Peter Aldous highlights the problem of patients waiting for discharge but with nowhere to go and calls on the Government to work with local councils, the ambulance service and the hospital to remove the blockage that is impacting all the way along the ambulatory care pathway.
Peter Aldous (Waveney) (Con)
It is a pleasure to serve with you in the Chair, Mr Stringer. I congratulate the hon. Member for Bath (Wera Hobhouse) on securing this debate. I will focus my comments on the work of the East of England Ambulance Service NHS Trust and the James Paget University Hospitals NHS Foundation Trust, which together serve north Suffolk and east Norfolk, including the Waveney constituency.
The staff and management of both NHS trusts are under enormous pressure at the current time and are working incredibly hard to meet a challenge that is largely not of their own making. The East of England Ambulance Service has faced a number of institutional and cultural challenges over the past decade, which the current management are addressing. During that time, for the most part, it has provided the local community with a good service, although there have been three occasions when it has not done so: in 2012, when the system broke down very badly, at around Christmas time in 2017-18, when the then management failed to properly plan for seasonal pressures, and today, as it works against a very difficult backdrop.
For the week ending 26 June, the average arrival-to-handover delay at the James Paget was one hour 30 minutes. For the previous week, it was one hour four minutes. For the week before that, it was 49 minutes. The trajectory is very much upwards. The worst individual case that has been brought to my attention is a wait of 16 hours, and I am also aware of the situation with poor triaging.
Working collaboratively and in a co-ordinated way, the ambulance service and the James Paget hospital are putting in place a range of measures to relieve the pressures. The hospital has expanded its emergency department, launched a new surgical assessment unit and invested £900,000 in a new GP streaming service aimed at providing care for patients who attend A&E and who need a doctor rather than hospital treatment. For its part, the ambulance service is putting more ambulances on the road, developing co-responses with the fire services and local communities, and staffing cohorting areas at the Paget with its own HALOs—hospital ambulance liaison officers.
Those initiatives are welcome, and the two trusts should be commended for putting them in place, but they are, in many respects, a sticking plaster. They do not address the root cause of the current crisis, which is the logjam caused by the difficulty that the James Paget and other hospitals are facing in discharging patients to free up beds.
The Paget regularly has an average of 100 patients—the equivalent of four wards—who are ready for discharge, but have nowhere to go. They have opened 22 beds at the Carlton Court Hospital, a facility that the Paget now shares with the mental health trust, but there is an urgent need for more beds to be made available in the community, whether at home, or in care and nursing homes.
The problem with care at home, which in many respects is to be preferred, is that councils such as Suffolk County Council and its social services department are struggling to recruit carers and agencies to go into people’s homes to look after them after they have left hospital. In the long term, there is a need for strategic workforce planning in both the health and care sectors.
In the short term, Government need to work with councils such as Suffolk, with the East of England Ambulance Service and with hospitals such as the James Paget hospital—as well as with the wider care sector—to remove the blockage that is impacting all the way along the ambulatory care pathway. I look forward to hearing from the Minister the Government’s plans for doing that.