Ambulance Response Times: Shropshire

Lucy Allan Excerpts

Thursday 31st March 2022 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

I thank Mr Speaker for granting today’s Adjournment debate on a topic that is so important to my constituents in North Shropshire and to people across Shropshire and across the country. I start by making it clear that I am not here to criticise the hard-working NHS staff in our ambulance services and emergency departments. Indeed, I thank them for their incredibly hard and dedicated work in difficult and demotivating circumstances, but there is clearly a problem with the provision of emergency care in Shropshire, with complex causes, and I bring it before this House to urge the Government to take some action.

It was clear throughout my election campaign, and has been clear from my inbox since then, that stories of excessive waits for an ambulance are not a rarity. I have since urged my constituents to contact me and share their experiences. Just since Monday, my office has been met with a tidal wave of correspondence, each story as saddening and frightening as the last. A care home reported a wait of 19 hours for an elderly resident with a broken hip. An elderly diabetic man fell and dislocated his shoulder. He was advised not to drink or eat anything in case surgery was required, and then waited 15 hours for an ambulance to arrive. A disabled man fell in his bathroom and waited for 21 hours for an ambulance. He was fortunately lifted from the floor after eight hours by a helpful neighbour. A man waited with a stranger experiencing heart attack symptoms on the side of the road for hours, only to give up and drive the gentleman to A&E himself.

A man with a suspected stroke waited nine hours for an ambulance and a further five in the ambulance waiting to be transferred into hospital. A 92-year-old lady fell at 8.30 in the morning, suffering bleeding from the head and a broken leg. She was looked after by her 75-year-old neighbour for almost eight hours until the ambulance arrived, and then waited in the ambulance for transfer into the A&E department until 2.30 the next morning. She had not eaten since 6.30 the evening before her fall. An elderly woman fell down the stairs shortly after lunch. Her emergency carers—she has a red button to press for them—made her comfortable and called an ambulance, but they could not carry on waiting forever. After an 11-hour wait, she was alone with her front door open so that the ambulance crew could access her house. That was 3 o’clock in the morning.

I could easily spend the next half hour relating heartbreaking stories, and I thank all my constituents who contacted me for taking the time to get in touch and explain the scale of the problem. One story in particular brought the issue home, and some Members may have read about it in the newspapers. It was the story of a young footballer who slipped on AstroTurf while playing football at school. He dislocated his knee and waited so long for an ambulance that by the time one finally arrived he had developed hypothermia. I do not know whether Members can imagine the distress of this young man, and the teaching staff who stayed on in the dark, long after the school day had ended, as his condition deteriorated out in the cold.

What all these stories have in common is that they could have been much worse. I am sure everyone in the House would agree that nobody should have to suffer waiting an excessive amount of time for an ambulance, yet tragically in North Shropshire it is pretty common. I know this problem is not unique to Shropshire. I am sure that many colleagues have received similar emails describing similar events. In parts of Britain, an excessive wait for an ambulance has become normal.

The problems surrounding this crisis are complex, and I am not here to propose a simple quick fix. However, there are consistent themes at the core of the issue. It is vital that we recognise them if we are to work out how to move on from here. The first is the problem of handing over patients at the emergency departments in Shrewsbury and Telford. West Midlands Ambulance Service has told me that, on the day the young footballer dislocated his knee, 868 hours were lost waiting to hand over patients, and that nearly 2,600 hours were lost in the month up to 29 March. Handover times in Shropshire are significantly worse than in the rest of the country, and there have been times when every ambulance based in Shropshire is waiting outside a hospital to discharge a patient.

The hospital trust has declared a critical incident on no less than four separate occasions so far this year, and each of those incidents coincided with an increase in the number of heartbreaking stories coming into my inbox.

[Lucy Allan (Telford) (Con)]

I congratulate the hon. Lady on bringing this incredibly important issue to the House. Such heartbreaking stories are common to all Shropshire MPs. Does she agree that a combination of factors—I am sure she will go on to discuss some of them—including the transfer of patients on to wards, as well as the inaccessibility of general practitioners, is putting additional pressure on A&E?

[Helen Morgan]

I thank the hon. Lady for her intervention, and I entirely agree with her. I will stress some of those points later in my speech.

The emergency departments of the Shrewsbury and Telford Hospital NHS Trust report that they suffer from a shortage of space and staff, along with the additional challenges of separating covid patients—on Tuesday this week, the trust had more covid patients than at any previous point in the pandemic. The trust also reports delays in discharging patients who are well enough to leave hospital because it is struggling to find care packages or care home spaces.

A number of care homes in Shropshire are currently closed because of the pandemic. Shropshire shares the national problem of a shortage of care workers and care homes, which is probably exacerbated by our high proportion of elderly patients. The inability to discharge patients who would doubtless be better off at home or in a care home setting reduces the flow of patients through the hospital.

The impact of all this is that, because ambulances wait so long at hospitals, the vast majority of ambulance journeys across Shropshire begin in Shrewsbury or Telford. It is not possible to reach the most seriously ill patients towards the edge of the county within the target time if the ambulance sets out from one of those two towns. This, combined with the closure of community ambulance stations, means that very few ambulances are free in places such as Oswestry and Market Drayton when people become ill and require one.

