Special report: Patients waiting in ambulances for 24 hours, exhausted and desperate staff feeling helpless and a health service now on life support
NHS past breaking point as ambulances queue at chaotic hospitals across region
In a packed and chaotic Accident and Emergency room in a hospital in Chester, a man clutches his chest and keels over as people sitting on floors around him look on in horror. His partner cries out for help as exhausted staff rush to try and treat him in his chair.
Around 25 miles away an 88-year-old woman is part-way through an agonising 24 hour wait in the back of an ambulance queuing up outside Whiston Hospital following a nasty fall.
A demoralised and frustrated paramedic joins the back of the same queue of emergency vehicles at the same hospital, preparing for yet another shift of waiting for hours and hours with just one patient in the back of his vehicle, leaving him unable to move around the region to reach those who need his help.
This is the reality of the NHS crisis in our region right now. Patients and staff have told us they believe the NHS is now beyond broken and that the situation in hospitals is unsafe, requiring immediate intervention at the highest level.
For James (not his real name), a paramedic working in Merseyside, the system is now past the point of collapse. He described a grim scene outside Whiston Hospital last week in which 26 ambulances were parked up, queueing for the majority of the night, waiting for hours on end to be able to transfer injured and ill patients into a heaving emergency department. The worst thing is that this sort of scene is now typical for James and his colleagues.
“Every year we think it can’t get any worse and then it does. But this is like no other year. I have never seen anything close to this,” says a despondent James.
“I don’t think it is appropriate to say the NHS is on the brink of collapse, I think we have to accept that it has already collapsed and what we are seeing is the fallout of that. I don’t think politicians or senior managers are willing to accept what is happening and those of us on the frontline are having to deal with it.”
James says that even two years ago, while times were tough, he would be able to bring people inside hospitals and despite a wait, would be able to hand them over to hospital staff before getting back to other jobs on the road.
“Now it is completely different,” he explains. “I start a shift at 6am and more often than not I am heading to a hospital to relieve a night team who have been waiting in their ambulance at the hospital through the night. Sometimes they have been parked there since 8pm the night before.
“One night this week there were 26 ambulances parked up outside Whiston Hospital. That’s 52 members of staff that are off the road, unable to respond to people who are having heart attacks, children who have been hit by cars.
“It is happening all over Merseyside, there is just so much pressure in the hospitals and it is cascading onto the ambulance service. The vast majority of A and E departments are now effectively seeing parked up ambulances as an extension of their emergency rooms. I have seen elderly people developing pressure sores because of how long they have been on our stretchers in the ambulance waiting, its not right.”
Having worked in the role for many years, James says he has thought about leaving because this is no longer the job he has signed up for, many others have already quit. “Lots of my colleagues have just burned out and have left for Australia or other countries,” he explains. “We feel like we are letting patients down every day and there is nothing we can do. I have seen patients really decline in the hours they are in the back of ambulances because they really need hospital care.
Dozens of ambulances queue up outside Whiston Hospital waiting to hand over injured and ill patients.
“I can’t believe how little of this we see in the news,” adds an exasperated James. “It should be top of the agenda in the House of Commons every day. The situation has become unsafe and urgent intervention is needed. It is really scary now.”
James, who has dedicated much of his life to working for the NHS says he used to believe that if family members got ill, the service would be there for them, but he doesn’t feel like this anymore. “I dread the news that a family member might needs us,” he explains with a sigh. “I don’t believe they will get an ambulance and get the treatment they need. That’s a scary thought.”
As James explains, the impact on the patients forced into excruciating waits in the back of ambulances outside hospitals is potentially enormous. One woman who asked not to be named shared the harrowing experience her 88-year-old mother faced on December 29.
After her mum suffered a painful and nasty fall, she called for an ambulance and were told they could face a five hour wait. “All we could do was try and manage her pain and make her comfortable while we waited for such a long time,” the woman explains.
Eventually, after just under five hours of waiting, an ambulance arrived to take the elderly lady from her home in St Helens to Whiston Hospital. As is so often the case, the vehicle arrived to form part of a large queue outside the A&E department.
This would be the start of a harrowing 24 hour wait for the woman, who would shockingly be transferred to the back of five different ambulances as she waited to be offered a space inside the hospital for treatment. A gruelling ordeal for her and her worried family.
“We felt angry, embarrassed and sad,” explains the woman’s daughter, who works in the NHS herself. “I am a nurse myself and the whole thing made me very emotional – it just felt like there was nothing we or anyone could do to help my mum.”
She arrived at the hospital at 4pm on the Sunday and only made it inside at 5pm the following day, the woman was then moved to a makeshift ward on a corridor where she would eventually find out she had a small fracture to her hip.
“I cannot praise the paramedics enough, they are incredible people and were so kind, its so hard for them,” adds the woman’s daughter. She said when she looked inside the A&E department herself it was ‘carnage’, adding: “It was awful, there clearly just wasn’t enough staff for the number of patients. On one corridor there was just loads of beds of older people.”
The woman says her mother, who also used to be a nurse, has now ‘lost all faith’ in the state of the NHS. She adds: “The situation made her feel like she didn’t matter because she is old and that is really sad.
“I think there are too many people high up who are ignoring what is going on, she add. “I can’t understand why this is not being highlighted more. We used to show off and be proud of our health service but now people are dying because of these huge problems.”
For Mike Jones, the carnage inside a hospital emergency room is something he won’t forget for a long time. After falling ill just before Christmas and vomiting violently for several days, he ventured to the A&E department at the Countess of Chester Hospital on December 27.
