Geoffrey Fuller

“Emergency department crowding is associated with increased mortality amongst admitted patients;”

“On the day of Mr [name redacted] ambulance delay, RCHT ED was accommodating 105 patients. ED has a capacity of 42 patients.”

“My concern here Is that handover delays are impacting upon response times in respect of patients requiring emergency treatment &/or conveyance to hospital.”

“Significant handover delays 1. The court noted that the NHS national target is for ambulances to handover patients to hospital is within 15 minutes of arrival.”

“What is of concern, however, is that these gains have not been maintained and the situation has now worsened with 15-20 ambulances waiting outside the ED on occasions over the last three weeks.”

“On arrival at Royal Cornwall Hospital (RCHT), Mr [name redacted] spent a further 2 hours and 52 minutes before being handed over to the emergency department.”

“The root cause for ambulance delays was found to be the lack of social care provision in Cornwall, whether care packages or beds in care homes.”

“The court found there was insufficient bed availability on acute wards which was attributable to significant numbers of patients in hospital with no reason to reside (NCTR), these being patients who are medically optimised but cannot be discharged due to lack of onward care support.”

“I am concerned that these continuing delays for ambulances at hospital handovers reflects a risk of deaths into the future.”

“These handover delays lead to the unavailability of ambulances to respond to emergency calls. Furthermore, the average handover delays conceal spikes such as that which led to the long delay in this case.”

“There is a direct connection between the risk of excessive ambulance delays and inadequate social care provision, community hospital provision and primary healthcare support for discharges in Cornwall.”

“The court noted the main cause for the numbers of NCTR patients was insufficient social care provision, whether commissioned by social services or NHS.”

“Continuing average handover delays (and therefore response delays) which create a risk of future deaths. The averages conceal spikes of delayed handover and ambulance response times which increase the risk of mortality.”

“These handover delays lead to the unavailability of ambulances to respond to emergency calls. Furthermore, the average handover delays conceal spikes such as that which led to the long delay in this case.”

“delay in discharge for patients ready to be discharged due to lack of suitable social care in the community is causing congestion”

“The court noted the main cause for the numbers of NCTR patients was insufficient social care provision, whether commissioned by social services or NHS.”

“there are a significant number deaths associated with long waits in the emergency department”

“Such long delays increase the risk of mortality.”

“Delay in ambulance response attributable to delays in handover of patients at Royal Cornwall Hospital”

“The court noted that the NHS national target is for ambulances to handover patients to hospital is within 15 minutes of arrival.”

“Significant handover delays leading to ambulance resources being tied up at hospital with increased risk in mortality for patients in the community waiting for emergency ambulances”

“Significant handover delays”

“The evidence given to the inquest indicated significant delays in the handover from the ambulance to the ED team. This was due to pressure on the ED but meant that ambulances were tied up for longer than necessary and then had a knock on impact on the ability of the ambulance service to respond to calls.”

“Significant handover delays”

“Insufficient social care provision leading to large numbers of patients in hospital who are otherwise fit for discharge, thereby impeding patient flow through hospital”

“Data indicates that RCHT have been failing to meet the 4-hour target for a significant number of patients.”