“Breaking the cycle” of ambulance delays in Lincolnshire is a waiting game

A pilot scheme aimed at decongesting overcrowded A&Es has “fundamentally” improved how quickly patients are taken out of ambulances at Lincoln County Hospital.

However, some patients up for discharge have been left sat in chairs rather than beds while they wait for their paperwork.

Breaking The Cycle, which United Lincolnshire Hospitals Trust began on November 7, attempts to take patients out of emergency departments and into wards whether there is a bed space available or not.

It also uses risk assessments to discharge some patients earlier than usual to help balance the pressures of different departments. This can, however, lead to patients sitting in other areas of the hospital while they wait.

Health services nationwide are regularly missing targets for the amount of time it takes for an ambulance to respond, or for the time patients are in A&E departments.

A report before United Lincolnshire Hospitals Trust board on Tuesday noted that in October 59.76% of patients spent four hours or less in the department. The trust has a target of 83.12%.

A total of 1,020 ambulances were delayed by more than 59 minutes.

ULHT Chief Executive Andrew Morgan told the board that health services continued to be under “significant operational pressure”.

However, he said the new scheme was “key” to helping both the ambulance service and the services’ own front door.

“The reason this has been done is to both decongest the A&E and the consequence of that is that we can unload ambulances quicker.

“People are not waiting in the back of ambulances so long, and equally as a system this allows those ambulances to get back on the road, to pick up those patients in our communities who are waiting too long on occasion.”

Dr Maria Prior, from Lincolnshire Healthwatch, picked up on a “small number of concerns”.

Chief Operating Officer Simon Evans said there was a “potential for patients to have a poorer experience because they move out of a bed space earlier than they do now and they might have to wait in a chair in a ward environment for longer.”

However, he said: “Overall, this is a much better experience for all of our patients because the consequence of not doing it is that a patient may wait for a prolonged period of time in an emergency department without the specialist team that they require.”

He said there had been an “overwhelmingly” positive response from emergency departments.

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