Ambulance handover policy criticised by clinicians

The ambulance service introduced an “immediate handover policy” last month, which allows ambulance crews to leave patients waiting at accident and emergency during periods of intense demand in order to respond to 999 calls.

However, clinicians at Brighton and Sussex University Hospital Trust, which has struggled to meet the A&E four hour target over the past year, have said the policy is “unsafe and likely to pose a notable increase to risk for patients in the emergency department”, according to a report in the trust’s February board papers.

The report said that the policy was enacted on 10 February when pressure on the ambulance service to respond to calls was “overwhelming”.

This meant that five ambulance crews were allowed to leave the hospital to respond to calls.

This created a “temporary care issue” for the patients left in the department by the ambulance crews and two other ambulances were held outside the emergency department while extra staff were found.

• Ambulance staff to leave patients waiting at A&E during busy periods
• Ambulance services given extra time to assess patient need

A spokeswoman for South East Coast Ambulance Service said the policy would only be implemented when “absolutely necessary”.

She added: “Delays at hospitals are a major issue for us and impact on our ability to respond to patients in the community. This year compared to last, across our region, we have experienced an increase in delays of more than 30 minutes of approximately 75 per cent.

“It should be remembered that clinical responsibility for all patients taken in by ambulance sits with the hospital 15 minutes after our arrival. It is vital that we balance the needs of the patients who are ultimately in the care of the hospital, with those patients out in the community who have called 999 for emergency medical assistance and who we will struggle to respond to if all our resources are tied up at hospital.”

“We will continue to work closely with our hospital colleagues who we appreciate, along with all parts of the NHS, are extremely busy, and would ask for the public’s support in remembering that calling 999 and visiting A&E should be reserved for serious and life threatening conditions.”

A spokesman for Brighton and Sussex University Hospitals Trust said it recognised the ambulances service’s pressure to attend 999 calls and the “clinical risk that is created when crews are held in the emergency department and we are working closely with them to manage this situation effectively”.

He added: “We have discussed the policy with them and due to collaborative working arrangements the policy has only been implemented once for one hour. Relationships between the trust and [the ambulance service] are strong and positive and we will continue to work together to ensure patients arriving at our emergency department by ambulance have the safest care in the most appropriate environment.”