A&E redirecting increasing number of ambulances to other hospitals

Sarah Marsh
A record number of ambulances were diverted from busy A&E departments last winter. Photograph: Rui Vieira/PA

A record number of ambulances were turned away from busy A&Es this winter and sent to other hospitals, preventing paramedics from responding to urgent calls quickly enough, according to a study.

The Nuffield Trust, a health thinktank, looked at NHS England data and found that nearly twice as many patients arriving in ambulances were turned away from hospitals and sent elsewhere this year compared with the same period over the last three years.

Ambulances were redirected 478 times over the three-month period from December to February, compared with an average of 249 times in 2013-14, 2014-15 and 2015-16. The NHS refers to such incidents caused by a lack of physical or staff capacity as “diverts”and says they should be a last resort.

The thinktank said this had a direct effect on paramedics’ ability to respond to emergencies – with none of the three main response targets having been hit since May 2015. Prof John Appleby, Nuffield Trust chief economist and lead author of the report, said: “There’s rightly been a lot of focus recently on the delays ambulance crews face in being able to hand over their most seriously ill patients at A&E.

“But what our research today has uncovered is the huge increase in the number of times this winter [that] ambulance trusts have been told they must take patients to another hospital altogether, because an A&E unit simply doesn’t have the capacity to accept any more patients.”

Of the 233,472 most serious category A calls received in January this year, at least 95% should have been responded to in 19 minutes. But 29,000 calls were not picked up within this timeframe, meaning 88% of responses met the target.

Richard Webber, national spokesperson for the College of Paramedics and a senior paramedic in the NHS, said: “While we are sympathetic to hospitals that are forced to implement diverts so that they don’t reach dangerous levels of overcrowding, in non-urban areas in particular the extra time taken to reach more distant A&E departments is significant.”

The report also found that paramedics were under increased pressure, with demand for the service rising at a faster rate than emergency admissions to hospital and A&E attendances. The Nuffield Trust said that morale in the sector was also poorer than other parts of the health service.

The figures come as the government faces calls to address growing demand on A&Es. In January, patients in England experienced the worst month of delays in emergency departments since a four-hour target was introduced 13 years ago.

Jonathan Ashworth, the shadow health secretary, said: “Theresa May has overseen a shocking and unacceptable decline in standards for the NHS this winter. Our ambulance services are under increasing pressure and we know that ambulance staff across England are really feeling the strain. They deserve much more support from the government.

“The truth is that years of under-investment by the Conservatives have left hospitals unable to cope with rising demand, and now shocking numbers of ambulances are being diverted because A&Es are stretched to the limits. The government urgently needs to set out what action they’re going to take to make sure patients and their families never have to suffer a winter like this again.”

An NHS England spokesman said: “Currently too many ambulances are dispatched to simply hit targets rather than attend to those patients most in need. This is why we’re carefully testing a change to the way in which the services can respond and will make our recommendations known in the coming weeks.”

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