Ambulance Response Times

Baroness Merron Excerpts

Tuesday 1st February 2022 Lords Chamber

[Baroness Merron (Lab)]

My Lords, I too extend a welcome back to the noble Baroness, Lady Penn, and offer congratulations to her and her family. I hope she finds her return to the House as positive an experience as I am sure the new addition to her family has been. I am grateful to the noble Baroness, Lady Barker, for securing this important debate and for emphasising the importance of integration in our health services, of which ambulance services are a key part.

I start by paying tribute to the staff in the ambulance services, not just those in the ambulances themselves but those who support the ambulance crew—from those in the control room, who use their skill to answer calls, reassure the caller and get the service to the right place, through to those who support the ambulance services to do their job by maintaining the vehicle fleet, cooking, cleaning and supporting in so many other ways. I also add my thanks to the volunteers of the St John Ambulance brigade and members of the Armed Forces who were deployed to alleviate ambulance staff shortages related to Covid-19.

As we have heard throughout this debate, there is intense pressure on ambulance services, and staff are struggling and patients suffering. Our health and care services were already weakened and exposed by inadequate levels of funding when the pandemic hit. As a result, the NHS now faces unprecedented challenges. Just last week, the Royal College of Emergency Medicine warned that patients will come to “avoidable harm” in A&Es across the country, estimating that over 4,500 patients are likely to have died during 2020-21 after waiting more than 12 hours in emergency departments.

As we have heard in this debate, the NHS in England has set a national target for ambulances to respond to the most life-threatening incidents within seven minutes on average. However, NHS figures show that the average response time in December for ambulances dealing with the most urgent incidents—defined as calls from people with life-threatening illnesses or injuries—was nine minutes and 13 seconds. This comes in at just under the average response time of nine minutes and 20 seconds in October, which was the longest since current records began in August 2017.

Ambulances also took an average of 53 minutes and 21 seconds to respond to emergency calls dealing with matters such as burns, epilepsy and strokes, which was the second longest time on record. Response times for urgent calls such as late stages of labour, non-severe burns and diabetes averaged two hours, 51 minutes and eight seconds—again, the second longest time on record. NHS England also said that staff dealt with the highest ever number of call-outs relating to life-threatening situations last month, averaging one every 33 seconds. One can only imagine what it is like for someone in pain and distress, and for those standing by, to wait for an inordinate length of time. After all, ambulances respond when there is an urgent need, whatever the grade of the urgency.

Unsurprisingly, the College of Paramedics has said that apologising to patients for long waits is the first thing paramedics are doing when they walk through the door. The latest figures show that nearly one in four patients arriving at hospitals in England by ambulance waited at least 30 minutes to be handed over to A&E departments. NHS England figures show that 18,307 delays of half an hour or more were recorded across all hospital trusts in the seven days to 9 January, which represents 23% of all arrivals by ambulance.

When asked what can be done to relieve the pressure, the College of Paramedics said that, in the short term, there are a number of ambulances that wait outside hospitals to hand over the care of a patient and are therefore not available in the community, as we have heard in this debate. What joined-up action is there to reduce handover delays? Has the Minister reviewed whether there is a need for more paramedics?

NHS workers have been warning for many months that the service is under strain due to a combination of waning workforce, Covid, respiratory infections, a backlog of patients and a build-up of health problems over lockdown. The Royal College of Emergency Medicine has been calling for months for a response from Ministers to provide short-term and long-term solutions. We have debated during the passage of the Health and Care Bill the vital need for workforce planning. What planning is there to ensure that the ambulance service has the right number of properly trained staff?

I am absolutely sure that the Minister will refer to the additional funding announced in July last year by NHS England to improve response times. I note that NHS England said at the time that the money would be shared by NHS trusts

“based on the number of patients they serve locally”,

with trusts being given discretion on how best to use the funding to increase staff numbers. What assessment has been made of what has happened across the country, and to what effect? What assessment has been made of the difference in response times that the additional funding has made? I understand that the Minister will need to write to me on this point, but I would be interested to know, on a trust by trust basis, how many additional staff are in control rooms and on the front line. How many additional ambulances were on the road during the winter as the result of this increase in funding?

Lastly, may I press the Minister on a matter which the noble Lord, Lord Scriven, raised, regarding prevention rather cure? What steps have been taken to avoid unnecessary ambulance calls and visits to A&E? How has NHS 111 done in respect of recruiting additional staff? How have GPs expanded their capacity, particularly in view of what we know about low morale and GPs leaving the service?

The Opposition wrote to the Secretary of State in August of last year outlining some of the terrible situations this pressure on ambulance services is leading to, and asking what the Government were doing to support the ambulance service to do its vital work. That question remains, and I look forward to the Minister’s response.