Patient Transfer Times from Ambulance to A&E Far Below Average Levels, Data Reveals

10 December 2013

Patient Transfer Times from Ambulance to A&E Far Below Average Levels, Data Reveals

Information released to the BBC under the Freedom of Information Act regarding ambulance services in England, Scotland and Wales have highlighted extended waiting times for patients when being transferred from ambulance to A&E departments, with particularly long delay times in Wales far below recognised waiting time averages.

The BBC made an FOI request to ambulance trusts regarding their longest waits during the 12 weeks from early August to the end of October 2013. The results showed that some patients taken by ambulance to A&E departments had to wait in vehicles far in excess of the recommended 15 minutes, with a shocking six-hour delay in one instance in Wales. In response to this, while the Welsh government conceded the figures were unacceptable, they were exceptional figures outside the norm and that the average waiting time was 20 minutes.

The incident in question in Wales saw an ambulance queuing for six hours and 22 minutes. The longest waits, in general, were seen in Wales with each weekly maximum wait there for the period concerned being above three hours. Meanwhile, in England one service in the East had the longest single wait time at five hours and 51 minutes.

Speaking to BBC Radio Wales, Mike Collins, interim director of service delivery at the Welsh Ambulance Service said:

"I think the length of the delays... outlined really are the exception to the rule and the significant majority of the patients that we do convey to the hospital the average handover delay is 20 minutes," he said.

"When we have those levels of delays there is very close consultation with the emergency department staff just to make sure that the clinical prioritisation of the patients in the vehicles is of paramount importance and that goes on on a 15 to 20 minute basis.

"The knock-on effect is simply, if we have high level delays outside of the emergency departments, then we simply don't have the level of resources available that we need to respond to our emergency high- level calls," said Mr Collins.

Speaking to the BBC, Dr Aruni Sen, who is an A&E consultant at Wrexham Maelor Hospital and former chair of the Welsh Board of Emergency Medicine, explained the dynamics of the patient transfer and what might account for the lengthened waiting times:

"It happens because the department is full and every single trolley bay is taken. If any patient has come by ambulance and could safely be put in the waiting room waiting to be seen by a triage nurse that patient can be offloaded," he said.

"If they (patients) need a trolley space to be monitored (and) those bays are full ...the patient has to wait, that is what's happening."

Mr Sen further added that any delay over half an hour was not acceptable:

"If I see 200 patients a day about a quarter of them will arrive by ambulance, or a third of them so that's around 30/40 ambulances a day, of which we will probably hold, on a bad day about five, six ,10 at various times of the day, and the length of wait will vary," Mr Sen said.

"The target is 15 minutes and we will exceed that target. Half an hour to an hour would be bad and that would happen at various times," he added.

While a Welsh government spokesman said that "Lengthy patient handover delays are clearly unacceptable" he also added these long delays were not indicative of general waiting times, which were around the 20-minute mark.

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