Every ambulance trust on highest alert level

One senior ambulance chief told HSJ that ambulance response times have dropped dramatically in the last few days, while A&E handover delays have surged. They said: “The wheels are falling off [the emergency care system] now, we’re in a really awful situation.”

They said ambulance leaders have major concerns about the planned strike action by nurses on Thursday, fearing this will exacerbate discharge delays and have a knock-on effect on ambulance handover problems.

It also comes ahead of strike action planned by ambulance staff for next week.

HSJ has seen internal communications which confirm all ten ambulance trusts in England are now in level four of their “resource escalation action plan”, which means they can seek assistance from other nearby trusts or services. However, this is more difficult when an entire sector is under pressure, as is the case currently. 

It is rare for all ten trusts to be in REAP 4 at the same time, although it did also happen during extreme pressures on the sector in July this year.

Another well-placed source described the ambulance service as the “canary in the coal mine” for the rest of the emergency system. They said the cold and snowy weather had impacted on demand while staff sickness was also an issue. “We are expecting response times across all categories for December to be much worse than the last set of data,” they added. Response times have already hit extremely waits in the past 12-18 months.

Last night, North West Ambulance Service issued an urgent appeal to the public, saying it had more than 600 patients waiting for ambulances across the region, and 100 emergency vehicles at hospitals waiting to handover patients.

It said it was maximising resources by putting all clinically trained staff on the responding frontline, increasing its use of private providers and working with partners to guide non-urgent cases to other healthcare services.  

Ged Blezard, director of operations, said: “Please only call 999 if someone has a serious illness or injury, you think their life is at risk, and you cannot get them to hospital by any other means. We know there are patients waiting for our help and we are sorry that we are unable to respond as quickly as we would like. Please be assured that we will get to you as soon as we can.”

Nurses at multiple hospitals across England are due to take strike action on Thursday this week, and Tuesday next week. Ambulance staff at nine trusts are set to walk out on December 21 and 28.

NHS England said in a statement: “This is an example of the significant pressures the NHS is facing currently with latest data showing there were 81,655 category one incidents in November…People should continue to come forward for care in the usual way including calling 999 in an emergency and using 111 online for other health problems.”