One GP spells out the risks for patients, and anxiety for health staff, when a patient in urgent need of hospital care ends up spending hours at a GP surgery – or their home – because no ambulance arrives to take them.
“In the summer I visited a patient at home who was barely conscious. Their sats [Oxygen saturation levels] were fluctuating between the upper 70s and low 80s. It took five minutes for the 999 call I made to be answered and then another 45 minutes for the ambulance to turn up. The situation is terrifying.
“Sadly that wasn’t an isolated experience. A few weeks later a patient came into the surgery with cardiac-sounding chest pain. When that happens generally the concern is that the patient may be having a heart attack. Again I was holding on the 999 line, waiting minutes for an answer. There was a wait of almost an hour before the paramedics arrived.
“In this instance, there were other health professionals around who could help if needed and also access to equipment should the situation have suddenly deteriorated, such as oxygen and an automated defibrillator, in case someone ends up with low oxygen levels or in cardiac arrest. I won’t speculate as to whether this particular patient could have died. But if a person has features of cardiac-sounding chest pain, there is the potential for deterioration and maybe cardiac arrest.
“My overriding feeling during that hour-long wait was shock that again there was a wait for the 999 call to be answered and a delay for help to arrive. It was at this point that it occurred to me that maybe the delays were becoming more commonplace, rather than being a one-off occurrence.
“I think back to my experience with the unwell patient on the home visit. I had no access to oxygen, no defibrillator. I was watching, waiting. I recall adjusting the oxygen saturation probe. If this clinical scenario had been playing out in a hospital, with the patient displaying those vital signs, a crash call would have been put out for a patient in peri-arrest.
“If this is frightening for a doctor, I can only imagine how helpless a non-medically trained friend or relative would feel and how frightening it must be for them.
“Increasingly, there are stories about relatives calling for an ambulance because an elderly relative has fallen and broken their hip and ended up waiting as much as 12 hours for help to arrive. Aside from the indignity, and the pain that must be experienced, the complications of being on the floor for that long start to stack up: dehydration, pressure sores, pneumonia, hypothermia, the consequences of muscle breakdown on the kidneys.
“Although the initial injury may not be life-threatening, the consequences of being on the floor for so long can end up being catastrophic for an elderly person. I wonder how the prime minister or the health secretary would feel if they found themselves in a similar situation with a loved one?
“The ambulance service are doing their absolute best in wretched circumstances, as is everyone who works in the NHS. How can you reconcile the emotional impact on paramedic teams that are increasingly finding themselves in situations where time has run out? Being held up outside A&Es, waiting to hand over, but unable to because there is nowhere for the patient to go.
“Given that the system was cracking in the summer and by October every ambulance service was at the highest level of alert, I fear what is to come this winter.”
As told to Denis Campbell. The GP asked to remain anonymous
