A&E Ambulance diverts: Trust diverted four patients in 13 week winter period to another NHS Trust outside of Pennine

A&E Ambulance diverts: Trust diverted four patients in 13 week winter period to another NHS Trust outside of Pennine
07 April 2017

The Pennine Acute Trust has issued the following information and statement following the publication of a national report by the Nuffield Trust into pressures facing the ambulance service.

A spokesperson for The Pennine Acute Hospitals NHS Trust said:

“We are one of the largest Acute NHS Trusts in the country and as a multi-hospital site organisation we run three category 1 A&E departments in North Manchester, Oldham and Bury, and an Urgent Care Centre in Rochdale. Last year we saw over a third of a million urgent care patients.

On occasions when one of our A&E departments is too busy to take more ambulances, we routinely agree with ambulance crews to take a patient to one of our other local hospital sites as an ambulance ‘internal divert’ to ensure patients are seen by our doctors as quickly as possible. This approach means that we can use our staff and internal operational arrangements flexibly and is best use of resources. These are not classed as diverts in the true sense that may be the case in the rest of the data presented in this report. An internal divert is usually for an hour or two.

During the 13 week winter period between 1st December and 28th February, we only diverted four patients outside of the organisation to another NHS Trust.

Under arrangements agreed with the ambulance service and all NHS Trusts across the region, the most serious cases, including patients for example who are having a heart attack, are not diverted at all and are brought by ambulance to any A&E.

Sometimes diverts are activated by the ambulance service as it may be more appropriate to take a patient to an alternative hospital site where the ambulance would be able to handover their patient in a timely manner; not undertaking such a system-wide approach could lead to longer delays for patients and staff with ambulances unnecessarily queuing at an already busy unit.

Unlike many rural areas in the North of England, within a conurbation such as Greater Manchester the distances between hospitals may not represent the time element that would affect a more rural setting so any direct comparisons can be misleading.

Our A&E departments have continued to face real pressures throughout the year and we know demand on our services further increases over winter. This report reflects the day to day pressures and challenges staff in our emergency departments and ambulance crews are facing.

We continue to work closely with our colleagues in primary care, community care and social services to improve patient flow in and out of our hospitals and to speed up treatment and discharge for our patients which in turn takes off the pressure in A&E.

We are also investing in our frontline services including in our A&Es and are actively recruiting more nurses and doctors as part of our improvement journey. 

Our priority continues to ensure patient safety and our staff always prioritise those who require urgent attention.” 

An NHS England spokesman said

“Currently too many ambulances are dispatched to simply hit targets rather than attend to those patients most in need. This is why we're carefully testing a change to the way in which the services can respond and will make our recommendations known in the coming weeks.”

The NHS has just coped with its busiest winter ever dealing with record numbers of calls to ambulance services. Many A&E diverts last only a matter of hours and are often operated within Trusts to deal with surges in demand and ensure patients get prompt treatment while not being diverted miles from home. 

Currently 25% of dispatched blue light vehicles are stood down before they reach the scene.