Ambulance Waiting Times: Royal Cornwall Hospital

Debate between Luke Pollard and Cherilyn Mackrory

Wednesday 29th June 2022 Commons Chamber

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

This issue of ambulance waiting times at the Royal Cornwall Hospital is vital to my constituents and the whole of Cornwall. I want to start by thanking all health and social care colleagues for their hard work. They work with such professionalism, dedication and selflessness, despite being short-staffed and under immense pressure. It is telling that the constituents who write to me on these issues include praise for the staff who have helped them with such compassion and care in their time of need. Over the past 12 months, I, alongside my five Cornish MP colleagues, have had many meetings with NHS leaders and other Cornish healthcare stakeholders to discuss these challenges. We have also written to Ministers to highlight individual cases and the wider situation on numerous occasions, and I appreciate this opportunity to again highlight the situation in Cornwall to Ministers.

Ambulance waiting times at the Royal Cornwall Hospital are an increasing concern, with the hospital recently recording the worst ambulance wait times in the country, topping the list for the proportion of arrivals that were delayed by more than an hour, at 41%; this represents 10% of the wait times in the whole of England. There is widespread consensus that ambulance response times are slow in Cornwall due to handover delays. The Royal Cornwall Hospital has the highest percentage of handovers over 60 minutes, at 25%. That is particularly concerning, given that the NHS standard contract states that all handovers of patients between ambulances and accident and emergency should take place within 15 minutes, with none taking more than 30 minutes. These handover delays of over 15 minutes have contributed to an average of 255 ambulance hours lost every day in May. I receive several emails each week from constituents who have experienced these delays first hand. One such constituent wrote recently that they were transferred by ambulance to the RCH in the early afternoon. On arrival, there were 15 other ambulances already waiting for their patients to be admitted. During the afternoon, evening and night, they were transferred to five other ambulances and crews. The various categories of ambulances offered stretcher beds of varying levels of discomfort, and there was a shortage of blankets, no access to food and no toilet facilities. They were eventually admitted to the emergency department at around 5 the following morning.

Delayed handovers result in poorer ambulance response times, as ambulances queue outside A&E unable to attend patients waiting in the community. That leaves patients at increased risk of delays in diagnosis and treatment, and compromises the ability to respond to serious incidents. These delays also increase pressure on clinical staff and on ambulance service call handlers, who look after distressed patients and their families, who call again and again, desperate to hear their wait time. That can lead to thousands of additional calls, placing even more pressure on the service. Constituents have told me that they have waited 13 hours for an ambulance and that they have called many times in the interim to chase an update on the expected arrival time.

Let me be clear: these delays are not to do with ambulance service call handlers; they are a whole-system issue and are impacted by acute challenges elsewhere in the system, particularly with hospital capacity and patient flow. The issues include delayed discharges to social care and other services, as well as bed occupancy. As such, a whole-system approach is needed to tackle this issue.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

This issue is important not only in Cornwall but in Plymouth, because Derriford Hospital serves part of Cornwall, providing some of the ambulances she mentioned. She is right that this is not the fault of the people who drive the ambulances or who dispatch them, but does she agree that it is utterly unsustainable that many ambulance crews may get only one shout per shift, because they spend the remainder of the shift queuing outside an emergency department in Cornwall or Plymouth waiting to hand over their patient? That is simply unsustainable if we are to have the NHS recovery we need in the south-west.

[Cherilyn Mackrory]

I thank the hon. Gentleman for his intervention, and he is absolutely right. He will know that, purely because of their geography, hospitals in Cornwall and Devon rely on each other, and the ambulance crews go between the two. He is also right that this is a multifaceted issue. Hopefully I will cover most of it in my speech and the Minister will respond knowing that there are many things we need to do to try to tackle it.

In Cornwall the capacity challenges stem partly from the hangover from the covid-19 restrictions. Predominantly, however, they are about staffing, which hinders our social care system’s ability to safely assess and care for patients at the rate necessary to clear the beds in the hospitals. On a single day last month, 190 beds in Cornwall were occupied by patients awaiting discharge into social care. Those patients had no medical need to be in those beds. Thankfully the number has now fallen below 130, but the issue remains that too many people are staying in hospital beds because of discharge challenges.

