Heart attack, stroke and burns victims wait up to five hours for an ambulance despite targets of 18 minutes, an investigation has found.
One in 16 seriously ill patients in England and Wales wait more than an hour for emergency services to arrive – 4,000 per week.
Delays mean patients are being ‘led down badly at their moment of greatest need’, experts said.
Data from ambulance services around the country was collected by the BBC between January 2018 and September 2019.
East Midlands Ambulance Service fared the worst, with one in eight calls taking more than an hour to respond to.
Seriously ill patients including heart attack, stroke and burns victims are among those who are waiting more than an hour for an ambulance to arrive in England and Wales, an investigation has found
Rachel Power, chief executive of the Patients Association, said ambulance arrivals were a ‘matter of life and death’ and that patients were being ‘let down’ when they need help the most.
She claimed the delays were ‘undoubtedly’ partly caused by a decision from the Government to ‘underfund the NHS over a sustained period’.
And Mark Macdonald of the Stroke Association, said the findings were ‘alarming’ given the need for patients who have suffered a stroke to be treated as quickly as possible.
The investigation looked at two high priority call groups – the immediately life-threatening category ones and the emergency category twos.
Data was obtained by Freedom of Information requests. Two ambulance services of 10 – the West Midlands and East of England – refused to participate.
Long waits for immediately life-threatening calls, known as category 1, were unusual. Just one in 270 cases took longer than 30 minutes to reach patients.
But delays for category two emergencies – including victims of heart attacks, chest pain, stokes and burns – were much more common.
Out of six million calls, there were 385,000 people desperately waiting over an hour from the moment they called 999 between January 2018 to September 2019.
Some patients were waiting for more than five hours, the BBC reports.
East Midlands Ambulance Service performed the worst – 12.8 per cent of category two incidents took more than an hour to reach.
Southeast Coast performed the best – 1.7 per cent of calls had a response time of over an hour.
East Midlands Ambulance Service director of operations Ben Holdaway told the BBC that the delays were a result of long waits for crews waiting to hand patients to hospital staff at A&E.
Why time is a matter of life and death
In medical emergencies, minutes can mean the difference between life and death.
Doctors say there is a ‘golden hour’ to treat heart attacks and strokes after their onset to minimise the damage caused to the heart and brain.
Within this time patients need to undergo an electrocardiogram or brain scan to confirm the condition and then be given drugs or surgery to remove blood clots.
A heart attack occurs when a narrowing in the arteries or a sudden blockage from a blood clot cuts off the nutrients and oxygen supply to the heart muscle.
Heart muscle begins to die within 80 or 90 minutes of losing blood supply.
The quicker that normal blood flow can be established, the less the long-term damage.
Stroke patients who reach hospitals within an hour of experiencing symptoms are more likely to be able to receive a powerful clot-busting drug.
Indeed, figures show that ambulances are having to wait outside hospitals where staff are overworked and beds are running low.
In the first week of 2020, almost one in five ambulance patients (18 per cent, equal to 18,000 people) waited more than half an hour to be handed over to hospital staff.
Any delays to treatment could be life-threatening, which is why NHS guidelines state that category one calls should take an average of seven minutes to respond to, with category two taking 18 minutes.
In Wales, nearly a quarter of category two calls – more than 1,000 cases a week – took more than an hour to arrive.
However, their second tier is broader than in England and includes less urgent cases such as diabetes complications.
NHS national ambulance adviser Anthony Marsh said: ‘It is not easy to reach everyone as quickly as we would all like. All our staff are working flat out.’
The Patients Association’s Ms Power said: ‘Ambulance services must respond in a timely and effective way with a clear focus on the needs of the patient – this can literally be a matter of life or death.
‘It’s obvious from these findings that on too many occasions, patients are being let down badly at their moment of greatest need.
‘Undoubtedly a proportion of these incidents have arisen directly from the decision to underfund the NHS over a sustained period and, in particular, funding of ambulance services has not kept up with the increasing demands made on the service.
‘Clearly category one calls take priority but all patients should expect an ambulance service they can rely on to respond to their care and treatment needs within an acceptable and safe time period.’
Mr MacDonald of the Stroke Association said that the quicker a person is diagnosed and treated for a stroke, the more likely it is they will make a good recovery.
He also claimed that increased demand and lost time due to delays at A&E were putting added pressure on ambulance services.
‘It is alarming to hear that in some cases ambulance staff are taking over an hour to reach patients because when it comes to stroke, being assessed quickly and then, if necessary, transferred to hospital, is really important,’ he said.
‘But it’s not just about how quickly ambulances get to patients. Guidelines say that stroke patients should receive a brain scan and any appropriate treatment as soon as possible on arrival at hospital.
‘Increased demand for ambulance services coupled with lost time due to delayed turnaround times at emergency departments has put significant pressure on ambulance services across the UK.
‘Quick turnaround times in A&E and getting people quickly into a specialist stroke unit are vital to ensuring stroke patients receive the expert treatment and care that they need.’