Patient harm ‘normalized’ as paramedics work round the clock, monitor warns

Patient harm has become “normalised” as burnt-out paramedics work non-stop, the NHS has warned.

Concerns have been raised about the pressure on South East Coast Ambulance Service staff Commission on the quality of medical care (CQC).

Senior staff told the CQC that the ambulance was having a negative impact on patients delays but it was now seen as ‘part of the culture’.

The CQC found after a recent inspection that “many staff work overtime and do not always get their breaks on time”.

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Figures from the trust showed that 41 per cent of crews were able to take a break when being allocated, and 10 per cent of staff finished their shifts late.

The news comes as unions have opened the ballot for 15,000 ambulance workers to vote on strike action over pay.

The CQC found that pressures on staff at South East Coast Ambulance Service, such as long waits outside the emergency department, led to low morale and staff feeling unappreciated.

It added: “Staff reported feeling frustrated and burnt out, and that senior management did not understand or respond to the challenges or concerns they raised.

“Some local senior managers described how harm to patients caused by delays in reaching them had become a normalized culture.”

The Care Quality Commission also found that people are waiting in queues after making 999 calls. 53 emergency calls and 123 urgent calls were made per day.

It said: “At times there were many Category 3 standouts [urgent] patients awaiting EMS or paramedic evaluation.

“During this busy time, these patients had long waits for crews and callbacks. Therefore, this group of patients was at risk of worsening while they waited for an answer.’

For one week, the ambulance service was 10 per cent understaffed to meet demand, with a private ambulance being used, according to the report ambulances to help offset their workload and help with staff shortages.

Some ambulance crews reported difficulties approving leave requests, which the CQC said had a “negative” impact on staff.

The regulator warned of long ambulance response times, but admitted that ambulances were also affected by delays in transfers outside the hospital.

Last year, 26 patients were reported to have been “seriously harmed” by ambulance delays, according to figures handed to the CQC.

However, it said the incidents involved “potential harm” caused or “not prevented” by the service.

Recent figures from the Association of Emergency Managers estimated that there were likely more than 4,000 patients who suffered “serious harm” due to delays in ambulance transfers.

Dinah Westwood, CQC network director, said: “During our inspection of South East Coast NHS Foundation Trust, our inspectors found that frontline staff are doing their best to provide safe and effective care to people in Kent, Surrey and Sussex.

“However, additional pressures on services, which included increased staff sickness and increased delays in handing over services from partner organisations, meant that the quality of care we saw declined.”

Last week, the regulator warned in its report on the state of care that ambulance handover delays were a symptom of a “closed” health and care system.

Siobhan Melia, Interim Chief Executive of South East Coast Ambulance Trust, said: “I am delighted that the excellent care provided by our staff has once again been recognized and rated as ‘Good’ by the CQC, despite the huge pressure, with which they face every day.

“I am very proud of the quality care and compassion of our staff. We have already taken our culture and leadership issues very seriously and are committed to making further improvements to ensure we improve our response to patients and the working lives of our staff.”