In March the Care Quality Commission inspected the whole of the Cornwall and the Isles of Scilly urgent and emergency care system. The report states:

“Delays in ambulance response times in Cornwall are extremely concerning and pose a high level of risk to patient safety. Ambulance handover delays at hospitals in the region were some of the highest recorded in England. This resulted in people being treated in the ambulances outside of the hospital, it also meant a significant reduction in the number of ambulances available to respond to 999 calls. These delays impacted on the safe care and treatment people received and posed a high risk to people awaiting a 999 response…Delays in discharge from acute medical care impacted on patient flow across urgent and emergency care pathways. This also resulted in delays in handovers from ambulance crews, prolonged waits and overcrowding in the Emergency Department due to the lack of bed capacity.”

The report goes on to state:

“Without significant improvement in patient flow and better collaborative working between health and social care, it is unlikely that patient safety and performance across urgent and emergency care will improve.”

That is key. Although we have seen some pilots and seen community services adapt to meet changes in demand, additional focus on health promotion and preventive healthcare is needed to support people to manage their own health needs.

The report also identified that adult social care in Cornwall has had one of the highest short staff shortage rates in the entire country. That directly affects the ability to discharge patients into the social care sector, as well as A&E and ambulance response times.

Keyham Shootings

Debate between Luke Pollard and Cherilyn Mackrory

Wednesday 22nd September 2021 Commons Chamber

[Luke Pollard]

I thank the hon. Lady, my colleague from just across the Tamar. This tragedy has affected not just our entire city of Plymouth, Devon and Cornwall and the wider peninsula, but the country as well, and it is something that we face together. I thank her for her remarks.

Our community in Plymouth is facing a collective trauma. We know that there are over 300 eyewitnesses to the shooting—people who have seen a body or blood on their street—and many of those are children, who should never have witnessed anything like this in their young lives. There is nothing that prepares you as an MP for the conversation with a parent about how their child saw someone get shot in front of them—what they should say, what they should do, who they should turn to—and not always having the answers to give them. Like many of the community responders, I had conversations like this not just once or twice but many times every day in the aftermath of the shooting.

My experience, though, has been no different from the school staff at Ford Primary School who opened their doors to the community just hours after the shooting, the street pastors, the police officers and the PCSOs, the local vicars, the staff at our local Co-op, or the residents told to stay in their homes for days after the shooting with the bodies of their neighbours on the streets outside. I say these things not just to seek and elicit sympathy but to illustrate what collective trauma means in a very real human sense. Biddick Drive in Keyham could be any street in any of our communities, and that is what makes this tragedy so scary for all of us.

Plymouth is a trauma-informed city, and the experience of communities in similar circumstances in the past has shown us that after an event like this there are consequences that can be predicted. More children will struggle at school, get lower grades and drop out of school earlier. More people will face unemployment and insecure work. More people will be a victim of crime and more people will themselves commit more crime. More people will experience and suffer from domestic and sexual abuse. More people will suffer from severe mental health problems, anxiety and depression. I see it as my job as Keyham’s MP to do everything I can to stop that from happening.

As a city-wide response, local councillors from all parties, community leaders and the police and crime commissioner all shared in this effort. This really has been a Team Plymouth response. I have never been so proud of my city as I was in the days after the shooting. There was an incredible response on the day from the paramedics and the police who rushed to the scene, the four air ambulances that attended, the doctors and the nurses, the city council and its staff, the local schools and many more. Our whole community stepped up. The teams at Ford Primary School and Keyham Barton, as well as Stuart Road and other schools, have been superb, as have the churches that opened their doors immediately—St Mark’s and St Thomas’s in particular. I want to thank the local councillors—Sally Cresswell, Jemima Laing, Bill Stevens, Mark Coker, Charlotte Cree, Tudor Evans, Gareth Derrick and Stephen Hulme—and the police and crime commissioner, Alison Hernandez, and her team for the work they have done. This was a Team Plymouth response. I also thank the Wolseley Trust for its co-ordinating and fundraising for the Plymouth together fund, which has already raised thousands for the funerals, the victims and the community, but more is needed. Donations are still being made online.

Local businesses large and small have also stepped up, including Zoe Stephens from the Co-op, who provided candles for the vigils and cups of tea at the events, and Richard Baron, who dropped everything to install more home security for residents. When your child cannot sleep because of what has happened and they are scared that a bad man will come through the window, a simple window restrictor is worth more than its weight in gold. I want to thank in particular Keyham neighbourhood watch—Sarah, John, Simon, Lena, Laura, Kicki and Hazel—and its relentless and positive chair, Kevin Sproston. I thank everyone for the outpouring of support from across the country. The support that we saw in Plymouth was cross-party.

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

I want to express solidarity from across the Tamar in Cornwall. We all feel what the hon. Member feels, particularly about children being safe. It should be a given that every child should be safe in their own bed at night.