'Slate curtain' divides hospital handover rates


Owen Evans

SHOCKING figures have laid bare the stark disparity between ambulance handover delays on opposite sides of the England-Wales border.

The Countess of Chester Hospital may only be a couple of miles into England, but patients taken there by ambulance can expect to be handed over for treatment in the hospital almost twice as quickly as those taken to North East Wales’ two main hospitals.

The contrast has been described as a “slate curtain” on the England-Wales border.

On average, patients waited 12 minutes and 51 seconds until they were handed over at the Countess, while sick and injured people waited more than 23 minutes to get from 999 vehicles into Wrexham Maelor Hospital and Glan Clwyd Hospital, Bodelwyddan.

About 28 per cent of patients taken by the North West Ambulance Service to the Countess of Chester Hospital had to wait longer than the 15-minute handover time target in 2013.

But in North East Wales, 46.8 per cent of patients had to wait longer than 15 minutes before being handed over by the Welsh Ambulance Service staff.

Out of 36,456 handovers in total at the Maelor and Glan Clwyd, there were 17,077 occasions where patients had to wait longer than 15 minutes.

Shockingly, one patient had to wait seven hours and 22 minutes outside Glan Clwyd Hospital, with another waiting seven hours – and in Wrexham one patient had to wait six hours and five minutes until they were handed over.

Outside the Countess, nobody waited longer than three hours to be handed over in 2013 and only 124 patients waited between one and two hours. More than 2,200 people waited between one and two hours outside the Maelor and Glan Clwyd last year.

Conservative AM Mark Isherwood said: “This ‘slate curtain’ in cross-border services is shocking and unacceptable.

“Despite the dedication of Welsh NHS staff, patients in Wales have had to put up with a substandard emergency service.

“The cut in NHS funding seen over three years in Wales compared with the growth over the border is scandalous.”

The Delyn parliamentary candidate added: “Further pressures have been caused by the repatriation of cross-border health services and loss of community hospital beds and services.”

North Wales AM Aled Roberts said the figures showed patients lives were being put at risk in Wales.

He said: “Nobody who comes into contact with the staff who operate the service doubts their commitment to providing the best service possible, but why is it that on the Welsh side of the border average handover times are nearly double the wait-time at the Countess of Chester Hospital?”

At Glan Clwyd Hospital, 33 patients waited between four and five hours in ambulances, 10 waited between five and six hours and one person waited six hours.

At Wrexham Maelor Hospital, eight people were forced to wait for between four and five hours, while two waited more than five hours.

At the two hospitals, 178 patients waited between three and four hours before being handed over in 2013 – 120 at Glan Clwyd Hospital and 58 at Wrexham Maelor.

Almost 600 patients had to wait between two and three hours, with 343 of those at Glan Clwyd Hospital and 254 at the Maelor.

There were 2,215 people having to wait between one and two hours before being handed over at the two hospitals – 1,117 of those were at Glan Clwyd Hospital, while 1,098 were at Wrexham Maelor.

Of the total number of patients waiting more than 15 minutes, 8,953 waited outside Glan Clwyd Hospital while 8,124 were outside Wrexham Maelor Hospital.

At the Countess of Chester, 3,533 patients waited more than 15 minutes, 124 waited between one and two hours and six waited between two and three hours.

A BCUHB spokesman said: “Ambulance handover times are dependent on the flow of patients through the whole hospital system.

“Our doctors, nurses and other staff are working incredibly hard to cope with a growing demand for care.

“An increasing number of patients who are coming to hospital have complex needs because they have multiple health conditions, are very elderly or frail.

“Because these patients can require a high level of care, this can affect waiting times.

“Patients needing urgent care are given priority; however our staff will always make sure that patients are safe and are seen as promptly as possible.

“We are working closely with colleagues in the Welsh Ambulance Service to ensure that handovers are made as swiftly as possible.”

He added people with less serious illness could get better care at high street pharmacies, GPs, NHS Direct and the minor injuries unit.

At the Countess of Chester Hospital, 18,889 patients were taken to hospital by the North West Ambulance Service in total last year, but only 12,992 of the handovers were measurable.

There were also 4,880 patients taken by North Wales Ambulance Service to the Countess of Chester hospital, but following a Freedom of Information request, Dawn Sharp, Betsi Cadwaladr University Health Board’s corporate secretary said handover times for those journeys are not recorded.

She said: “The...trust does not, at this time, collect handover data for the Countess of Chester Hospital.

“This hospital is in England and the technology differs from that of the hospitals in Wales.”

A spokesman added that Welsh Ambulance Service crews deliver an approximate handover time verbally by crews to control rooms.

A ‘turnaround time’ is the time it takes, following the arrival of an ambulance crew to hospital, to notify the hospital that they have arrived, to hand over the patient, and to book clear so that they’re available for the next 999 call.

Plans are in place to install systems at the Countess to allow handover times to be recorded.

See full story in the Chester Leader

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