Day 3 of volunteering with the Ambulance service.
In the last two days I have been in the HALO (Hospital Ambulance Liaison Officer) centre at the NNUH and visited the Queen Elizabeth Hospital listening and understanding the issues they are having with slow ambulance response times.
Yesterday, I also spent time with Sam Higginson, the Chief Executive Officer at the NNUH to understand his views.
It is very clear that there are multiple issues all conspiring to why ambulance response times are slow. Normally we see Winter pressure peaks from September to March, but this year this has simply not dissipated and the intense pressure has remained.
WHY?
Capacity and flow of patients is the overriding issue. Why are the ambulances queued up at the hospital? The problem is the ‘backdoor’ not the ‘front’.
The largest issue there is the lack of capacity to get a patient into the hospital and that is a problem caused by the backdoor - not being able to get patients returned to the community, who are dischargeable. At anyone time there are approximately 150 patients at the NNUH who are medically fit for discharge but maybe not able to be self sufficient yet in their own home. They are stuck in the hospital until they can get a care package in place.
This slows down the whole flow of the hospital and means the ambulance teams can’t get a patient out of the ambulance until there is capacity inside to take the patient. This causes a wait, the queue and getting the ambulance back onto the road.
The whole cycle fluctuations daily, impacted largely by other factors including the nature and number of 999 calls, ambulances being pulled off their patch to respond, the availability of crew teams, sickness levels etc.
There is not a singular issue to fix this, but solving the capacity and flow appears to be a major plank of the problem. It has been invaluable to get up close and personal to see first hand the challenges.
Thank you for those that have continued to look after me and put this week together. Brilliant to meet two paramedics from Cromer yesterday - Spud and Tim!
