Waiting, and waiting, and waiting. For a GP appointment, a routine screening, a vaccine. To see a clinician in A&E, or for an ambulance to take you there. Waiting for a referral appointment, for the community nurse to arrive, for a care worker to call. The NHS waiting list feels endless. And all our leaders seem to do is tell us we must do our best so the health service doesn’t become overwhelmed.
As a paramedic with more than 20 years in the ambulance service, I know we are not the only ones to cry, “We are overwhelmed.” Over the past three nights I’ve been working the 7pm-7am shift. Every evening, I’ve arrived at work to a list of more than 160 outstanding 999 calls. That’s more than 160 people waiting for an ambulance. Some have been waiting for longer than 12 hours; some will have life-threatening or life-changing conditions.
Six hours into a recent shift, I attended an elderly woman who had fallen over seven hours earlier. She had fractures to her hip and wrist, and bruises to her face. In addition, she had suffered the indignity of being incontinent. But there is nothing new in this: in fact, stories like hers are a daily occurrence.
How long must we wait for the situation to improve? The NHS and its patients need support. The ambulance service has been failing for years. Although Covid has shone a bright light on this, it alone did not create these problems. There are multiple reasons for failure.
It’s clear we can’t blame the crews for these problems. Paramedics and call handlers turn out for 12-hour shifts knowing they’re unlikely to feel they have really made a difference. Over the past three nights, my colleagues told me of a 28-year-old man with groin pain and a woman who had eaten a muffin passed its best-before date and now felt some stomach discomfort. Why did they take priority over the woman on the floor? Why don’t those patients make their own way to hospital?
Is it because our management doesn’t have the courage to say no to anyone? The frustrating result is that we let down the patients who need us most. Patients die while they wait for us to attend the out-of-date muffin case.
In the south of England, many local ambulance stations have closed to make way for “super hubs”. So why are people still waiting? Local ambulance stations served local communities; now, with super stations, ambulances have to travel for 30 minutes or more to reach people. The idea is that larger towns, which have the largest call volumes, hit the target times in those areas. But the result is that patients in smaller communities – which don’t seem to matter as much – are left waiting.
Another flaw is the system followed when answering a 999 call; the way calls and concerns from the public are prioritised and routed to front line staff. Among call handlers, it’s called “fire fighting”, which is funny because if you leave a fire waiting there is often nothing left to extinguish and it burns itself out. It can feel as though this is all part of some grand plan to eventually privatise the ambulance service.
I feel deeply sorry for all the people who had to wait for us to arrive when they needed us, for those families who had a loved one die while they waited, and for those who will have to wait in the future. Frontline ambulance crews want our management to manage and take responsibility for their actions. We want more funding to clear the waiting lists and ensure we can help those who need it most. Unless the waiting list ends, the ambulance service, like a fire, will only keep going until it burns itself out.