NHS Improvement has warned acute trusts that their current practices are compromising the safety of patients.
Some trusts have been guilty of introducing what the organisation describes as ‘unacceptable rules’, which are having the unfortunate effect of delaying ambulances at Accident and Emergency.
The regulator has written to trusts across the country revealing concerns about rules and approaches causing delays to ambulance crews.
NHS Improvement states that this presents a risk to safety owing to the fact that it “takes ambulance crews off the road”.
The letter goes on to outline the nature of problems within the ambulance service.
“There is recognition that ambulance trusts’ response to 999 calls is impacted significantly by handover difficulties and protracted turnaround times at some hospital emergency departments. There are also incidents of unacceptable rules being applied by acute trusts to regulate or delay ambulance access and of ambulances queuing outside of EDs to transfer patients.”
NHS Improvement aims to enhance the way that the ambulance system operates, and thus suggested that “no restrictions should be placed on ambulances in order to limit or regulate access to the emergency department”.
Further guidelines indicate that patients should be managed in the clinical setting most appropriate to their acuity.
In order to address the problems, NHS Improvement indicated to trusts throughout the healthcare system that all ambulance handovers longer than an hour will be followed up by its regional leads every day.
The regulator has also developed a new programme with the express intention of ensuring that trusts improve in this department.
“To enable us to work alongside the sector better we have started developing a new programme of enhanced support to help providers continue to improve the experience of those needing urgent medical attention,” a spokesman stated.
A further letter, distributed by NHS Improvement to acute trusts on 17th January, documented the safety risks being accumulated recently.
“Time spent waiting to hand patients over takes ambulance crews off the road and reduces capacity of the ambulance service to respond to new calls,” the letter notes.
The letter also explains that Keith Willet, NHS England medical director for acute care, “has identified the issue of patients being forced to wait for paramedics’ assessment as his top priority for improving patient safety and reducing clinical risks”.
Commenting on the issue, a spokesman for NHS Improvement expressed the keeness of the regulator to address what it considers to be an extremely important issue.
“Improving the handover of patients from ambulances to hospitals is absolutely vital. We know that delays can have a real impact on patient safety by constraining the ability of the ambulance service to attend to the sickest patients promptly. Clinical teams make decisions every day, often under great operational pressure, in order to free up paramedics but there still isn’t a consistent approach in the sector.”