PERFORMANCE: Ambulance handover times have deteriorated across the capital since the government relaxed accident and emergency targets last year, a report has said.
A confidential NHS London report said “no trusts are meeting the required standards” and the average arrival-to-patient-handover time had risen by 3.5 minutes from April 2010 to April 2011. The average was 13.5 minutes last year, rising to 17 minutes this year.
It said the decline “coincided” with the “A&E indicator change by the Department of Health to 95 per cent [of patients having to be seen within four hours] in June 2010”.
The report was written by Simon Weldon, who has been seconded to NHS London to lead its work on improving performance. It also said a “reduction in bed base led to A&E pressures including delaying off-load from ambulances by some trusts”.
It said the main issues were: “Lack of effective processes in place for handover and a lack of joined-up, focused attention to this indicator [handover time] between trusts and the London Ambulance Service.”
It added that the worst performers were the trusts with highest turnaround and poor A&E performance, citing North West London Hospitals Trust, South London Healthcare Trust and Barking, Havering and Redbridge University Hospitals Trust. These three trusts plus Whipps Cross and King’s College Hospital also had hand-overs taking longer than an hour. Only Homerton University Hospital had a handover time of less than 12.5 minutes.
NHS London has said hand-overs taking more than an hour are now declared as “serious breaches”.
Mr Weldon, north west London PCT cluster’s head of acute commissioning and performance, is to lead the improvement project. Each trust will have to submit a joint action plan with the ambulance service to improve hospital turnaround.
HSJ last week revealed how the government will continue to performance manage trusts against the four hour A&E standard and was relaxing its time-scale for the introduction of new indicators.
LAS deputy director of strategic development Lizzy Bovill said: “Hundreds of hours are lost every week because of delays in hospital handovers. We are working closely with our hospital partners and commissioners in London to ensure robust processes are in place within every emergency department ensuring our patients receive the highest quality clinical care and that our crews are freed up as quickly as possible to attend the next call.”
Average arrival to patient handover time at eight outlier trusts:
- Queen’s, Romford: 23.7 minutes
- Princess Royal University Hospital: 20.7 minutes
- Northwick Park: 19.4 minutes
- Barnet: 19 minutes
- Queen Elizabeth Hospital: 18.5 minutes
- Croydon: 18.1 minutes
- Royal Free: 18 minutes
- King George: 17.4 minutes
- King’s College Hospital: 17.3 minutes
- BARKING, HAVERING AND REDBRIDGE HOSP NHS TRUST
- BARNET AND CHASE FARM HOSPITALS NHS TRUST
- Croydon Health Services NHS TRUST
- Department of Health and Social Care (DHSC)
- Emergency care
- HOMERTON UNIVERSITY HOSPITAL NHS FT
- KING'S COLLEGE HOSPITAL NHS FT
- London Ambulance Service NHS Trust
- LONDON NORTH WEST HEALTHCARE NHS TRUST
- ROYAL FREE LONDON FOUNDATION TRUST
- Ruth Carnall
- SOUTH LONDON HEALTHCARE TRUST
- WHIPPS CROSS UNIVERSITY HOSP NHS TRUST