The performance of the region’s ambulance service has come under fire from MPs and unions after an investigation by The Yorkshire Post revealed a postcode lottery for critical care.
Emergency response times to top-priority ambulance calls reached an all time low for Yorkshire in March, with not a single ambulance arriving within target time in some areas over the month.
The “alarming” figures are the worst on record for the last five years and come despite a warning from a health watchdog that the trust must improve.
“It’s just unacceptable,” said Ray Gray, Unison officer for the ambulance service. “There are not enough ambulances. There are not enough paramedics. At a time when most areas are seeing a growing population, we know there is a growth in demand. But there isn’t a growth in response.”
The investigation is based on a series of Freedom of Information Act requests to Yorkshire Ambulance Service (YAS) for March 2016, just before the authority changed the way it records data.
Nationwide, NHS guidelines say 75 per cent of Category Red 1 calls are to be responded to within eight minutes. But the trust failed to meet its targets in Yorkshire, where 68 per cent of calls were responded to in time.
The figures vary widely across the county, with some towns and cities faring well while others are harder hit. Response targets in Halifax were met 83.3 per cent of the time, while in Doncaster it was just 64.8 per cent.
The Post’s investigation, which included a snapshot of some rural postcodes, found a huge disparity within a few miles, with not a single ambulance arriving within the targeted eight minutes in some more rural areas.
Beverley and Holderness MP Graham Stuart said it’s a major concern, while Guiseley MP Stuart Andrew, whose contituency is one of the hardest hit, said this needs to be looked into urgently.
Steve Page, executive director of quality, assurance and performance, said demand is increasing across the country. “We aim to reach all our patients as quickly as possible, including rural areas of our region, where sparsely dispersed populations present particular challenges for all emergency services,” he said.
“Whilst we are working hard to make further improvements to our response times, it is important to remember that they are not the only measure of the care we provide. We are focused on working more efficiently and effectively.”
MPs ‘concerned’ over lottery
The stark postcode lottery for critical ambulance care in Yorkshire has been branded “unacceptable” by MPs who have pledged to investigate.
The figures show that paramedics in Yorkshire responded to 68 per cent of the highest priority emergency calls within eight minutes in March, against a nationwide target of 75 per cent.
But the investigation, analysing a snapshot of single postcodes, uncovered a huge disparity between towns and cities, with some rural areas at zero per cent.
“I am very concerned,” said MP Stuart Andrew, whose constituency in Pudsey, Horsforth and Aireborough is one of the hardest hit. “This needs to be looked into urgently, and I will be raising this directly with the service to see what action they are taking. It should not be a postcode lottery.”
The figures uncovered through a series of Freedom of Information requests are from March, just before Yorkshire Ambulance Service (YAS) introduced a new trial system. This system groups together the highest priority calls with the second most critical, raising the average to above targeted rates from April onwards.
Beverley and Holderness MP Graham Stuart began campaigning on the issue earlier this year after figures fell to 34.2 per cent in June 2015.
He raised the issue with the previous Trust chairman Della Canning and chief executive at a briefing in Westminster in February, saying it was “unacceptable”.
“The disparity between response times across Yorkshire is a source of major concern,” he said.
“Response times in rural Holderness are unacceptably poor, and there have been tragic cases.
“It is hard not to believe this is jeopardising outcomes for people in Beverley and Holderness when they need help most desperately.”
Julian Smith is MP for Skipton and Ripon, including parts of the HG3 postcode where targets were met just 20 per cent of the time.
“I have been concerned for some time about cases brought to me at my MP advice surgeries reporting slow ambulance response times in our very rural area,” he said.
“Whilst the ambulance service has always responded to my enquiries and questions by defending its response times, these figures do show that this issue is very real.
“Yorkshire Ambulance service has very dedicated staff and works hard to ensure cover across a huge geographical area but I want to get a clearer picture as to why these poor figures revealed by the Yorkshire Post have occurred.
“Many of my constituents live in very isolated areas and I want to ensure they have the very best response times from the ambulance service.”
Independent patient watchdog Healthwatch has said it is aware of the issue and has met with the chairman and chief executive.
But union leaders have said the big issue lies in funding for services, calling on the Government to intervene.
“We still have problems with ambulances going to A&E and they can’t get in,” said Ray Gray, Unison regional officer for the ambulance service. “At really bad times, we can see every ambulance sitting outside a hospital.
“There’s not enough money going into the NHS. This is a vicious cycle, the whole health service isn’t coping with the volume of patients.
“What we are seeing is the health service that the Government is prepared to fund -and it isn’t good enough.
“It’s not the paramedics’ fault, in many ways it’s not the trust’s fault. It’s down to the Government. And we can only see it getting worse.”
Pilot scheme underway
YAS is now taking part in the pilot of a new programme, which means top priority and second priority calls - until now called Red 1 and Red 2 - will be banded together.
As a result, the joint figures have improved to 73.8 per cent for early April, and then 76.8 per cent since.
A Department of Health spokesperson said: “We know ambulance services are busy but we expect patients to be reached quickly regardless of where they live, which is why we’ve increased paramedic training places by over 60 per cent this year, on top of 2,300 extra paramedics that have joined the NHS since 2010.
“We are committed to the NHS and we have invested £10bn to fund its own plan for the future.”
‘Lost hours’ during hospital handover delays add to 999 problems
Ambulance crews have been seen queuing to hand over patients to staff at Yorkshire hospitals in recent months.
Delays in the handover of emergency cases to A&E staff at York District Hospital saw paramedics waste an average of 14 working hours every day in May.
The tally of “lost hours” was the worst in the region, closely followed by that of Pinderfields Hospital in Wakefield (13 hours).
Guidelines state that handovers should take no longer than 15 minutes but crews are not allowed to leave until patients are signed over to the care of hospital doctors. Delays mean paramedics are not available to respond to fresh 999 calls.
Elsewhere in the region, Bradford Royal Infirmary (eight), Hull Royal Infirmary (seven) and Scarborough Hospital (seven) recorded lengthy handover delays each day in May.
Both Leeds St James’s Hospital and Leeds General Infirmary recorded an average of two lost hours per day due to handovers.
Dr David Macklin, executive director of operations at YAS, has said effective handovers between ambulance crews and hospital staff are “an integral part of delivering the best clinical care for patients”.
York Teaching Hospital NHS Foundation Trust, which runs York and Scarborough hospitals, said it had been unable to achieve the “expected performance levels” due to high attendance rates, delayed discharges and wards closed due to norovirus. The introduction of new roles on wards at both hospitals is aimed at helping to reduce delays.
Mid Yorkshire Hospitals NHS Trust, which runs Pinderfields, said delays are taken “very seriously” and work has been done to streamline the process.