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Patients with sepsis, smoke inhalation and other grave conditions and symptoms are reportedly being treated inside ambulances due to lack of space in the hospitals. Often, hospitals are seeing as many as 17 ambulances queuing outside ward entrances and paramedics requesting doctors come out to offer aid, it is claimed.
Health bosses in Greater Manchester have admitted the NHS is under “exceptional” pressure right now.
And the paramedic, who works for North West Ambulance Service (NWAS), told Manchester Evening News: “They don’t even let us into the hospital with our patients, we’re expected to keep them in the back of the ambulance.
“The staff come out, they might do bloods on the back of the ambulance, a doctor might come out and assess them on the back of the ambulance.
“So, the bed status is the biggest thing that we hear about, but we also know that because hospitals are struggling with staff shortages, [the hospitals are] basically using the ambulances and the crews as an extension of their department.”
It’s ridiculous, honestly. There can be 17 ambulances parked up at any one time, and that’s at one hospital
The medic added: “It’s ridiculous, honestly. There can be 17 ambulances parked up at any one time, and that’s at one hospital.
“We have had people who have been flagging with red flag sepsis, they have been left outside. They’re poorly.
“I took a smoke inhalation after a house fire down to Royal Oldham, they waited under the canopy for six-and-a-half hours, outside. He was on oxygen throughout, we were basically pinching oxygen cylinders off each other’s vehicles to keep him oxygenated.”
Hospitals across Greater Manchester are having to “divert” patients to units seeing less demand, adds the paramedic, who wishes to remain anonymous.
The “divert” system is a ‘well-established’ method of managing busy hospitals, according to regional health bosses.
“Diverts” are done through a “24/7 operational hub” with access to live information from the different hospitals across Greater Manchester, helping the system to ‘react to issues quickly’ and prevent pressures “before they arise”.
The system “excludes people in extreme clinical need”.
But the paramedic fears short term solutions will not be enough to carry the NHS into what is promised to be a heavy winter for the service, as Covid cases rise and the number of hospitalisations increase, according to the latest figures from Greater Manchester Health and Social Care Partnership.
“The oldest job I went to on Wednesday (October 20) was 18-and-a-half hours old,” said the paramedic. “It was an elderly female who had a fall, and was believed to have a broken ankle. She couldn’t walk, she couldn’t get herself to hospital, very elderly.
“She had been assisted into a chair by one of her neighbours and she had been left there, overnight, waiting for an ambulance.
“Another job I went to was only 14 minutes old. It genuinely does depend on what they are saying on the phone. Obviously, the highest coded calls, we’re never going to get to them in time, so to speak.
“We all recognise that we are failing with the time frames.
“But there could be jobs 24 hours old that are still waiting on ambulances.”
Meanwhile, non-emergency patients can be left for more than “24 hours” as ambulances are unable to be sent out to them, caught up in hospital queues where they cannot be relieved of patients.
Non-emergency patients can also come directly from GPs, says the paramedic, which is an “inherent problem” adding to the volume of cases NWAS is asked – and unable – to attend.
“We are still taking a lot of GP attendances into hospitals because they are unmanageable for the GP or the GP wants further investigation doing [at hospital]. So the impact is still there from them,” the medic said.
“If somebody just wanted transport, it wouldn’t be coming. We’re too busy.
“Everything is getting booked as a higher priority, or a category two emergency. And like I say, they are waiting for six, 12, 18, 24 hours. We get to you when we can.”
She added: “GPs have to book those. GPs will book it as an admission. [GPs grading calls higher] is an inherent problem. It could be a new cardiac issue – they’ve done and ECG or they’ve presented with some kind of a pain and the GPs don’t have the facilities to do an ECG or they want them to go in for bloods.
“It can be arranged blood results; it can be Covid symptoms, we’re seeing a lot of Covid patients again. It can be anything, honestly, absolutely anything. A GP has been out and they’re not happy with what they’ve seen, or they’ve discussed it over the telephone, they’re not happy with what they’ve heard.
“The next thing, we’re requested and off we go.
“We’re seeing a lot of Covid patients again, some we are managing to leave at home to be self-cared for, some we are having to take into hospital. Some are not testing positive but have the classic Covid symptoms.”
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Greater Manchester Health and Social Care Partnership responded to the paramedic’s claims – a body which represents all the major players in the health and wellbeing of people in Greater Manchester.
The partnership includes services like the national and regional NHS organisations, local authorities, the Greater Manchester Combined Authority (GMCA), primary care groups, the voluntary sector, the police and fire services.
It says the NHS in Greater Manchester is facing an ‘exceptionally difficult period’ amid myriad of pressures.
Sarah Price, interim chief officer of the partnership said: “The NHS in Greater Manchester is facing an exceptionally difficult period as we tackle the backlogs of people waiting for care that have built up during the pandemic, delivering two vaccination programmes (Covid-19 and flu) and starting winter with a rise in Covid cases.
“Increased pressure on ambulance services, which includes 111 calls, reflects increased pressure in other parts of the NHS.
“We understand this is a worrying time for people and places extra strain on all NHS and care staff. Patient safety will always be our highest priority. This means the ambulance service and emergency departments (A&E) will treat the sickest patients first and others may face a longer wait.
“Reducing waiting times is a priority and our plans to improve this include additional support for 999 calls to increase call handling capacity by trained professionals and support for mental health calls to ensure people can access support from the right person, in the right place.
“Hospitals in Greater Manchester are working to increase the number of beds, improve patient flow and facilitate timely discharge. At the same time, we are finalising plans to use national funding to improve access to general practice for patients.
“It’s really important to recognise the efforts of NHS and care staff across all of Greater Manchester who are working incredibly hard to provide the best care and support possible. Our staff are working tirelessly to ensure we keep our patients safe whilst responding to high levels of demand.
“Going to the right place for treatment has never been more important. Everyone can help us reduce delays by only calling 999 or going to emergency departments (A&E) for life-threatening emergencies and contacting NHS 111 online or by phone for other medical assistance and advice.”
North West Ambulance Service said staff are working “under extreme pressure” at the moment.
A spokesman added: “Our staff are continuing to work very hard under extreme pressure to ensure that everyone who needs an ambulance gets one.
“To help us, we are increasing the numbers of ambulances available by utilising some of our Patient Transport Service staff and with the support of private providers.
“We are also taking on additional call handlers and clinicians in our 999 call centres. As always, the public can assist by only calling 999 in life-threatening emergencies, and consider if other options including NHS 111 online, GPs and pharmacies may be more appropriate.”
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