Watch ITV News health editor Emily Morgan's full investigation into the ambulance waiting times crisis
There is one thing we have heard consistently about the ambulance service this year - and that is it is not delivering the sort of service it used to.
Wait times for ambulances have increased, handover times have skyrocketed and patients are deteriorating in the back of ambulances before they even get the chance to be admitted to hospital.
We know this, not only because the statistics tell us, but also because distraught patients and their families regularly offer horror stories of ambulances not turning up and loved ones dying at home before they arrive.
Glenn Carrington, a senior paramedic and UNISON branch chair, is nearing retirement after 30 years on the job.
He recalls waiting ten and a half hours outside a hospital with a patient in an ambulance waiting to be admitted
What we don’t often hear is what it’s like for the people who work for the ambulance service.
The paramedics whose job it is to get to sick patients, treat them as best they can and transport them as quickly as they can to a hospital. Or workers in the control room, whose job it is to answer the phones, calm and help the caller, and get an ambulance to them as soon as possible.
These people are at the sharp end. Having spoken to a couple of members of staff, I can tell you that what is happening today, is breaking them.
Glenn Carrington has worked as a paramedic for 36 years. He won’t mind me saying he’s a big man, a proud man and a man who takes his job extremely seriously, but he is also a man who goes home after a shift and cries.
He cries for his patients whom he can’t get to. He is lucky if he picks up more than a couple of people per shift, because he is usually stuck at the local hospital waiting to hand over someone from the back of his ambulance.
He’s waited ten and a half hours before and watched them deteriorate before his eyes. He told me the guilt he feels if they die, or simply get sicker, is immense; it’s "soul destroying" he says.
Glenn loses a little bit of himself whenever someone dies, but when they die before he’s even got them into hospital he loses a lot of himself. Hearing this just made me question how long he can continue like this.
He told me he can’t leave, he’s thought about it but wouldn’t do that to his patients or colleagues.
The point is, Glenn can’t do anything about the problems he faces at work.
The reason he sits at hospital waiting to handover is because there is no room in A&E for his patient. The reason there is no room in A&E is because the patients already there are waiting for a bed to come free on a ward. The reason there is no bed available on a ward, is because there are patients in those wards, fit to leave but can’t.
And the reason they can’t leave is because there are not enough carers to look after them at home, or there are no spaces in local care homes.
And the reason for this, is multiple.
Glenn’s problems stem from complex issues in social care. He says unless the government sorts out social care, ambulance wait times will continue to rise and patients will continue to die at home.
'We have had people unfortunately pass away waiting for the ambulance,' Reena Farrington, a call supervisor and UNISON staff chair, told ITV News
I saw these problems first hand in the West Midlands Ambulance Service Control Room.
Supervisor Reena Farrington showed me round. After telling me that she and her colleagues feel hopeless and helpless because they can’t send an ambulance to sick patients, we went to check on the current situation.
There were 263 people in the region waiting for an ambulance. Some had been waiting for more than 9 hours. Category 2 calls, which are for things like heart attacks and strokes, should be attended to in 18 minutes - they are time sensitive.
That evening there were 60 people waiting, one was a stroke patient who’d waited more than an hour.
I asked Reena how it makes her feel seeing this; she starts to cry and can’t answer for a few minutes. She says it’s heartbreaking, it makes her sick to her stomach and often results in her not being able to sleep at night.
What was most shocking is that she says her team regularly gets abused down the phone, has threats of rape and threats to their family.
Again, she pauses to compose herself, when she continues she says she can understand why the caller might do that, they are at their lowest ebb and their family member is dying in front of them.
Although bed levels are down, occupancy levels have increased said Charles Tallack, Health Foundation
What struck me most was the resilience both Reena and Glenn show.
The issues facing them are completely out of their control, they are trying to work in a system that doesn’t appear to be working anymore.
Glenn told me that currently, if someone rings 999 there is a 52% chance an ambulance won’t come. The Health Foundation has similar shocking statistics.
In July 2019, 1 in 50 ambulances waited more than an hour to admit patients to hospital, in July this year that rose to 1 in 10.
And there’s more, the Association of Ambulance Chief Executives says around 38,000 patients experienced potential harm because of handover delays in September, 4,000 of those suffered severe harm.
National Officer for UNISON Alan Lofthouse, said they often hear of ambulance workers crying in their cars and in toilets because of the pressure they're under
There is no getting away from this. People are dying in their homes because ambulances are not getting to them in time.
Patients are suffering longer term health problems because they’re not getting from the ambulance into A&E quickly enough.
The root causes of this is bed capacity and the inability to get fit, elderly patients home safely.
The government says it is urgently increasing bed capacity, recruiting more 999 call handlers (which won’t make any difference) and putting more money into social care.
But critics point out it’s not enough money, social care needs more funding and completely overhauling.
If the Health Secretary Steve Barclay is serious about tackling ambulance wait times, he will also tackle social care in this country.
Without that, he will not solve the crippling wait times. It’s as simple as that.
'Trust leaders tell us that they are anticipating the most challenging winter that they have ever seen in their careers,' Miriam Deakin of NHS Providers said
A spokesperson for the Department of Health and Social Care said: “The secretary of state for health and social care is hugely grateful for the dedication and hard work of our committed ambulance workers and wider NHS staff - and is taking firm action to ease pressures during the challenging winter ahead.
“We’re recruiting more 999 and 111 call handlers, creating the equivalent of at least 7,000 more beds and investing £500 million to free-up vital hospital beds by moving patients who no longer need hospital treatment into social care.
“We also recognise there is significant regional variation across the NHS when it comes to ambulance response times, so are supporting to the most challenged hospital sites to deliver quicker handovers and get ambulances back out on the road.”
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