AMBULANCE provision in Gloucestershire has been branded “an absolute disgrace” – by one of their own paramedics.
Speaking exclusively to the Cheltenham Post the ambulance worker, who asked not to be named, said pressure on paramedic crews is now “beyond breaking point.”
“Things have been totally unacceptable ever since England came out of lockdown last summer,” he said.
The service has a colour-coded four-stage system for grading the pressure of demand, known as Resource Escalation Action Plan (REAP) levels. Green is “steady”, Amber is “moderate”, Red is “severe” and Black is “extreme pressure”.
The Post’s source said: “Our normal state is supposed to be green or amber. REAP Black means the service has the potential to fail. We escalated to REAP Black last September, and have stayed there ever since. This is unprecedented.”
In one local station 25 percent of the paramedics are currently signed off sick due to stress, and three-quarters of the team have either already reduced their working hours in order to cope, or are seeking to do so.
Gloucestershire’s ambulance service, like NHS departments across the country, has faced unprecedented demand since the start of the COVID pandemic. But now the situation is reaching breaking point, ambulances are queuing outside hospitals for hours, and patients are “suffering like never before”, according to one local paramedic.
“I recently brought in a woman with internal bleeding, which was very painful and likely to become a surgical emergency. We queued, and I was unable to control her pain despite my best efforts. She began to writhe; you know severe pain when you see it, they can’t stay still. I went inside to try to escalate her and get her in – nothing. The place was chaotic.
“I eventually pinned down a Doctor who said he would come out to the ambulance and review her. He never came – probably just too busy. We eventually got her in after 3 hours. “That poor woman. Can you imagine if that was someone from your family? It’s an absolute disgrace.”
Since the South Western Ambulance Service officially escalated its situation to REAP Black (“Extreme Pressure”) last September, staff have regularly been experiencing ‘burnout’ from the effort to cope with demand.
“12 hour shifts run over time most days due to the demand and queues. It’s not uncommon for crews to be doing 14 or 15-hour shifts on a regular basis. It’s impossible to have a normal family life when you’re working that hard.”
In an effort to reduce ambulance queues outside hospitals, Accident and Emergency departments across South West England have also introduced “Cohort” areas, which are essentially small wards within A&E, run by paramedics instead of nurses.
“To be honest, ‘ward’ sounds too nice,” our source said. “They are cramped rooms with sick people shoulder to shoulder. Instead of one crew caring for one patient whilst outside A&E in the queue, as soon as a bed, chair or space in ‘Cohort’ becomes available patients are offloaded there.
“We almost never offload directly to an A&E bed now, unless the patient is critical, and even then there’s no guarantee there will be space. This means one Paramedic can be asked to look after up to six patients.
“The idea is that this frees up other ambulances to go back out there, pick up more patients and bring them back to the queue. The general consensus amongst Paramedics is that this is not safe working practice.
“Corners are being cut everywhere you look, it’s so demoralising, it looks like some kind of messy field hospital set-up in a third rate country. This is no way to run a health service.”
Speaking in November, South Western Ambulance Service chief executive Will Warrender said it was “recruiting more people” after receiving “additional funding” from NHS England.
The trust added in a statement at the time that delays were reaching intolerable levels and it was working hard with the NHS to reduce them.
The trust said: “We are experiencing very high demand on our 999 emergency service across the south west area and are asking people not to make any unnecessary 999 calls.”
Chief Operating Officer, Qadar Zada, said:
“NHS services across Gloucestershire continue to experience considerable operational pressures, reflecting the picture throughout the country. These pressures stem from high levels of demand for services, both COVID and non-COVID related, alongside high numbers of patients whose discharge from hospital is delayed.
“This means that at times of peak demand, when our Emergency Departments (ED) are at their busiest, ambulances can queue outside despite the very best efforts of our teams.
“It is important to stress that all ambulance patients waiting to come into our EDs are assessed for their clinical priority to ensure that patients are afforded the correct level of priority.
“The flow of patients in and out of our hospitals is pivotal to enabling patients to be handed over without delay.
“Wards across both our hospitals continue to prioritise the safe discharge of patients to help free up beds in our hospitals. In turn, this enables patients to be handed over to ED by ambulance crews in a timely way and for those patients that need admission from ED, to be able to access a bed without delay.
“Our EDs at Gloucester and Cheltenham remain incredibly busy and we would appeal directly to the public to please think carefully about whether your condition could be treated elsewhere, not least as waiting times for less urgent cases are longer than we would like. Other alternative services including your local pharmacist, GP or Minor Injuries and Illness Units (MIIUs) are available where you can often be seen in a more timely way and parking is available.
For more information visit ASAPglos@nhs.uk or call 111.”