Ambulance Response Times

Baroness Brinton Excerpts

Tuesday 1st February 2022 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, I too congratulate the noble Baroness, Lady Barker, on securing this important debate and welcome the noble Baroness, Lady Penn, back to her place on the Front Bench.

The subject of tonight’s debate is literally a matter of life and death for too many people at the moment, and while most of our debate so far has been about statistics, health policy and hospitals, and much of the debate will refer to those strategic issues, at the heart of it is the key ambulance service that we have all come to expect by our sides at the worst times in our lives to rescue us and get us emergency help. This debate is all about how our paramedics and their colleagues save lives day after day, and I pay tribute to them.

However, it is also about patients and how they have come to expect that their ambulance service will be there for them. I thank the Library for its excellent briefing and also the TUC for its report on The NHS Workforce Crisis—a Decade in the Making, which has a couple of interesting facts about the current pressures that paramedics and ambulance service personnel are under.

As we have heard, the national standards were set in 2017. Calls are triaged into four categories, and I want to make a further point on response times for categories 1 and 2, which my noble friend Lady Barker alluded to. For most levels of injury and illness in categories 1 and 2, there is a golden hour in which treatment needs to be started at hospital to help survival. Strokes used to be in category 1, along with heart attacks and cardiac arrests, but were moved into category 2 after, fairly recently, paramedics were allowed to administer clot-busting medication en route to hospital. Unfortunately, however, even with that extra bit of time, now there is extra queuing time outside hospitals, ensuring that patients are delayed in getting into A&E.

Before Christmas, I asked Questions on the crisis in the Cornwall Ambulance Service. At one point, there were more patients queuing in ambulances outside A&E at the Royal Cornwall Hospital in Truro than there were beds in A&E—all of which were already full. Five days ago, once again more than 20 ambulances were queuing. The consequences for patients and ambulance service staff of working under such permanent pressure are difficult. For patients in the middle of a major medical crisis, seeing ambulances arrive and paramedics assisting and then, sometimes, having to watch them depart again to leave for a more urgent case is very distressing.

For staff, as outlined in the TUC report, there are intense frustrations and stress at not being able to do properly the job that they love and have trained for. Once admitted to A&E, patients have been left on trolleys for hours while staff waiting with them are unable to get on with other jobs. Steve, aged 21, a clinical care manager in the ambulance service, said:

“Ten years ago, paramedics would do between 12-14 jobs in one shift, but now many paramedics have to stand in corridors with patients for hours. I've known”


ambulance service

“staff to wait in a corridor for up to four hours.”

On delayed discharges, Cornwall recently sought to solve its problems by paying families £1,200 to take their loved ones home because there were no social care beds available either. The TUC report confirms the stress to staff. It says:

“In the NHS, anxiety, stress, depression and”—[Inaudible]


But it is really important to understand that the stress and depression are absolutely appalling and result in time being taken off on sick leave by ambulance staff and others.

My noble friend Lord Scriven talked about the problems of delayed discharges and workforce—[Inaudible.] In another place, MPs Daisy Cooper and Helen Morgan jointly wrote to the Health Secretary on the crisis in our ambulance services. They wrote:

“This year the Association of Ambulance Chief Executives found that 160,000 people a year are coming to harm, of whom 12,000 have experienced ‘severe harm’, because of the issues impacting ambulances.”


Helen Morgan, the new MP for North Shropshire, has also asked the Government to commission an investigation into the ambulance service crisis in Shropshire, where strategic decisions to close ambulance stations have led to severe problems. There have been deaths among those kept waiting. Before Christmas, one man who lived just three miles from the hospital waited 10 hours for an ambulance that did not turn up.

Yesterday, an Answer from Health Minister Edward Argar to a Written Question from Daisy Cooper about the number of ambulance services at REAP level 4 in England said that

“nine ambulance services were at Level 4 REAP.”

That rather emollient Answer means that all but one of the ambulance services are still under the highest levels of pressure. In responding to recent Questions in your Lordships’ House, the Health Minister has repeatedly told noble Lords of the funding that will come to increase the workforce. But this problem is more complex. As with other clinical and healthcare professionals, recruitment and training does not solve an emergency overnight. Care homes, hospitals, delayed discharges—as we have heard—and pressures on A&E are all causing pressures on ambulance services.

Along with the exceptional work of St John Ambulance volunteers, many of our service personnel have been assisting ambulance services during recent months, but this was always intended only as a temporary measure. My noble friend Lady Barker outlined four key actions that would help, so I ask the Minister: what urgent actions will the Government take to reduce the logjam in our hospitals and care homes so that A&E and ambulances can once again come to the aid of people in an emergency, whether accident or illness? This is a real crisis for our ambulance services that needs help now.