Ambulances bosses urge NHS to treat patients in corridors as emergency vehicles forced to wait in 10-hour queues outside hospitals amid junior doctor strikes

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  • NHS England figures show nearly 29,000 hours were lost last week to delays
  • Ambulance bosses said it would be better to admit patients into corridors

Ambulance bosses have urged the NHS to treat patients in corridors as emergency vehicles are being forced to queue for up to 10 hours outside hospitals.

NHS England figures show nearly 29,000 hours were lost last week to delays when handing over patients who arrived at A&E in an ambulance.

One in three patients were forced to wait more than 30 minutes while one in seven had to wait more than an hour. The target time is 15 minutes. 

Daren Mochrie, chair of the Association of Ambulance Chief Executives (AACE), said that, while it was ‘never ideal’, it would be better to admit patients into corridors than leave them in the back of ambulances.

NHS bosses have blamed a lack of space in hospitals, which is being fuelled by striking junior doctors reducing capacity to discharge patients and free up beds.

NHS England figures show nearly 29,000 hours were lost last week to delays when handing over patients who arrived at A&E in an ambulance

Mr Mochrie told MailOnline: ‘It is never ideal to be holding patients in the back of ambulances outside emergency departments or treating them in the corridors of emergency departments.

‘But it is more appropriate to do that than cause potential further harm to patients by keeping them in the back of ambulances outside and preventing those crews from attending other potentially life-threatening patients in the community.

‘At least if the patient’s condition was to deteriorate, the emergency department would have the equipment and clinical staff on hand to immediately intervene.’

He said it was ‘obvious’ that there is much greater risk to people who become seriously ill at home or in the street if their ambulance is delayed at the local emergency department. 

‘Our staff come to work to save lives and improve the outcomes for patients and I so am also deeply concerned about the impact this is having on our staff, from those in our control rooms who are having to stay on the line trying to provide lifesaving help and reassurance over the phone or the paramedics who come to work to respond to patients, not to spend a full shift sitting outside emergency departments or standing in corridors, unable to help,’ Mr Mochrie added.

NHS rules set out that handovers should be completed within 15 minutes and that none should last more than one hour. 

Long handover delays can see ambulances stuck in queues outside hospitals for hours, instead of responding to incoming calls.  

Latest health service data shows ambulances lost 28,966 hours in handover delays in the week to December 17 that took longer than 30 minutes to complete.

However, this is lower than the 46,085 hours during the equivalent week last year, which was considered the worst NHS winter crisis in a generation. 

Terrifying scenes saw military personnel drafted in to drive ambulances during strikes and waits of up to 30 hours in A&E, with patients treated in corridors and sleeping on the floor due to Dickensian overcrowding.

Meanwhile, a third of patients arriving at hospital by ambulance last week had to wait more than half an hour to be handed over to A&E teams.

One in seven ambulance handovers — 14 per cent or 12,196 patients — were delayed by more than an hour, below the 24 per cent reported at this stage in 2022.

Handover delays signal severe strain on the NHS, as it means there is a mismatch between capacity in hospitals and demand for emergency care.

The NHS experiences a surge in demand every year due to an influx in seasonal illnesses, such as flu and the winter vomiting bug norovirus. Chronic conditions worsened by cold weather, such as respiratory diseases, add further pressure. 

NHS figures show that 96 per cent of hospital beds were taken up last week, which is the second highest on record. This is despite staff rushing to free up beds ahead of strikes by junior doctors and to ensure patients get home in time for Christmas.

An average of over 12,700 (12,728) beds were filled every day last week by patients ready and waiting for discharge — known as bed blockers. The health service blames a lack of capacity in social care, which forces patients to spend longer in hospital.

Health leaders have warned that walkouts by junior doctors this week further exacerbate the problem.

The AACE said that, while it doesn’t have data on the effect of junior doctors strikes, they are ‘clearly likely to result in additional pressures on an already-challenged system’. It called for a swift revolution to the dispute. 

Health Secretary Victoria Atkins earlier this week warned that the strikes ‘will mean that people will stay in hospital longer than if the strikes had not happened because hospitals will not be able to discharge them.’

NHS bosses had already warned that hospitals will operate at full capacity for just four weekdays until January 10. Only December 27, 28, 29 and January 2 are unaffected by the impending chaos of the holidays and walk-outs until January 10

NHS bosses had already warned that hospitals will operate at full capacity for just four weekdays until January 10. Only December 27, 28, 29 and January 2 are unaffected by the impending chaos of the holidays and walk-outs until January 10

She launched a crackdown on five of the worst-performing NHS trusts, summoning bosses with the some of the longest A&E waiting times and ambulance handovers to a meeting.

