‘It feels like a war zone’: Exhausted ambulance workers in England tell their story

PAramedics in England cannot respond to 3,500 urgent 999 calls every day as they wait outside hospitals to transfer patients, putting other lives at risk, a Guardian investigation has found.

Here, two ambulance service employees describe their experiences on the front line. They say it ‘feels like a war zone at times’ amid the worst NHS winter crisis in years.

Reena Farrington, ambulance control room supervisor in the West Midlands

“I feel emotionally exhausted at the end of a shift, despite my 26 years of service. You never stop caring, and I often find myself in tears.

“Talking to patients and their loved ones as they deteriorate is so disturbing. People are calling back and desperately trying to get help. And unfortunately, some people die while waiting for an ambulance.

“This cannot continue. The heavy emotional strain is relentless and has major consequences for the control room personnel and those on the road.

“Delays in hospitals are holding up staff and people are calling 999 because they can’t see a GP. We are everyone’s last resort.

“In the West Midlands we have a great triage process, which often allows us to find alternative, more appropriate help for people who have nowhere else to go. But managing these calls is also challenging and time-consuming.

“We often have to ask people to come to the emergency room as safely as possible. It’s never pleasant to say those words, and it’s horrible to be in this position because we know it’s far from ideal.

‘Some call three or four times, hoping we can arrange an ambulance, but that doesn’t work. It’s really difficult.

“On Monday we had calls on hold until 7 p.m. We call people back; we are doing everything we can to find other ways to get them to the hospital.

“It’s both soul-destroying and overwhelming. Sometimes people become aggressive out of frustration, that’s understandable.

“The whole situation is just terrible. I’m here to do my best for my patients, and it’s heartbreaking that I can’t do more.

“Not being able to help seriously ill people has major consequences for the staff. It’s horrible to see the calls piling up at the control room as hundreds of people wait for ambulances.

“It sometimes feels like a war zone. Delays mean some crews can only complete one task per shift, sometimes even two if they’re lucky.

“It can be very humiliating when patients have to be cared for for hours in the back of an ambulance. Staff must ensure that patients can go to the toilet, eat and feel as comfortable as possible. But that’s hard, since they’re probably in pain or feeling terrible.

“After my last shift, there were less than 400 people waiting for help. How can I get rid of that?”

Lyndsay Hewitt-Brown, a paramedic based in Leeds

“I have worked for Yorkshire Ambulance Service for ten years and this is the worst I have ever seen. Over the past two weeks, some of my colleagues have waited with patients outside hospitals for up to eight hours.

“There were sometimes queues of perhaps seventeen ambulances outside the emergency department.

“The worst wait I’ve had so far was three hours for a critical illness patient. The hospital staff was of course aware of the situation, but there were no beds available.

“This meant the patient had to be seen in the corridor, but we couldn’t leave them as they were still on our stretcher, which was necessary for the next consultation.

“Patients should be continuously monitored from the moment they are in the care of an ambulance crew and treated accordingly. But the supply of medicines and oxygen is limited.

“So if we have to wait for a longer period of time, we are afraid that we will soon run out, unless we can borrow from other ambulance personnel.

“We are aware that there are capacity issues in the emergency department when we transfer patients. There are not enough staff, there are no beds available and the hospital corridors and waiting areas are full.

“But we can’t reach other patients if we’re held up, and that’s frustrating. We know that if people take a long time to receive treatment or be hospitalized, there can be a detrimental effect on their health.

“When we finally get there, we need to make sure patients know to expect a long wait in the hospital. Sometimes, instead of waiting for hours, they choose to relieve themselves before receiving treatment.

“Often that means they go home, their condition worsens and they end up having to be brought back all over again. By then they have deteriorated further.

“The situation became much worse last month as respiratory diseases and norovirus cases increased.

“Due to the current pressures, we often work after our shifts have ended, so it can be extremely tiring. But I never think about leaving.

“I feel part of the NHS and finding another job will not improve the situation. It’s about making sure patients get the best care we can provide.”

Hewitt-Brown and Farrington are volunteer workplace representatives for Unison, Britain’s largest health association.

• In Great Britain Frontline 19 is an independent not-for-profit organization providing free and confidential psychological support to frontline NHS staff