Another factor, as the hon. Member for Telford (Lucy Allan) alluded to, is the volume of patients accessing emergency departments, or being taken to one in an ambulance, because there is no other option locally, particularly in the evening or at the weekend. Shropshire has a worsening shortage of GPs, which is leading to patients attending emergency departments for relatively minor issues because they simply have no alternative. A key reason behind the problem of staff recruitment is the chronic lack of other services in Shropshire, but that is a debate for another day.

The Government must deliver on their promise to recruit more GPs, and they must ensure that people with non-urgent healthcare needs are provided with adequate resources in the community. I am incredibly proud that my constituents Sian Tasker and Lawrence Chappel in Oswestry and, beyond my constituency, Darren Childs in Ludlow, and other campaigners, are working tirelessly to keep this issue in the public light and are campaigning to keep their community ambulance stations open. It is partly because of their hard work that we are finally discussing this issue in Parliament.

I am afraid to say that, so far, the Government have refused to listen to the countless warnings by campaigners and those working on the frontline. The Care Quality Commission’s “State of health care and adult social care in England” report last year, gave a stark warning that overstretched ambulance services and emergency departments are putting patients at risk. The numbers speak for themselves. The Association of Ambulance Chief Executives has found that, nationally, 160,000 people a year are coming to harm because of delayed handovers to A&E. Of those, a shocking 12,000 experience severe harm.

I have repeatedly asked the Secretary of State for Health and Social Care to meet me and the West Midlands Ambulance Service to discuss how we can tackle local issues together. I am deeply disappointed that, so far, he has refused my request. It seems to many people in Shropshire that the Department of Health and Social Care is burying its head in the sand and refusing to acknowledge the seriousness of the issue we face. I take this opportunity to urge the Minister to meet me and my colleagues across the county to discuss the crisis and to hear some first-hand accounts of those left waiting in distress so that we can come to some sort of solution together.

I have no doubt that all hon. Members present, including those on the Government Benches, want to ensure that people at their most vulnerable are kept safe. I welcome the recently announced additional £55 million of support for ambulance services. I fear, however, that that money may not go far enough or may not be targeted in the areas of greatest need. The hopes of the Shrewsbury and Telford Hospital NHS Trust are pinned on the Future Fit hospital transformation programme, which kicked off in 2013. It is reliant on £312 million of funding, the source of which may be an interest-bearing loan—I will happily correct the record if I am incorrect, but that is my understanding. Unfortunately, more than eight years later, a strategic outline case has still not been signed off. The estimated costs have spiralled by almost 70% and it is likely that they will not be covered by the Government.

The initial promises of urgent care centres in more rural areas—for example, one was guaranteed for Oswestry—investment in community hospitals and local planned care centres were all quietly dropped in the summer of 2015. Promises of investment in public health and prevention, which is a good idea and would have been welcome in Shropshire, are also apparently no further forward. We are consistently told that there is no more money in the pot for faster, better-resourced ambulance services or urgent care staff, yet the Government wasted more than £10 billion on personal protective equipment that is not up to scratch. It is time that they listened to the warning signs that they have been ignoring and finally step up to provide proper support for ambulance services and accident and emergency departments.

There are several steps that the Government could take right away to get to the bottom of the causes of the issue. The Secretary of State could commission the Care Quality Commission under powers laid out in section 48 of the Health and Social Care Act 2008 to conduct an investigation into the causes and impacts of ambulance service delays. That is a fairly simple step and the law already allows for him to commission the CQC. Once the Government have a professional assessment of the complexity of the causes of the delays to ambulance service response, they can take the correct steps, targeted at the correct causes of the problems, to make some rapid improvements to the service. As I have outlined, the causes will most likely lie in a number of areas across emergency and social care, but until they are fully understood by the right people, they cannot be resolved.

The Government could also pass the Ambulance Waiting Times (Local Reporting) Bill of my hon. Friend the Member for St Albans (Daisy Cooper), which would require accessible, localised reports of ambulance response times to be published. Once the data was available, it would enable central and devolved Governments to accurately understand where the delays are and how best to tackle them, because we should be following the data and the facts to provide the right solutions and the right resourcing in the areas that need them most. That Bill is already written, it has had its First Reading and it is ready to go.

I brought this debate to Parliament to ensure that the Minister and the Secretary of State understand the scale of the problem in Shropshire and, crucially, the urgency in resolving it. How many more elderly citizens will have to wait for 10 hours, with their front door open, for an ambulance? How many more people will have to wait at the roadside with a stranger who they believe might be close to death? How many more young adults will develop hypothermia when they initially have a trivial injury, such as a dislocated knee? How many more cases of serious harm, or even avoidable death, will it take?

I thank the Minister for being here this evening and responding to my speech. I also thank Mr Speaker for granting this Adjournment debate. I take the opportunity to thank everybody in the Chamber for coming along and to wish them a happy Easter and a restful break.