Devon’s hospitals should adopt the model used at the Royal Devon and Exeter Hospital to reduce lengthy waiting times by ambulances, a new report says.
The spotlight review by Devon County Council’s health and adult care scrutiny committee found handover times by the South Western Ambulance Service (SWAST) are consistently longer than the national average and “higher than ever previously experienced.”
The NHS standard contract states that all handovers of patients between ambulances and emergency departments must take place within 15 minutes, with none taking more than half an hour.
More than one in three (36 per cent) of SWAST’s handovers were delayed by 30 minutes or more in the week ending Sunday 20 February according to the report, significantly more than other regions such as the south east (12 per cent) and London (14 per cent).
The situation worsened over just three months.
In November 2021, SWAST lost the equivalent of around 750 hours a day to handover delays at hospital emergency departments, compared to around 400 hours a week in 2019.
“This results in many ambulances queuing outside hospitals, and unable to respond to other emergency calls,” the report says.
But the Royal Devon & Exeter (RD&E) “does not have the issue with ambulances waiting outside its emergency department.”
This is because it has a “rapid patient assessment and triage model which benefits from senior decision-making clinicians at the front door.
“This results in patients either being assessed as fit to sit or provided with a trolley until a bed is available in the hospital, rather than remain in an ambulance outside the hospital.
“Patients are brought into the emergency department for assessment as quickly as possible and seen in a dedicated space.”
Devon’s three other acute hospitals are recommended to adopt a similar model used by the RD&E to reduce handover delays, but the report accepts there is a “complex landscape” to healthcare in the county.
It states how the NHS has been under huge pressure for the last two years through the pandemic, as well as having ongoing staffing issues and demand for social care being higher than the available capacity – leading to people staying in hospital longer than necessary.
Plymouth’s Derriford Hospital also has extra pressures. It covers a wide catchment area and is the regional centre for trauma, brain surgery, kidney transplants and complex liver issues.
A spokesperson for the South Western Ambulance Service NHS Foundation Trust (SWASFT) said on the findings: “The whole health and social care system has been under sustained pressure for many months now, meaning patients are having to wait longer for an ambulance than they would expect.
“Our performance has not returned to pre-pandemic levels, partly due to handover delays caused by capacity issues in hospitals, and in community and social care. This means it’s currently taking us too long to get an ambulance to patients.
“We continue to work on a daily basis with our partners to ensure our crews can get back out on the road as quickly as possible, to respond to other 999 calls.”
John Finn, director of in hospital commissioning at NHS Devon CCG acknowledged the review and said patient safety and care is “our number one priority.”
He added: “We are sorry for the delays people have experienced and for the huge anxiety this causes to patients and their families and to hard working frontline staff.
“Ambulance handover delays are a symptom of pressure across the entire health and care system, both nationally and here in Devon and we are working together as a system to reduce them.”