It is understood the CEOs from University Hospitals Plymouth Trust, Royal Cornwall Hospitals Trust, Gloucestershire Hospitals FT, The Shrewsbury and Telford Hospital Trust and Worcester Hospital attended the virtual meeting with the Secretary of State.

It followed reports of emergency patients were being kept waiting in ambulances for 10 hours in some areas while hospitals prioritised existing patients. 

A source close to the Health Secretary said they were told ‘in no uncertain terms’ that their performance not acceptable and they would be closely monitored this winter.

The source said: ‘The Secretary of State made it abundantly clear to senior management that they should buck up their ideas this winter.

Junior doctors’ pay – the truth 

Junior doctors were awarded a pay rise of 6 per cent plus a consolidated payment of £1,250 in July, in line with the recommendation of the Independent Review Body on Doctors’ and Dentists’ Remuneration.

The package was equivalent to an average increase of 8.1 per cent from 2022/23 to 2023/24, or 10.3 per cent for those in their first year of training.

Average basic pay for a first year doctor increased from £29,384 to £32,397, while a junior doctor who had been a specialty trainee for six years or more saw their pay rise from £58,398 to £63,152.

Many are paid a higher sum for working overtime and receiving enhanced rates for working unsociable hours.

Junior doctors pocketed the extra money despite vowing to continue striking, with some boasting the additional income would subsidise further walkouts.

Steve Barclay, who was Health Secretary from October 2022 until November 2023, and Prime Minister Rishi Sunak had described the settlement as final and insisted there would be no more talks about pay.

But the British Medical Association has held further negotiations with officials and ministers in the Department of Health and Social Care since October, resulting an offer of an extra 3 per cent, which has been rejected by union representatives.

The BMA has claimed that junior doctors have seen their pay eroded by more than a quarter in real terms over the past 15 years.

The trainee medics have been demanding full pay restoration — worth around 35 per cent — and have said they would not settle for anything less, although senior figures within the union have suggested they may compromise.

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‘The managers accepted they had all the resource they needed from the department and NHSE but were not hitting their targets and failing their local communities.

‘It is frankly, not fair that patients in these areas are facing the longest delays due to poor management – whether that is stuck on an ambulance, sat in A&E or waiting to be discharged from the wards to go home for Christmas.’

Junior doctors kicked off at 72-hour strike at 7am on Wednesday, which will wrap up tomorrow morning. The medics will return two days before Christmas before embarking on a mammoth six-day stoppage from January 3. 

It comes after weeks of promising talks between ministers and members of the British Medical Association (BMA), which is coordinating the action, broke down. 

Ministers had initially offered junior doctors an 8.8 per cent pay rise, on average, for the 2023/24 financial year. 

However, the uplift was higher for first year medics, who were given a 10.3 per cent boost.

Junior doctors in their first year now have a basic pay of £32,300, while those with three years’ experience make £43,900. The most senior earn £63,100.

Ministers insisted this was the final offer, despite weeks of devastating strikes by junior doctors staged since March. 

But Ms Atkins offered the medics an additional 3 per cent on top of this rise.

However, Dr Robert Laurenson and Dr Vivek Trivedi, who co-chair the BMA’s junior doctor committee, said this sum was still ‘completely insufficient’ and pressed ahead with fresh walkouts.

The BMA has claimed that junior doctors have seen their pay eroded by more than a quarter in real terms since 2008.

Trainee medics have been demanding full pay restoration — worth around 35 per cent — and have said they would not settle for anything less. 

However, senior figures within the union have suggested they may compromise.

After talks broke down, Ms Atkins said the union walked away from the table before it was presented its ‘final offer’. 

Danny Mortimer, chief executive of NHS Employers, yesterday warned that the January action planned by junior doctors will present a ‘dramatic risk’ to patients.

He said hospital staffing levels seen during this week’s industrial action will not be ‘sustainable’ next month. 

Most medics already ‘dread’ the first week of January as it is typically the year’s most challenging, and services are ‘already facing enormous demand’, Mr Mortimer said.

In a letter to Professor Philip Banfield, chairman of council at the BMA, Mr Mortimer called on the union to grant more exemptions when doctors could cross picket lines to help out.

Professor Banfield said the BMA is ‘strongly committed to ensuring that patients are safe during strikes’. 

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