Prolonged turnaround times show pressure on service

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HUNDREDS of patients arriving by ambulance at A&E units each year face waiting for hours before they are handed over for specialist care, figures obtained by the Yorkshire Post indicate.

A snapshot survey for the eight weeks to May 12 looked at turnaround times for ambulances – the period between paramedics arriving to discharge their patient to hospital staff and leaving after cleaning and restocking.

The indicator is a key sign of stress on A&E services and also has knock-on impacts on 999 response times if ambulances are tied up waiting at hospitals.

Figures show 73 ambulances waited between two and three hours at 12 hospitals over the period, including 24 times at York District Hospital and 16 at Barnsley’s hospital. Eight were left waiting more than three hours.

Overall, 37 per cent of 80,300 ambulances took more than 30 minutes to leave, with nearly 2,100 – one in 40 – taking more than an hour.

At Huddersfield Royal Infirmary nearly half of 3,650 ambulances failed to leave within 30 minutes. Fewer than three in five ambulances departed A&E units in Leeds, Bradford, Dewsbury and Wakefield within half an hour.

Demand for ambulance care is rising significantly. Latest figures for April show there were more than 58,000 ambulance journeys to A&E in the region, 4.8 per cent up in the last year.

Handover delays can be caused by problems as simple as a shortage of wheelchairs in A&E or lengthy journeys from the ambulance to casualty. Problems occur when a series of ambulances arrive in a short period, often in early afternoons when GPs carry out home visits. One measure being introduced to ease problems in York has led to GPs from Haxby and Pickering working on staggered earlier timings for admitting patients to reduce peaks.

Yorkshire ambulance chiefs say a regional team had been set up to improve turnaround times. It comes ahead of the introduction of a system of fines in October. Hospitals face penalties of £200 for every patient left waiting for more than 30 minutes before handover and £1,000 for every patient waiting more than an hour. Ambulance services will be penalised £100 for each one hour delay.

Officials at York’s hospital said turnaround times were hit by a norovirus outbreak which put pressure on beds but it recognised “significant improvement” had been needed. A nurse coordinator from A&E was managing handovers and a 10-bed escalation area had been opened to increase peak capacity. It hit the 30-minute target on 44 per cent of occasions in March and April but this had risen to 93 per cent in June.

Mark Davies, clinical head of A&E at the Calderdale and Hudddersfield NHS trust, said ambulance crews now called A&E staff in advance to reduce handover times which was “already seen to be working”. “Along with partners across the entire local health economy, in very challenging times, we are continually working to improve the timeliness and quality of care we provide.”