Minister demands reduction of ambulance handover delays at at Morriston

THE Minister for Health has demanded action to reduce ambulance handover delays at Swansea’s Morriston Hospital.

Vaughan Gething said there were “continued challenges” which delayed the transfer of patients into the accident and emergency department.

This in turn affected paramedics’ response times when the next 999 call came in.

The issue was flagged up at a Swansea Bay University Health Board meeting on May 30.

Speaking in the Senedd in the days afterwards, Mr Gething said the Welsh Ambulance Service (WAS) had made a number of improvements this year.

It followed a comprehensive review of the way the WAS categorises calls – in particular urgent but non-life threatening ones, which are classed as “amber” and have no response time targets.

Mr Vaughan told AMs that amber response times over the winter had been quicker than in the same period the year before. “However, there does remain local variation, and whilst amber responsiveness in the Swansea Bay area has improved when compared to last year, there are continued challenges caused by ambulance patient handover delays at the Morriston site,” he said. “In recognition of this challenge, I have directed the chief ambulance services commissioner to place immediate and targeted focus on achieving improvements at this site. “A series of new actions have now been agreed with local clinical teams.”

The expectation is that these measures will reduce the number of times ambulance crews have to wait for over an hour to discharge their patients. The figure just for April this year at Morriston Hospital was 669, compared to 380 in April 2018.

The sharp rise prompted the health board’s chief executive Tracy Myhill to say at the May 30 board meeting: “Ambulance delays are not going in the right direction, and we need to get a grip on that.”

The amber review cited by Mr Gething involved an analysis of WAS response times and other data between April 2016 and March 2018.
The resulting recommendations are being implemented across Wales.

One of the recommendations was that WAS chiefs must ensure staff numbers are sufficient to meet the expected demand.

This resource gap – measured as actual staff availability compared to planned staff availability – worsened slightly between April 2018 and March 2019, according to the latest figures.

There was only one month out of the 12 – January this year – where actual staff availability was higher than planned staff availability.

During the 12-month period there were 64,898 hours lost to ambulance handover delays in Wales, which was on a par with the previous two-year average.

The figures follow a Freedom of Information Request from the Local Democracy Reporter Service.
The WAS also said there were 50 “serious adverse incidents” requiring investigation in 2018-19, of which 29 were initially coded as amber callouts. This was fewer than the previous year but more than the year before that.

The WAS said all such incidents were subject to a “robust review process”. It also said it was taking steps to boost staff availability. Referring to handover delays, the WAS said it worked very closely with all of Wales’ health boards and backed a number of actions to improve delays outside accident and emergency departments. It said it was investing in more advanced practitioners to support patients at home when clinically safe to do so, thus avoiding hospital admissions. “We are also increasing paramedic and nursing clinicians within clinical contact centres and the 111 service who can advise patients on alternative pathways where an ambulance is not the best clinical alternative,” it added.