East of England Ambulance Service

Jonathan Djanogly Excerpts

Tuesday 25th June 2013 Westminster Hall

[Priti Patel]

My hon. Friend is right. Many hon. Members have experienced horrific delays, particularly across our rural constituencies. I know of delays in excess of two hours. That is unacceptable. Lives are put at risk.

[Mr Jonathan Djanogly (Huntingdon) (Con)]

I congratulate my hon. Friend on calling this important debate on an unacceptable level of service. Further to the previous intervention on rural areas, can we also agree that this is not just about what are called emergency services, but also about non-emergencies? Many people in my constituency, particularly elderly people, are kept waiting for up to eight hours, often in significant pain, before the ambulance gets to them.

[Priti Patel]

My hon. Friend makes the point clearly about the impact on elderly patients and the unacceptable waiting times that his constituents, and those of other hon. Members, have endured.

Data from the trust show that in the last quarter of 2012-13, the A8 target for paramedic arrival to treat a patient in a life-threatening condition within eight minutes was met 70% of the time, compared to the 75% target. The A19 target was also missed, as ambulances arrived to transport patients with life-threatening conditions within 19 minutes 92% of the time, compared to the 95% target. Patients with other conditions have experienced appalling delays. In each of the 10 months from April 2012 to January 2013, the trust failed to meet the target to get 62% of stroke patients to hospital within 60 minutes. In fact, in seven of those months the figures were below 50%.

The delays in an ambulance arriving to transport patients to hospital after they have been attended to by a volunteer community first responder or paramedic in a rapid response vehicle are particularly alarming. Figures provided by the trust to me covering Essex showed that in 2012 there were 39,921 of these back-up requests, but on 12,584 occasions it took more than 30 minutes for the ambulance to arrive. In Witham alone, in 206 incidents it took more than 30 minutes for an ambulance to arrive, from 639 back-up requests.

It is scandalous that almost one third of patients needing to go to hospital by ambulance were left waiting, causing them distress and preventing the initial paramedic or volunteer who attended the scene from moving on to help other patients elsewhere. Four patients a week in Witham, 242 in Essex and many hundreds more across the region have endured those waits, and the trust’s board sat idly and did nothing while the situation got ever worse. The failures have led to the trust becoming the worst performing ambulance trust in the country. The statistics are terrible and the delays can have serious consequences for the lives of patients affected.

The Minister will have seen numerous news reports from local, regional and national newspapers highlighting devastating cases across the region. Colleagues from across the region will, like me, have seen cases all over their local newspapers and will have had numerous constituents writing to them about their own experiences.

There have been some dreadful incidents affecting my constituents who have faced not only unacceptable delays, but a devastating impact of the consequence of those delays. One constituent from Tiptree suffered lengthy delays on not just one but two occasions—in August and September—before passing away. On the first occasion, she suffered a mini-stroke, and the emergency doctor who attended her home called for an ambulance that morning, but it took more than three hours for a paramedic to arrive. The paramedic then called for a back-up ambulance, which did not come. After waiting four hours, members of my constituent’s family placed her in one of their cars to take her to hospital. Although my constituent had suffered a stroke, the trust neglected her. If her family had not taken the risk of transporting her to hospital, she may never have got there.

The following month, my constituent fell in her care home and banged her head, resulting in a lump larger than a chicken egg on her temple. The ambulance was called at 9.38 pm, but it did not arrive until almost two hours later, at 11.25 pm, despite the fact that the care home was barely five minutes from Colchester ambulance station. Once my constituent was in hospital, a CT scan confirmed that she was haemorrhaging on the brain, and she died soon after. Had the ambulance arrived sooner, my constituent would have received treatment more promptly and might still be alive today. I raised the case with the trust, but it took two months to reply, coming up with a feeble excuse and a shallow apology.

Other constituents have also let me know of their frustration about delays. Mrs Houghton, from Tolleshunt Knights, has two young daughters with serious medical conditions that require frequent hospital care. One has a condition that can lead to sudden death syndrome; the other suffers from a condition that includes supraventricular tachycardia, which can cause her heartbeat to quicken, and her treatment requires a life-saving injection. Last year, my constituent reported to me that ambulances were taking longer to arrive than they used to and that rapid response vehicles were sent instead to take her daughters to hospital. As the Minister will appreciate, these incidents have caused Mrs Houghton increased anxiety, particularly given that her daughters are children. They need an ambulance to attend promptly, but that is simply not happening.

In a separate case, a constituent who is a carer for a relative, Mrs Gladys Money, reported to me the delay Gladys experienced while waiting for an ambulance. Only two weeks ago, Gladys, who is 96 years old, suffered a fall in her kitchen. She could not reach the telephone, so she used the emergency call line button she carries with her at all times to request assistance. An ambulance was called, but it did not arrive for an hour and a half. During that time, Gladys was in much distress and could not lift herself up or even call for further help. Such delays in the treatment of elderly people are unacceptable; they are simply not right, and people cannot be treated in this way.

Another constituent reported to me his outrage when, in November, an ambulance failed to arrive after his 20-month-old grandson started hyperventilating and developed a high temperature. After two hours’ waiting and three telephone calls, he was assured an ambulance would arrive shortly, but that did not happen. After being told that ambulance crews were too busy to attend, he resorted to taking his grandson to accident and emergency himself. There are so many other cases I could mention, and I have no doubt that other hon. Members have plenty of other examples they wish to raise.

Despite the fact that the trust received complaints from Members of Parliament, members of the public and its own staff, nothing was done to address the problem seriously. What made the trust’s lack of attention to the problems all the more shocking was the fact that, in May 2012, the CQC reported concerns with response times. It clearly stated that

“the Trust had not met some of its key performance standards in relation to response times”

and needed

“to seek ways of addressing the challenges it faces in responding quickly in very rural areas and on improving turn around times at the hospitals in its region so that people receive care in a timely and effective manner.”

Senior managers, directors and non-executive directors should have seen the warning signs. They should have been working with hospitals in the region to improve handover times. They should have reassessed changes to staffing rotas and brought in new front-line staff to fill the 200 empty posts. They should have re-examined how they prioritise calls. They should have altered the allocation of resources to put more ambulances on the road. Finally, they should have got a grip on the trust’s growing deficit.

Many things should have been questioned and required serious attention. However, the trust acted only this year, following another CQC inspection in February, the report of which was published in March. That inspection came about only as a result of the persistence of my hon. Friend the Member for Suffolk Coastal (Dr Coffey)and other Members of Parliament in the region, who pressed for an investigation into the trust. The report demanded action to improve the

“Care and welfare of people who use services”.

It concluded that since the

“last inspection the trust’s performance in relation to its ambulance response times had deteriorated and people could not be assured they would receive care in a timely and effective manner.”