helps to respond to our region’s patients’ needs in as timely a fashion as possible.
“Communication is a key to this, because when ambulances are ‘delayed’, the patient and their carer(s) desperately need to know. The appropriate use of the amazing First Responder volunteers is also essential.
“Healthwatch Suffolk is currently asking the public to share stories about the ambulance service they have received recently, whether this is good, bad or indifferent. Your voice matters and any themes and trends we identify will be raised directly with the trust’s quality and governance committee.”