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Scots 999 ambulance delays putting lives at risk warn paramedics

Excessive ambulance waiting times are putting lives at risk, under pressure paramedics have warned.

The average 999 ambulance waiting time has increased to six hours and worried staff say it is down to “system overload”.

Some paramedics believe lives have already been lost because of delays and fear more patients will die.

And union bosses have urged the Scottish Ambulance Service to declare a “major incident” status to protect the public.

The time from all 999 calls being received until the patient is delivered to hospital was on average between 55 minutes and 70 minutes.

But now it is taking six times as long with patients waiting several hours at the door of the hospital to be handed over to medical staff.

This, in turn, is having an impact on subsequent calls. Over the last three days paramedics have been aware of several cases where it has taken more than 20 hours for an ambulance to even arrive at a patient’s home.

At the heart of the problem, according to paramedics, is the fact ambulances are getting clogged up at hospital A&Es where under-pressure staff are struggling to find beds for patients.

Trade union Unite said waiting times outside hospitals on Tuesday peaked at seven hours, with some patients waiting 24 hours for a bed during the crisis.

In real terms, this means an ambulance misses three 999 calls while located at a hospital waiting for patient discharges.

Unite has asked the Scottish Ambulance Service to declare a major incident status arising from excessive hospital turnaround times of 30 minutes or more because of the “significant impact” on all outstanding 999 calls.

Any occurrence which presents a serious threat to the health of the community or causes casualties to require special arrangements to be implemented can be deemed a “major incident”.

The status is currently “normal” but if the Scottish Ambulance Service elevate the status to “major incident” then other public health bodies are required to immediately assist.

Unite has asked the Scottish Ambulance Service to declare a major incident

Unite said, in practice, this means that NHS Scotland or community health workers may be required to attend to a patient in the community, which could involve the setting up of clinical tents until paramedics are able to attend.

It could also involve pop-up wards or even the army providing support to free up paramedics at hospital.

Unite has also raised concerns over the potential risk to patients over clinical decision making due to fatigued ambulance staff.

And the union understands there have been several “adverse clinical events” over the last 72 hours arising from the delays.

A serious adverse clinical event means there is a significant, persistent or permanent change, impairment, damage or disruption in the patient’s body function and/or quality of life up to and including death.

Jamie McNamee, Unite convenor at the Scottish Ambulance Service, said: “I have no doubt in my mind there have been significant adverse events over the past 36 hours.

“Serious adverse events from the ambulance service have been on an upwards trajectory since the start of the year. They are through the roof.”

McNamee added: “Unite has asked the Scottish Ambulance Service to declare a major incident status arising from excessive hospital turnaround times due to the significant impact on all outstanding 999 calls.

“The reality is that there are excessive waiting times for paramedics to attend to a patient in the community as they are being held up at hospitals.

“On average the waiting time taken for an emergency call out to a 999 call has grown from around one hour to six hours to complete. Due to the system overload in NHS Scotland, there is the potential for adverse clinical events to happen to patients in the community.

“It’s essential that we elevate the status immediately because having ambulance crews tied up for extensive periods and subsequent fatigue, due to the long hours, is a known public safety issue. Lives of both the public and the crews are being put at risk.”

Labour’s health spokeswoman Jackie Baillie said: “Paramedics, nurses and doctors are doing the very best they can but the NHS is in crisis.

The Scottish Government has lost control and the Cabinet Secretary Humza Yousaf is nowhere to be seen.

“Patients and staff deserve much better than this.”

A Scottish Ambulance Service spokesperson stated: “The NHS is currently experiencing significant sustained pressure across Scotland due to hospitals operating at or near full capacity and staff abstractions.

“These capacity challenges are because of increased Covid cases and increasing non-covid demand and are causing lengthy hospital handover delays.

“In response to these pressures, we have escalated in line with our plans to maximise resource provision and placed all clinically trained staff on frontline duties whilst working with health boards across Scotland to minimise delays.”

A Scottish Government said: “Despite the pressure Covid has brought upon our ambulance service, which serves some of the most rural areas in the UK, in 2020-21 crews responded to over 70 per cent of highest priority calls in under 10 minutes and more than 99 per cent in under 30 minutes.

“It is vitally important there are no unnecessary delays for ambulances taking patients to hospital and we continue to work closely with the Service and Health Boards across Scotland.”

Isabel’s story

A 92-year-old woman with dementia fell backwards on to a pile of stones in her garden but had to lie outside for nearly three hours until an ambulance arrived.

Isabel Irvine’s daughter Alison, 60, said: “I was told it could take up to five hours for an ambulance to arrive because the crews were exceptionally busy but I knew she wouldn’t be able to survive that long.

“Her lips were blue, she was struggling to breathe and her head was bleeding.

“I was beside myself with fear.” Alison found her mum on the ground outside her East Kilbride home last month and phoned 999.

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Almost two hours later, Alison called them back to say Isabel’s breathing was really bad.

She said: “I’d tried to lift her twice but she said her neck was sore and as a former nurse, I knew she shouldn’t be moved.

“I knelt beside her and cuddled her to try to keep her warm.

“She told me she was desperate for the toilet but I said she would just need to do it lying there. I thought she was going to die in an undignified heap in her own urine.”

It was almost three hours after Alison’s call that Isabel was eventually taken to Hairmyres Hospital and almost eight hours later before she was found a bed on a ward.

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