• East Midlands Ambulance Service says 13,057 hours were lost waiting at hospitals for pre-handover of patients
  • Additional staff, shift incentives and new handover procedures were not enough to cope with winter pressures

Ambulance crews in the East Midlands spent a cumulative total of almost 18 months waiting at hospitals in the region in December, despite a variety of actions to mitigate winter pressures. 

East Midlands Ambulance Service Trust’s bosses have stated that 13,057 hours were lost waiting at hospitals for the pre-handover of patients, more than double the amount in December 2018. 

In its board papers for January, EMAS listed a set of actions it took to mitigate winter pressures, including the deployment of 275 additional operational staff compared to December 2018, bespoke escalation procedures within hospitals, and incentive shifts for covering key operation periods.

However, EMAS director of operations Ben Holdaway said all those actions were exhausted by the demand seen in December.

In reference to the trust’s action plans, he said in a report: “All the above actions have been implemented, however they have not fully mitigated the increases in demand and the lost hours arising from hospital handover delays….

“The trust has implemented all action which is practical to take in managing the risks associated with winter pressures, however activity levels and hospital handover delays mean the trust is not delivering the level of service to which the trust aspires.”

The transfer target allows up to a 15-minute wait, which includes a verbal briefing and transfer of paper and electronic records to hospital staff.

In his report to the board, chief executive Richard Henderson stated EMAS increased its double crew ambulance output in December by more than 14,000 hours compared to the previous year but, because of hours lost at hospitals, only 9 per cent of that resource was available to respond to patients.

His update also provided locations of handover delays with Leicester Royal Infirmary accounting for the highest number with 3,418 hours lost, an increase of more than 2,100 hours compared to December 2018.

Mr Henderson stated: “Harm reviews have been undertaken by EMAS and the trust is in the process of undertaking full reviews in conjunction with commissioners which will consider the whole of the patient pathway and identify any harm.

“Although the internal reviews have not identified any patient harm to date, the current level of service is impacting on patient experience.

“EMAS is working closely with partners in the local health economy and with regulators to influence action to manage activity.”

EMAS also saw an increase in the amount of reported serious incidents related to delayed response and hospital handover with a year-to-date total of 16 incidents compared to four in relation to a delayed response at the same point in the previous financial year.

The picture at the ambulance service mirrors winter pressures nationwide, with a record collapse in emergency care performance during December.