• New leak shows 91-year-old stroke patient waited 19 hours for ambulance
  • Also reveals that serious incidents with very long waits persisted for weeks beyond a period subject to an external patient safety review
  • Comes as trust’s performance dipped in the spring

A 91-year-old stroke patient who waited nearly 19 hours for an ambulance in the East of England was among 22 cases investigated by an external review which found no one died “as a direct consequence” of long delays, HSJ has learned.

HSJ has obtained previously unpublished details from seven East of England Ambulance Services Trust serious incidents reports from January and February, involving ambulance delays which one trust source described as “a disgrace”.

The serious incident report regarding the 91-year-old’s case said: “Ambulance arrived at 04:58. Call to arrival of the [rapid response vehicle] 16 hours 49 minutes. Call to arrival of ambulance was 18 hours 44 minutes for a stroke patient. Patient died in hospital [four days later].”

The incident information said: “999 call for a 91 year [old]. Stroke symptoms (unable to raise arms and speech problems).”

A trust insider told HSJ: “How can you defend a 91-year-old in that condition waiting over 18 hours for an ambulance? You can’t. It’s disgraceful.”

The leak also reveals that serious incidents involving very long waits persisted for at least a month beyond the chaotic festive period which was subject to an external safety review after the trust notched up 138 “significant” ambulance delays between 17 December and 16 January.

The review, which looked at 22 serious incidents, was launched after a whistleblower alleged long delays had contributed to a significant number of deaths and patient harm in this period. It concluded last month that nobody had died as “a direct consequence” of significant ambulance delays.

Of the seven cases HSJ has seen new details of, two took place during that month-long period – one of which was the 91-year-old.

The other five cases took place between 19 January and 22 February. In four of them the patient died – one had waited for longer than six hours, two for longer than an hour, and in one case the wait is not detailed.

The fifth case was an 88-year-old fall victim who had suffered a fractured neck of femur then waited over nine and half hours for an ambulance.

The trust told HSJ the 91-year-old’s death was examined by the external review. It said it could not comment further due to patient confidentiality rules.

The fresh leak comes amid concerns the trust’s response time problems are dragging on from winter into spring and the summer. Official data for May shows the trust recorded the worst average response time, eight minutes 35 seconds, to category one calls, the most urgent category, of the NHS’s ten English ambulance trusts.

HSJ also understands internal data shows the deterioration has continued into June, a month in which very serious performance problems are not common. The trust insider told HSJ that category one performance was getting worse at a time of year the trust had expected improvements.

The trust also confirmed that a separate internal patient safety report from June, seen by HSJ, concerning a heart attack fatality after an ambulance delay, was being investigated as a serious incident.

North Norfolk MP Norman Lamb said there were “parallels between the rotten culture at the trust and the culture at Gosport Memorial Hospital”, the scandal hit hospital it was yesterday confirmed that over 450 patients died after being given dangerous amounts of painkillers.

The former health minister Mr Lamb, a long-time critic of the trust’s current management, added: “The long delays are hugely concerning for patients. There is a bullying culture at the trust. Instead of being concerned about patient safety, they seem more concerned about targeting anyone who leaks information.”

He called on the Care Quality Commission to “call out” the trust’s leadership and government and regulators to examine why there “does not appear to be any improvement” since a risk summit in February.

Responses from the trust, commissioner and CQC

The ambulance trust said in a statement: “The risk summit are aware that the trust has a significant capacity gap and is working towards its trajectories against the independent service review [a recently published report on the trust’s capacity gap]. The trust is not commissioned to meet national targets until April 2019.

“Our staff have continued to work hard with the capacity we currently have and we know it will take time to show improvement. As we have now secured funding for additional resource for the next three years we look forward to continuing to work with partners to improve our service to patients.”

A spokesman for Ipswich and East Suffolk Clinical Commissioning Group, the lead commissioner for the 19 East of England CCGs, said it would “seek to reconfirm” assurances that the trust had a “robust process for identifying and investigating patient safety incidents”.

He added: “We are monitoring the ambulance service performance closely and are clear about the improvement plans they have in place. While it is recognised that there is much work to be done to deliver national performance standards, the ambulance service and the wider health care system are already acting on the findings of the recent risk summit and subsequent review.”

A CQC spokeswoman said it inspected the trust in March, had looked at information including from whistleblowers, and that its report would be published soon.

“We take whistleblowing concerns very seriously and use these to inform our inspections and judgements,” she said.

The Department of Health and Social Care had not responded to HSJ at the time of publication.