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Ambulances stuck outside A&E as acute beds closed

EXCLUSIVE: Accident and emergency nurses across London are being left unable to treat patients who are stuck outside in ambulances because of bed shortages.

Data released exclusively to Nursing Times has revealed the extent to which ambulances have sat outside A&E departments for more than an hour at a time, unable to handover patients.

The London Ambulance Service operation data shows there were 673 such incidents – known as “black breaches” in the first seven weeks of 2012. The strategic health authority is concerned about the problem across the capital, but there are some sites where it is particularly acute.

Queen’s Hospital in Romford reported 186 black breaches between the start of the year and 19 February. Northwick Park Hospital in Harrow had 105 over the same period, while University Hospital Lewisham recorded 84.

Andrew Frazer, chair of the Royal College of Nursing’s Emergency Care Association, said the issue was not confined to London and would affect other densely-populated areas.

Nurses were “frustrated” when patients were stuck outside A&E on an ambulance trolley, he said. “We want to provide good care – knowing you have patients who you aren’t able to bring in gives rise to considerable stress,” he added.

An NHS London spokeswoman said Northwick Park had seen a 10% increase in A&E attendances over the past three years combined with a “lack of bed capacity”. Bed capacity was also identified as an issue at Queen’s.

“Across Britain we have cut beds in order to save money,” Mr Frazer said. “We did that with the mantra that we will get more efficient but that hasn’t matched up.”

Readers' comments (9)

  • The problem is not confined to London there have been so many frozen posts and bed closures that if god forbid there is ever a massive flu outbreak the NHS will be unable to cope.

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  • does all this news and the comments get back to Messrs Lansley and Cameron?

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  • And Theatres and elective surgeries are canceled and closed every other day at our hospital because A&E and emergency surgery takes priority and ITU don't have enough beds because the wards don't have enough beds so the whole Hospital is grinding to a halt. Good job Government.

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  • There is the same issue across the East of England. Some ambulance crews have waited 2 hrs to handover patients to A&E staff! This has a severe impact on the number of ambulances to attend other emergency calls. Then the public complain to the ambulance service because it takes too long to back up single responders. This is unacceptable Mr Cameron!

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  • This is really important, we have patients dying at weekends because money isn't available to offer 24/7 services and patients being treated in ambulances because there is no money to open more beds.

    All this going on and we are expected to fret about whether we call a patient Mr/Mrs or Dear.

    Time to get our priorities right.

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  • it is reassuring to know that the patients continue to get treatment in the ambulances although obviously this is not optional but shows that people are doing all they can. However, the management practice of directing these patients to hospitals where there are no available beds is disgraceful and inexcusable.

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  • Ambulances often wait outside A & E. To solve the problem perhaps someone should look at the abuse of the service and perhaps evoke penalty charges for wrongful use, or persisitant abusers. Although i believe the operators use pathways for identifying needs these are not A1, the service refused to attend my collapsed daughter who we had to carry to a car with neighbours help - and she spent 3 weeks in ITU, yet I see people coming in by ambulance for constipation or aches and pains, colds. Lets look the system, find a better way to identify needs and reduce the demands of the service to those that really need it.

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  • The NHS is really going to have to look at this. We cannot admit people to wards where they do not have the staff to look after them either.
    Many of the money saving ideas have not been thought through and cannot be justified.
    The health services are not joined up and each group is fighting the other for funding.

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  • why are patients being made to pay with their health or even their lives for this debacle?


    ... and why are staff being penalised for problems not of their making?

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