Some of the country’s GPs are advising patients who need urgent hospital care to “get an Uber” or use a relative’s car because of England’s worst ambulance service delays.
In some cases, patients with breathing difficulties and other potentially serious conditions are told that they are likely to move from general practice to accident and emergency more quickly if they travel by taxi or private vehicle.
Figures from NHS England show that October’s average ambulance response time for category 1 to 3 emergencies, covering all urgent conditions, appears to be the highest since the categories were introduced. introduced nationally in 2017. Some patients requiring emergency treatment may have to wait several hours for an ambulance to arrive.
Dr Selvaseelan Selvarajah, a GP partner in east London, said: “If someone is not having a heart attack or a stroke, my default advice is ‘do you have someone who can drive you or do you want to get a Uber?’
“These are patients who may have difficulty breathing or have severe abdominal pain, but their lives are not in immediate danger.” He said these patients would have been taken by ambulance beforehand.
Health chiefs say the biggest delays in ambulance services are being caused by delays in delivery to A&E departments, with vehicles queuing for hours before seeing their patients.
The proportion of delays of more than an hour for ambulance transfers to hospital in England rose from 3% in October 2020 to 18% in October 2022, according to the latest figures published by the Association of Ambulance Executive Directors. The number of deliveries longer than one hour reached about 52,000 in October, the highest number so far.
Dr Neena Jha, who works as a substitute GP in Hertfordshire, said: “I’ve never seen ambulance services put to this degree because of the pressures they’re under. It’s very worrying when it comes to a very sick patient.
“If someone needs an urgent transfer to accident and emergency, we don’t trust the ambulance service. We call taxis or ask relatives to drive them if they want to be stable on the trip.
“I’ve had patients with declining oxygen levels, who are pretty bad, and I’ve been quoted an 18-hour wait for an ambulance.”
The NHS says the problem of ambulances queuing at A&E departments is caused by hospitals being full. Photograph: Andy Rain/EPA
Jha said it was often a dilemma whether to keep a patient in the practice and wait for an ambulance with oxygen on hand, or risk them going unaccompanied to the hospital to ensure they have faster access to ‘medical care they need.
He said delays in the ambulance service were highlighted when he was treating a baby this month at risk of cardiac arrest. He had initially been given a waiting time of two and a half hours and said the baby’s life could have been saved because a vehicle was diverted and arrived at the practice where he worked within 10 minutes.
In April it was reported that Deborah Lee, head of the Gloucestershire Hospitals NHS Foundation Trust, was taken to hospital by her husband after a suspected stroke because he had heard him complain about the delays in the ambulance She wrote on Twitter: “What if my husband hadn’t been there and my daughter had called an ambulance and they had put me in the [Category 2] ‘pile’?”
GPs say they are increasingly concerned about the risk to patients due to wider failings in the health system. Doctors at a conference of local medical committee representatives on Thursday backed a motion saying “general practice in England is unsafe due to a shortage of doctors and lack of investment”.
Dr Kieran Sharrock, vice-chairman of the British Medical Association’s Committee for General Practitioners in England, said: “We are committed to our patients and so we continue, but we know that this trajectory for general practice cannot continue if you want to survive.”
The NHS says the problem of queuing for ambulances in A&E departments is caused by hospitals being full, with delays in discharging patients to community or social care. An NHS spokesman said: “Ahead of what is likely to be a challenging winter for the NHS, services are facing considerable demand, with October the busiest ever for A&E attendances, difficulties in discharging thousands of patients who are medically fit for discharge, and this is alongside new data this week showing a 10-fold increase in the number of flu cases in hospital in compared to last year.
“NHS staff are working incredibly hard to prepare for the busy period with plans for new 24/7 system control centres, fall response services and extra beds and call handlers, so it’s vital that people continue to come forward to get care when they need it. using 999 and A&E in emergencies and 111 online for other health conditions.”