- Patients in the worst-performing areas stay in hospital twice as long on average
Patients are facing a life-threatening postcode lottery of ambulance response times in an emergency, a damning report from MPs has warned.
The Public Accounts Committee discovered that how quickly an ambulance arrives depends too much on where the patient lives.
The new report also says not enough is being done to tackle hospital bed blocking, meaning 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 them properly to improve access for patients needing urgent care.
Performance in this area has fallen ‘well below the standard that 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.
A report by MPs has found that emergency ambulance response times vary widely depending on where a patient lives (file photo)
People in some parts of the country are having to wait more than three minutes longer for an ambulance to arrive if they are dealing with a life-threatening emergency, the commission said.
It highlighted that in 2021/22, average ambulance response times for the most serious incidents – including cardiac arrests – ranged from six minutes and 51 seconds for the London Ambulance Service to 10 minutes and 20 seconds for the South Western Ambulance Service.
There are also big differences in how the NHS performs in sending patients home when they no longer need hospital care.
Lengths of stay in the worst-performing areas for discharging medically appropriate patients are more than double that in the best-performing areas, the report points out.
The number of patients staying in hospital despite no longer needing to be there averaged 13,623 in the final quarter of 2022/23 – up from 12,118 in the same period in 2021/22.
Too long a hospital stay can hinder recovery and prevent patients needing surgeries and other care from being admitted.
The report blames problems in 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.
This latter group may be forced to wait up to five weeks from the time they are ready to leave the hospital.
The MPs said: ‘Not enough is being done to tackle the systemic problems with redundancies that are within the control of the NHS and its hospitals and cannot be attributed to external factors.’
The NHS has missed targets for emergency department wait times since July 2015, and the time taken by ambulance staff to hand over patients to doctors since November 2017.
“Against this background, we asked how effective the (health) department has been in holding NHS England to account for its declining performance,” the committee added.
It said investment in technology and infrastructure will be ‘critical’ to improving productivity, but the Department of Health and Social Care ‘does not appear to have budgeted for such investment’.
The new report also identified bed blocking as a critical problem, with patients from the worst-performing areas spending almost double the time in hospital than those in high-performing areas (File Photo)
Furthermore, NHS England’s existing plans are lacking ‘given the scale of the problem’.
The report also highlights very high levels of staff ill health and staff turnover, with the PAC unconvinced by NHS England’s approach to tackling staff shortages.
NHSE hopes to retain 130,000 staff over the next fifteen years who would otherwise leave, an ambition the PAC describes as ‘highly questionable’.
Labor MP Dame Meg Hillier, chair of the cross-party PAC, said: ‘Patients facing long waits and under-pressure staff working in a system that doesn’t deliver results deserve better.
‘If we exclude demand-driven spending such as benefits, healthcare takes up around 40 per cent of the daily budgeted expenditure of Whitehall departments.
‘It is critical that this delivers benefits to patients.’ Professor Julian Redhead, NHS England national clinical director for emergency care, said performance has since improved and staff are working hard to meet record demand.