Patient died one and a half miles from hospital waiting for an ambulance

A patient died a mile and a half from hospital with the ambulances needed to treat them stuck waiting outside hospital, it has emerged.

The county's ambulance service has voiced frustration at the issues it has faced in handovers at local hospitals
The county's ambulance service has voiced frustration at the issues it has faced in handovers at local hospitals

The harrowing detail was revealed by one of West Midlands Ambulance Trust’s executive directors as he was quizzed on the issues facing the service in the county.

Speaking at a meeting of the county’s Joint Health Overview and Scrutiny Committee Mark Docherty, director of nursing, quality and clinical commissioning at WMAS, expressed frustration at the continuing delays experienced at the Princess Royal and Royal Shrewsbury hospitals.

He said: “It is not unusual in Shropshire to have a patient on an ambulance for seven hours and that is completely unacceptable.”

He added: “We cannot, even if there is an emergency round the corner, we cannot even respond. You will probably be aware of the patient just one and a half miles from Shrewsbury hospital who sadly died waiting for an ambulance.

“The ambulance productivity has completely dropped because of handover delays at hospitals in Shropshire, Telford & Wrekin.”

Mr Docherty said the issue needed to be tackled by the management at the trust which runs both hospitals – the Shrewsbury & Telford Hospital NHS Trust. He also revealed he takes part in fortnightly meetings to discuss improvements to handover times at the trust, but said he was disappointed senior management had not taken part.

He said: “I believe if you could release the ambulance resource tied up at hospitals we could get most of those performance times back to where they were – I will call it pre-Covid although I do not think Covid is the problem – to do that you have got to have a better grip at the hospital and get the ambulances prioritised to get them back on the road.

“If six of the ambulances in Shropshire are tied up at hospital that will absolutely impact in response times.”

Ambulances queuing at Royal Shrewsbury Hospital on Monday evening

He said: “Six days ago there was one person from the hospital who attended the handover meeting. That was the consultant from the ED who is as frustrated as we are that they are not getting a grip of it.

“Now I am an executive director at West Midlands Ambulance Service, we cover 22 hospitals. I put my time aside to help the hospital but none of their staff other than the ED consultant attended that meeting. I am not going to solve the hospitals’ problems, I have no jurisdiction over it. I do know things I would do and I have given them those ideas and they need to be getting on with it.”

Mr Docherty said that one of the issues raised during the meetings is that the emergency department (ED) at RSH is too small. He said: “My concern is saying the ED is too small is not going to answer it because it is not going to be re-built in the next few months – we need an answer that will solve it now.”

Mr Docherty said the meetings had also heard that patients for other specialities are seen in the same ED space – reducing room for A&E patients. He said: “In my world that would take a day to agree it and sort it. Two weeks on that is still happening.”

He also urged more to be done to get out and prevent patients having to go to hospital in the first place.

He said: “The frailty team at Worcester Hospital want to get out in to the patients homes and look after them before the ambulance arrives. There is a really different appetite for clinical responsibility to what we seeing in Shropshire.”

Steve Tranchard, executive director of transformation for NHS Shropshire, Telford and Wrekin CCG, addressed the criticisms and said he believed there is a plan for the county’s health system, and urgent care, to improve.

He said: “I do not think it is correct to say the system is not working together on these issues. I would like to say there is a clear improvement plan around urgent care. We all acknowledge that care is not where it should be and there is an improvement plan in place.”

Handover times in Telford are also an issue

Responding Mr Nicholas said: “The thing is, from our point of view is not whether there is a plan, anyone can have a plan. The issue is what difference is it making.”

He added: “We are on a burning platform getting narrower and narrower, but a situation getting worse so to some extent even if there is a plan it cannot be the right plan if it is not getting the traction and improvement it needs.”

“The hospital handover meeting I mentioned being chair of – I did not set that up, I did not agree to chair it but I am quite happy to do so, but I do want people to attend and do things and that is quite clearly not happening.”

Responding to the comments Nigel Lee, chief operating officer at the Shrewsbury and Telford Hospital NHS Trust, said: “Our hospitals continue to be under extreme pressure, and at a time of unprecedented levels of demand for urgent care, we are working hard with West Midlands Ambulance Service and other partners to address the whole-system demands that lead to these delays.

“We are undertaking major investment to increase the trust’s urgent and emergency care capacity, including a £9.3m expansion of the Emergency Department at the Royal Shrewsbury Hospital, and have set out longer-term plans to reconfigure the delivery of our services, including A&E, which are explicitly designed to address the kind of pressures we are currently experiencing.”

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