“As soon as I got in there it was very intense,” explains 33-year-old Mike from Ellesemere Port. “Every seat was taken and some people were on the floor. As soon as we got in they put a sign up saying the expected wait would be seven hours.”
After swiftly getting triaged, Mike returned to the main A&E room which he says now resembled “a war zone.” “It was just chaos. There was one guy who had come in who was struggling to breathe. He was holding his chest and trying to get to the front desk and was told to get a seat. After a while he sort of keeled over and his partner was screaming. I was just thinking what the hell is going on.”
Video footage captured the moment a man waiting in a packed emergency room at the Countess of Chester Hospital keeled over as staff rushed to treat him.
Concerned about the state of the hospital and the wider NHS, Mike decided to start filming inside the emergency room, footage he passed on to the ECHO to raise awareness, on the agreement that we will blur any faces to hide people’s privacy. We have chosen only to use blurred screengrabs from the footage in this report.
“I just couldn’t believe how bad things were so I thought people should know what is going on,” adds Mike. “The staff were so stretched but eventually they brought an ECG machine out for the guy who had keeled over but he was getting worse. All of a sudden they realised how bad he was. He shouldn’t have been left like that really but there was no staff. I
“There was an older woman there too, maybe in her 80s,” Mike adds. “She was with her family and had been told she couldn’t go home and needed a hospital bed. But she had already been there for five hours when we got there and had been told she might not get a bed until the next day. It was horrible to see.”
“I have been to A&E a few times before but this was different, this didn’t feel like the NHS to me anymore,” says Mike. “I felt bad filming but I don’t think we can hide away from this, people need to see what is going on because it was so upsetting to see.”
“It feels like there is a nail in the coffin of the NHS,” adds Mike. “It is not the staff on the ground’s fault, you can see they are facing moral decisions every day about who they can treat and who has to wait. I can’t imagine having to make those decisions.”
What health leaders say about the current crisis?
The NHS, already in a perilous state, has been hit by what officials are calling a ‘quad-demic’ this winter, with soaring rates of flu, covid, RSV and norovirus adding huge additional pressure to an already exhausted system and its staff. NHS national medical director Stephen Powis said this particular winter flu season could be the worst ever seen.
New NHS data covering the Christmas and New Year period shows flu cases have continued to skyrocket, with more than 5,000 patients hospitalised around the country with the virus at the end of last week. In the week ending December 29, there were an average of 4,469 patients with flu in hospital each day – almost 3.5 times higher than the same week last year – including 211 a day in critical care.
Here in Merseyside, health bosses are warning that services are under major pressure, with demand for primary care, hospital services, mental health, and emergency services continuing to rise. Hospitals across the region are currently seeing high numbers of sick patients including those with existing chronic respiratory conditions which are often exacerbated by cold weather.
There were an average of 125.3 flu patients in the region’s hospital beds in the week ending December 29. That’s up from 112.7 a week earlier and is almost three times as many as the same time last year when there were an average of 44.1.
This is what the various trusts referenced in this special report had to say. A spokesperson for the North West Ambulance Service said: “We know these delays have a significant impact on patients and staff, and we continue to do all we can to address this.
“We are working with our colleagues in hospitals and other parts of the NHS to highlight the issues and make improvements. We have more ambulances out on the road and continue to make sure that people who do not need to go to hospital receive the right care closer to home, helping to reduce pressure on busy emergency departments. We have put additional measures in place so that patients who are waiting for an ambulance are regularly reviewed by a clinician to keep them as safe and well as possible.”
A spokesperson at the Countess of Chester Hospital NHS Foundation Trust said: “We have a growing number of elderly people in our community with complex health and social care needs and, like many NHS hospitals, demand in our A&E is unprecedented.
“Our staff are working hard to see and treat patients quickly based on the urgency of their needs – regrettably, this means some will have a long wait in a busy environment, which is not the experience they have a right to expect, and for this we are wholeheartedly sorry. Although we are exceptionally busy, we are still here to care for anyone who needs us in an emergency, or if it’s less urgent please use NHS 111 for the most appropriate local service.”
A spokesperson for Mersey and West Lancashire Teaching Hospitals NHS Trust said: “Whiston Hospital is currently seeing exceptionally high levels of demand for care, and at times this may mean longer than normal handover times for ambulance crews at our hospitals.
“We want to apologise for the impact that this may be having on some patients and their families, and to provide reassurance that patient safety continues to be our main priority and our staff are working incredibly hard to deliver the best care possible.
“The Trust is working closely with partners across all parts of the health and social care system to support patients to leave hospital and go home as safely and quickly as possible, and address the delays that people are currently experiencing.’’
A spokesperson for NHS Cheshire and Merseyside said: “Across all hospitals in Cheshire and Merseyside there are many patients who are medically well enough to no longer be in hospital, but who require ongoing community care or support in order to be safely discharged. This is especially important in this immediate period after Christmas and New Year when we know that the number of people needing care and treatment will be greater. Therefore it is more important at this time that people who are medically fit to leave hospital can be discharged in a timely manner, freeing up beds for other patients who need them.
“The public can also play their part by taking simple measures to stay well this winter such as getting winter vaccines, keeping their home warm, staying active, looking out for others, and using services wisely. Please remember that A&E should only be used for major, life-threatening illnesses and injuries. Use 111 online as the first point of contact for non-urgent medical advice or consider visiting a local pharmacy, walk-in centre or GP practice for support.”