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Ambulance trusts facing possibly “the worst ever” handover times at emergency departments have all now escalated to their highest levels of alert.

HSJ has learned all ambulance trusts in the country have gone to level four of their escalation plans amid increased demand due to the heatwave, and also covid-related staff absences.

West Midlands Ambulance Trust has told HSJ a patient spent 24 hours in an ambulance waiting to be handed over to an accident and emergency. More than half of its ambulance crews were queued outside hospitals at one point on Monday.

And one leader in the North has said the situation is “dire for patients and staff,” while one acute trust CEO in the Midlands said their trust had “possibly the worst ever” night for handovers, adding ominously “it’s only July”.

Whilst some ambulance trusts have remained in their highest alert levels for many months, others have re-escalated their alert levels in recent days.

It means the current situation in ambulance services mirrors that of January – the height of the omicron wave – when every ambulance service had declared their highest alert levels.

Put that hospital on hold

An East of England health system has dropped a bid to buy a private hospital in its area, saying there were “commercial barriers” to the deal.

Hertfordshire and West Essex Integrated Care System was exploring purchase of the One Hatfield facility to expand its elective activity, after initially looking at plans to expand an NHS treatment centre at the Lister Hospital in Stevenage.

The initial plans were complicated by the “emergence of a potential option” to buy the private hospital. East and North Hertfordshire Trust’s latest board papers said the ICS had asked to finalise the Lister Treatment Centre option in a bid to improve waiting times in line with NHS planning guidance targets.

Neither the ICS nor One Hatfield would answer specific questions from HSJ, such as what the complications were that prevented the deal. It seems likely that price was a factor.

In June last year, the Royal United Bath Foundation Trust announced it bought the Circle Bath private hospital – renamed Sulis Hospital Bath – to increase capacity. It seems to be working well for the hospital so it remains to be seen if the same will happen at ENHT.

The outcome of what happens once the treatment centre at Lister is expanded remains to be seen – though the hope is for waiting times to improve in line with NHS planning guidance targets.

Also on today

In our comment section, Niall Bolger and Carolyn Regan explain how a new framework for addressing inequalities aims to improve health for the most disadvantaged communities, and in news we report that NHS England clinical lead Tom Hughes has said “hard legislation” is needed to push suppliers to make the IT systems used by the NHS interoperable.