Coroner: 'More lives at risk' due to ambulance delays
A coroner said it was "unacceptable" for ambulance delays to cause the potential loss life, and warned other lives would also be at risk if action was not taken to improve matters. Fred Pring, 74, died last March after waiting 50 minutes for help.
The widow of a man who died after waiting for an ambulance for 50 minutes after developing chest pains has said she is grateful for the "thorough investigation" into his death.
Speaking after a coroner said it was “unacceptable” for ambulance delays to cause the potential loss of someone’s life, Fred Pring's widow said:
"Firstly I am grateful to the Coroner for conducting such a thorough investigation into the circumstances surrounding my husband’s death.
"It is a lasting sadness that it was only after he had died that he was elevated to the highest response category".
“I sincerely hope that my husband’s death will lead to improvements in the way the Welsh Ambulance Trust and the hospitals manage their services especially in respect of the handovers of patients to A and E departments".
The Welsh Ambulance Trust and Betsi Cadwaladr University Health Board have expressed their "deep regret" that an ambulance was not sent to Fred Pring in a "more timely manner".
A joint statement said:
We extend our condolences to the Pring family at what is a very sad and difficult time. It is with deep regret that on this occasion there was no ambulance available to send to Mr Pring in a more timely manner.
It is our responsibility to ensure we have a safe, effective and high-quality urgent care system and together we are working hard to reduce any delays in transferring patients to hospital. We have already made a number of improvements since March 2013.
We are taking a range of actions to ensure that our busy ambulances and emergency departments are available to those who need them most urgently.
Standing outside the inquest, Joyce Pring said she was glad her husband's death had received such media attention because the feels it is "such an important issue".
She said she had been "shocked" at some of the revelations during this inquest, and says to this day she has "no idea" what she could have said to the ambulance call handlers to elevate it from a category 2 emergency to category 1, the highest emergency.
She said she hoped changes made following this inquest would stop others going through her ordeal.
The categorisation of [ambulance] calls and the prioritising of resources does not currently appear to take into account the issue of delay and the potentially catastrophic impact of delay on both the patient and those seeking care for him.
– John Gittins, Coroner
He also criticised the current system of giving ambulance crews rest breaks that mean them returning back to their base because it "may result in an unacceptable diminution in available resources".
He also said the current practices in place for the handover of patients at A&E departments "far too often results in wholly unacceptable delayed with patients being kept waiting for long periods in ambulances and ambulance resources consequently being unavailable for allocation to other calls".
The loss of even a single life to a potentially avoidable delay is unacceptable and so I intend to make reports to both the Ambulance Trust and the Health Board advising them of my concerns that unless action is taken, circumstances creating a risk of other deaths will continue to exist.
Ending the inquest with a narrative conclusion, the coroner said if an ambulance had been sent sooner - after Mrs Pring's first call - it was "probable" that Fred Pring would have survived long enough to receive medical attention at hospital.
He said it was "unacceptable" for ambulance delays to cause the potential loss of one life, and warned that other lives would also be at risk if action was not taken to improve matters.
The inquest has heard that one ambulance, which would have been allocated Fred Pring's emergency that night, was stuck at Wrexham Maelor Hospital waiting to transfer a patient for almost five hours - 287 minutes to be exact.
Coroner John Gittins told manager Ms Plemming that is "a very long time" to wait to transfer a patient.
She replied: "Yes, it is."
When he asked if there was a target patient transfer time, she told him it was 15 minutes.
Mr Gittins: "So, in a nutshell, six ambulances waiting to transfer patients at Wrexham Maelor, three ambulances waiting to transfer patients at Glan Clwyd. All experiencing delays significantly longer than the 15 minute target time?"
A Welsh Ambulance Service manager has told an inquest she held an investigation after Fred Pring's death, which concluded that there were no ambulances available to go to his aid.
Jill Plemming said: "Between 0109 hours and 0142 hours there were no resources available to this patient. The reason for this was the significant delays in transferring patients both to Wrexham Maelor and Glan Clwyd hospitals."
She added the delays were further impacted by the urgent requirement to give crews 'non-disturbable' breaks after five hours of duty.
An accumulation of these breaks also had a knock-on effect on resources available at that time, Ms Plemming said.
The second day of Fred Pring's inquest at Ruthin has started with evidence heard from a forensic pathologist.
Mr Pring died at his home in Mynydd Isa, Flintshire, in March last year, after waiting for an ambulance.
Dr Brian Rogers undertook an autopsy following Mr Pring's death. He concludes the former gardener experienced significant congestive heart failure and the chest pains he complained about whilst waiting for an ambulance would have been similar to angina.
Dr Rogers added that Mr Pring was clearly a very ill man.
Asked whether or not Mr Pring would had survived if the ambulance had got there sooner, he replied: "I find it impossible to say, though I think it's unlikely."