In 999 emergencies, patients face life-threatening postcode lottery due to ambulance waiting times, report warns

A damning report by MPs has warned that patients face a life-threatening postcode lottery of ambulance response times in an emergency.

The court of audit found that the speed at which an ambulance arrives depends too much on the patient’s place of residence.

The new report also says that not enough is being done to combat the clogging of hospital beds, which means there is not enough capacity for new arrivals.

MPs say the NHS has more money and staff than ever before but has failed to use it properly to improve access for patients who need urgent care.

Performance in this area has fallen “well below the standard the NHS says patients should expect and receive”, members added, calling on the NHS and the Department of Health and Social Care to make improvements.

In some parts of the country, people have to wait more than three minutes longer for an ambulance to arrive in a life-threatening emergency, the commission said.

It highlighted that average ambulance response times for the most serious incidents – including cardiac arrest – in 2021/22 were between six minutes and 51 seconds for the London Ambulance Service and 10 minutes and 20 seconds for the South Western Ambulance Service.

There are also big differences in the way the NHS sends patients home when they no longer need hospital care.

In the lowest performing areas, the length of stay required to discharge medically fit patients is more than twice as high as in the best performing areas, the report said.

The number of patients who stayed in hospital even though they no longer needed to be there averaged 13,623 in the last quarter of 2022/23 – compared with 12,118 in the same period of 2021/22.

Staying in the hospital too long can delay recovery and prevent patients who need surgery or other care from being admitted.

The report blames problems with discharging older patients from hospital to adult social care, delays in hospitals’ own processes, transfers to NHS community settings and the provision of short-term care packages or nursing or residential care.

The latter group may have to wait up to five weeks from the time they can leave the hospital.

The MPs said: “Not enough is being done to address the systemic problems with redundancies which are within the control of the NHS and its hospitals and are not due to external factors.”

The NHS has missed targets for waiting times in emergency departments since July 2015 and for the time it takes emergency staff to hand patients to doctors since November 2017.

“Against this background, we asked how effectively the (health) department has managed to hold NHS England to account for its declining performance,” the committee added.

It said investment in technology and infrastructure was “vital” to improve productivity, but the Department of Health and Social Care did not appear to have planned for such investment.

The new report also identified bed-blocking as a critical problem, with patients from the lowest-performing areas spending almost twice as much time in hospital as those in the best-performing areas (file photo).

Furthermore, NHS England’s existing plans are flawed “given the scale of the problem”.

The report also highlights very high levels of health problems and staff turnover, with the PAC unconvinced by NHS England’s approach to tackling staff shortages.

NHSE hopes to retain 130,000 staff who would otherwise leave over the next fifteen years, a target the PAC describes as “highly questionable”.

Labor MP Dame Meg Hillier, chair of the cross-party PAC, said: “Patients with long waiting times and overwhelmed staff working in a system that is not delivering deserve better.”

“If we exclude demand-driven spending such as benefits, health accounts for around 40 per cent of daily budgeted spending by Whitehall departments.”

“It is crucial that it brings benefits to patients.” Professor Julian Redhead, NHS England’s national clinical director for emergency care, said performance had improved since then and staff were working hard to meet record demand.