Heart attack responses a ‘shambles’ as patients face eight-hour ambulance waits

Senior doctors have sent a warning over the “shambles” of heart attack care after pressures on the NHS have left patients waiting eight hours for an ambulance.

The caution comes as several hospitals in the past week have declared critical incidents over the level of pressure on their emergency care services.

Portsmouth Hospital said on Monday: “Demand for an emergency response is far outstripping the capacity available in Portsmouth and South East Hampshire at this time.”

The hospital said it was operating a “strict redirection” policy to alternative services for people who attend A&E and do not have a life-threatening condition.

Meanwhile, the Isle of Wight on Tuesday said it would have to postpone some planned surgical activity due to pressures on its emergency department.

Professor Mamas Mamas, a consultant cardiologist in Stoke and Professor of Cardiology at Keele University, told The Independent: “I was on call this weekend and I was seeing delays of eight hours. It was several people, three or four this weekend with heart attacks that waited between four and eight hours … it’s a national disgrace that we’re in this situation.

“I think that patient care is being compromised. We know that time is muscle and an eight-hour delay getting an ambulance to a patient with a heart attack is impacting on the survival levels.”

In a tweet on Monday, Professor Mamas said he’d never seen such a “shambles” in the NHS and revealed that over the weekend he’d seen two patients who faced delays, one who had a cardiac arrest while waiting for an ambulance and another whose wife had called 999 20 times.

Several doctors replied to the tweet saying response times were similar in their area of the country.

According to the most recent NHS data for April, response times to patients who had suffered a heart attack caused by a sudden blockage of the blood supply exceeded four hours in the East Midlands and South West.

Professor Mamas told The Independent: “We cannot continue like this and if people are coming in later and later for their heart attacks, and undoubtedly they are dying, their risks are increased. Someone that is waiting for eight hours, has a far lower chance of survival ... For the first time in my career, I’ve publicly said, ‘maybe it’s better to just to get someone to drive you in’.”

Warnings over the state of emergency response times have been repeatedly levied by senior NHS leaders during the summer as patients were found to be waiting 25 hours for an ambulance in some instances.

Clinicians told The Independent a key driver of emergency response times is the fact hospital beds are full due to difficulties in discharging patients. This means people cannot be admitted from A&E, which causes a backlog of patients waiting in ambulances outside emergency departments.

Speaking with The Independent Professor Amitava Banerjee, consultant cardiologist in London and professor of clinical data science at University College London, said: “We’ve got very little reserve capacity in the system and it’s October, it’s not yet the usual winter surge. This is happening in respiratory disease. This is happening in endoscopy. This is happening in cancer two-week wait.”

He added: “We don’t want to go back to the Nineties … This kind of eight-hour [delay] was absolutely one-off, if not never seen, so to hear of several of these delays happening regularly, that is a deep concern … This is avoidable mortality in 2022. It’s avoidable harm and it’s only because of system strain that we’re in this situation – that strain is also avoidable.”

Dr Tom Johnson, a consultant cardiologist in Bristol and associate professor of cardiology, said: “I think the criticism has to go to the government, in terms of not addressing and funding the gaps that exist or overcoming the problems, facilitating community beds so that patients can be discharged from hospital.”

He said once a heart attack patient had waited longer than 12 hours, the “damage was done”, adding “the real worry is that this is only going to get worse and going to be placed to even greater risk through a very challenging winter period.”

The news comes as Covid admissions to hospitals in England have increased in recent weeks, while on Wednesday NHS Blood and Transplant declared its first ever amber alert as stocks in England fell to critically low levels.

A Department of Health and Social Care spokesperson said: “No-one should have to wait longer than necessary for emergency care, and the Health and Social Care Secretary has set out her priorities of A, B, C and D – ambulances, backlogs, care, doctors and dentists.

“Our Plan For Patients sets out a range of measures to help ease pressures, including an extra £500m to speed up discharge and free up hospital beds, reducing waits in A&E and getting ambulances quickly back on the road.

“This is alongside NHS plans to rapidly boost capacity and resilience ahead of winter, including increasing the number of NHS 999 and 111 call handlers and creating the equivalent of at least 7,000 more beds.”