Western Morning News: Why proper ambulance funding is urgently needed

Imagine you’ve had an accident and have a badly sprained knee or ankle. It doesn’t require urgent medical attention but you can’t walk or drive, you’re somewhere remote, so you call an ambulance – it could happen to any of us.  

How long would you expect to have to wait for the ambulance to arrive to this “Category 4” incident - one of the least serious call-outs that includes vomiting, diarrhoea or urine infections?  

Under NHS response time targets, 9 out of 10 of these incidents should be sorted within 3 hours. However in Devon, according to January 2024 figures, the longest wait time was nine hours – three times as long, and a very long time if you’re in pain.  

It’s shocking, but what’s worse is that South West Ambulance Service isn’t only underperforming in Category 4 responses. Last year it ranked consistently near the bottom across every category of ambulance response times. 

Now, the geography of rural Devon is not conducive to speedy ambulance response times. I would challenge anyone to drive along our hedge-lined rural roads at speed, even with a blue light flashing.  

So, it’s no wonder that our figures might be lower than national NHS targets dictate. But these figures are particularly concerning in the context of the proposed move of out of hours emergency cardiac services from Torbay Hospital to Exeter.  

Currently, patients in Torbay and South Devon face significant delays, with ambulances already struggling to meet response time targets. But with the relocation of cardiology services, ambulances will now have to travel an extra 20 miles to Exeter after collecting and stabilising a patient. 

And for those who live in the most southern part of my constituency of South Devon, Dartmouth, for example, this is a significant extra travel time on top of what is already quite a long and slow journey.  

This extra travel time will delay critical interventions for heart attack patients. For every 30-mintue delay to treatment, we know there is a 7.5% increase in mortality. In other words, that’s 15 people out of every 200 who could lose their life because of an extra half hour delay.  

In March, I and other local MPs met with a dozen cardiologists at Torbay Hospital. They told us that they’ve been calling on Devon Integrated Care Board (ICB) for a year not to go through with this change, and that no evidence has been presented to justify it.  

Most worryingly, the South West Ambulance Service didn’t know anything about this proposed move. After the meeting, I wrote to Devon’s ICB demanding the rationale behind this decision. I’ll be meeting with NHS Devon’s CEO soon about this.  

Reading over the January 2024 figures, another issue came to me, and it’s one I raised in a recent parliamentary debate about ambulance wait times.  

Currently, strokes are labelled as Category 2 incidents. That puts them on par with chest pain, but, crucially, deems them less serious than cardiac or respiratory arrest.  

Personally, I find this strange. We all know time is everything when it comes to a stroke. The first 3 hours are critical for intervention as brain tissue continues to deteriorate after that, so surely, it would make sense to classify them alongside other time sensitive conditions, like a heart attack. 

Fortunately, I’m not alone in this view. There is growing support for treating strokes as Category 1 emergencies, partly fuelled by poor ambulance wait times. In the southwest, the mean time for an ambulance to respond to a Category 2 call was nearly 52 minutes, against an NHS target of just 18 minutes. The longest was 1 hour, 53 minutes.  

Changing the categorisation of strokes could ensure that ambulances prioritise stroke victims as they would a cardiac arrest or a trauma cause, which could improve response times and overall care.  

Now, obviously, this would put yet more pressure on ambulance services. However, with all the excellent public education campaigns about recognising stroke symptoms, ambulances are simply not arriving in time to provide the necessary treatment.  

Our paramedics and ambulance services have so much to offer, from providing life-saving medical care to delivering care in the community. Yet in the winter of 2023-24, ambulances across England collectively spent an unbelievable 112 years waiting outside hospitals to hand patients over.  

What an astonishing and dangerous waste of resources for them to be stuck for hours waiting outside crammed A&Es.  

The crisis in our social care system goes a long way to exacerbating the bed blocking in hospitals that we’re seeing, which is having a direct impact on ambulance services.  

The Liberal Democrats are calling on the government to publish accessible localised reports of ambulance response times, create an emergency fund to reverse closures of community ambulance stations, particularly vital in rural areas, and cancel planned closures where needed.  

We need a proper plan to fund this crucial part of our NHS, rather than last minute emergency funding each year during repeated winter crises which don't enable local trusts and ICBs to plan effectively and efficiently.