The ‘Postcode Lottery’ of Emergency Ambulance Wait Times

People needing an emergency ambulance face a “postcode lottery” on how long they will have to wait depending on where they live, a report by MPs reveals today.

It says that bad long-term workforce planning, bed blocking in hospitals, and lack of new technology are all contributing to an uneven ambulance service across England.

MPs on the House of Commons’ Public Accounts Committee found that services in the south-west and east of England were particularly challenged and disproportionately affected by problems.

Average ambulance response times for the most serious incidents varied from 6 minutes and 51s in London; to 10 minutes and 20s in the south-west in 2021-22. Average 999 call response times ranged from 5.4s in the West Midlands to 67.4s in the south-west.

Labour’s Dame Meg Hillier, the committee’s chair, said: “Anyone who has had recent contact with the NHS knows it is in crisis. Patients suffering long waits and hard-pressed staff working in a system which is not delivering deserve better.”

The report says that failures to meet national standards for the handover of patients to hospitals since November 2017 and ambulance waiting times since July 2015 – well before the pandemic – have made matters worse. These have since recovered from the worst days of the Coronavirus crisis.

Bed blocking caused by the shortage of care home places has got worse in the past year as the social care system is also in crisis. The number of people stuck in hospital has risen from 12,118 between January and March 2021; to 13,623 in the first quarter of this year.

Lack of new technology has also delayed people taken to hospital to get a bed. Some 21 NHS trusts do not have an electronic register of patients and only four out of 215 trusts have a state-of-the-art electronic bed management system. Another 16 trusts are planning to install one but will have to raid their capital budgets to provide it as the Government has not given the extra cash.

The report is also critical of the financing of the long-term workforce plan by NHS England, which has recently been promoted by the Government. It depends on the NHS retaining some 130,000 staff who would leave as the health service has a 9% staff turnover every year.

“The realism of the assumptions underpinning this aspiration seems highly doubtful, given NHS England has identified multiple dependencies on other factors and unknowns,” according to the report.

The committee was not impressed by the costings for long-term planning either – particularly as ministers have not released any figures.

“The plan does not include any estimate of total additional running costs for the significant increase in workers it has identified, such as salaries for an extra 260,000 to 360,000 staff,” the report states. “There is no information available on either the scale or source of how staff costs in future years will be met. Neither is there any cost or funding information on the other enablers without which the plan will fail for patients, such as expenditure on other salaries, estates, technology, and infrastructure.”

Professor Julian Redhead, NHS England’s national clinical director for urgent and emergency care, said: “While this report includes data which is more than two years old and coincided with a once in a generation pandemic, it is right to note the NHS has been under increasing pressure with staff experiencing record A&E attendances, hospitals fuller than at any point in their history and with thousands of beds taken up each day, in part, due to pressures in social care.

“It is testament to the hard work of staff and results of our NHS winter plan – rolling out 800 new ambulances, 10,000 virtual ward beds and work towards 5,000 extra core beds – that waiting times for ambulances, 999 calls and in A&E have improved across the country during this financial year.

“This progress has come as the NHS has committed to delivering £12 billion of annualised savings by 2024/25 – all while dealing with more than a 100,000 staff posts being vacant.”