21 July 2008
By Mike Waites Health Correspondent
THOUSANDS of frail and vulnerable patients daily arrive late for routine hospital check-ups before facing long delays to return home amid critical failings in ambulance transport in Yorkshire, a shock survey has found.
As many as 1.6 million people each year use the region's patient transport service to travel to hospital or for daycare.
But a snapshot survey by ambulance chiefs of 30,000 patients has discovered only two in five arrive for their appointment on time – with a staggering 36 per cent delivered late and 20 per cent more than 30 minutes early.
The worst performance came in the York area where 92 per cent of 257 vulnerable patients were late for daycare.
The best performance was for patients travelling to the Friarage Hospital in Northallerton but even here only three in five arrived on time during the two-week survey period in March.
The study also found a massive 84 per cent of patients waited more than an hour to be picked up and a fifth faced journeys of more than an hour to get home.
In Barnsley and Rotherham, 95 per cent of 2,700 hospital patients waited more than an hour while more than 90 per cent of patients in Bradford and Doncaster faced similar delays.
In a report, ambulance chiefs have admitted major changes are needed to "outdated" services.
They point to "large-scale late and early delivery" which affects the running of hospitals and fails to meet contracted standards. They have ordered a review of services which could mean some high-cost contracts to transport patients are axed.
Efforts to "fix the front line" focused on staff will also be made to eliminate early and late journeys.
Labour's Selby MP John Grogan said: "Clearly the Yorkshire Ambulance Service needs to look at how they are doing things and improve.
"As well as a situation where you have elderly and frail people hanging around waiting to be delivered for their appointments, it must be a nightmare for medical staff trying to run a rota if you can't be sure patients are going to turn up on time. It's also a waste of resources if doctors and nurses are twiddling their thumbs waiting for patients."
David Bolam, a former ambulance service patient representative in Yorkshire, said it was difficult to organise services because people on the same ambulance had appointments at different times but improvements were needed.
Patients often faced long journeys on ambulances which were getting noticeably older and were not being replaced as quickly as emergency vehicles.
"If you fill an ambulance up, you are going to find some of those people won't arrive at the right time," he said.
"But where you have a situation where very few people are arriving on time, then you've got to do something about it."
A spokeswoman for the North Yorkshire and York Primary Care Trust, which pays for transport services for elderly daycare patients, said it recognised there were problems.
"We are working closely with our ambulance service colleagues to improve the level of service and to ensure that our patients receive the best possible care throughout their journeys," she said.
The Yorkshire Ambulance Service, set up two years ago, has come under fire for failing to meet 999 response times and has received millions of pounds in extra funding to meet new Government targets.
But concerns have been raised that resources have been diverted to meet the additional demands, with patient transport staff stepping up to work as paramedics.
Hospitals have already explored privatising patient transport, prompting fears the ambulance service overall could be undermined.
Bryn Webster, secretary of Unison's ambulance branch in Yorkshire, said work was now under way to improve patient transport services and address staff shortages.
"A lot of staff have moved onto A&E and it's a question of getting people trained up to replace them," he said.
"A year ago the trust was in a real financial state but that has now been turned around. We have to try to compete with the private sector which means being more efficient."
Sarah Fatchett, interim operations director for the patient transport service in Yorkshire, said "significant improvements" were needed to get patients to their appointments on time.
"One of the ways in which we plan to do this is to liaise more closely with each hospital and identify different ways we can work together better," she said.
"We have been trialling new ways of working in Leeds and Scarborough which will improve the promptness of patient pick-up times and arrivals at appointments.
"A Yorkshire-wide roll-out of these initiatives is planned in the coming months.
"We have undertaken two assessments of quality, one being journey times and the other being patient satisfaction.
"We have recorded high satisfaction ratings on our staff through this independent assessment process."
Ms Fatchett added: "The focus of our work for the remainder of the year is to improve journey times and to ensure that patients continue to be well cared for and treated with empathy and respect."