A coroner has warned that a private hospital is relying on NHS ambulances to transport patients despite “being fully aware” of the pressures on the ambulance service and resulting delays.
The warning came at the end of an inquest into a patient who died after a 14-hour wait for an ambulance to transfer him from the private Spire hospital in Norwich to the NHS-run Norfolk and Norwich university hospital a few minutes’ drive away. The last two years have seen a succession of inquests relating to ambulance delays. But in the latest case Jacqueline Lake, senior coroner for Norfolk, expressed concerns over Spire hospital’s use of NHS ambulances when complications and emergencies mean its patients need NHS care.
“Spire Norwich hospital does not deal with multi-disciplinary and emergency treatment at its hospital and transfers patients requiring such treatment to local acute trusts, usually the Norfolk and Norwich university hospital,” Lake wrote in a prevention of future deaths (PFD) report. “Spire Norwich hospital continues to rely on EEAST [East of England Ambulance Service NHS Trust] to transport such patients to the acute hospital, being fully aware of the demands placed on the EEAST generally and the delays which occur as a result.”
The local patient representative group expressed concern in response to Lake’s report. “This is the third inquest we are aware of in the last 12 months in similar circumstances where patients have faced long delays when being transferred from the Spire hospital to the Norfolk and Norwich university hospital,” said Judith Sharpe, deputy chief executive of Healthwatch Norfolk.
None of the PFD reports for the three cases criticised Spire’s clinical care. PFD reports highlight problems that could lead to deaths in future rather than attributing responsibility for the death covered by the inquest.
Research suggests that nearly 600 patients were urgently transferred from private healthcare to NHS emergency care in the year to June 2021 across the UK – around one in a thousand private healthcare patients. But previous analysis by the Centre for Health and the Public Interest (CHPI) thinktank found that some private hospitals were transferring more than one in every 250 of their inpatients to NHS hospitals.
“Transferring unwell patients from a private hospital to an NHS hospital is a known patient safety risk which all patients treated in the private sector face – including the increased numbers of NHS patients who are now being treated in private hospitals because of government policy,” said David Rowland, director of the CHPI. “And despite numerous tragedies and despite the fact that politicians and regulators are fully aware of this risk, nothing has been done to address it.”
A spokesperson for the Independent Healthcare Providers Network said: “Not all healthcare facilities, whether NHS or independent sector, have intensive care provision. In the course of their treatment, patients may sometimes need to be transferred to a setting with intensive care facilities.
“This happens rarely – around one in every 1,000 patients treated in an independent sector hospital will be transferred to the NHS. In such cases it’s important that the right arrangements are in place between providers to safely transfer patients when it is needed.”
A spokesperson for Spire Healthcare said: “Spire Healthcare offers our sincere condolences to the family of the deceased for their loss.
“Spire, like all hospital providers, continues to work closely with the ambulance service and local NHS trusts on ways to ease delays for patients receiving care, recognising that this is a challenge for the entire local healthcare system.”
EEAST said its response times had improved since the start of this year but recognised that more work was needed.