Air ambulance crews fear critically ill patients won’t get to hospital in time amid NHS crisis
Air ambulance crews fear patients with life-threatening injuries are not being taken to hospital on time as the NHS finds itself in an “absolute crisis”.
earlier this month, I spent a shift with the East Anglian Air Ambulance Service (EAAA), with crews based in Cambridge and Norwich.
“A typical ambulance crew might see a major trauma patient once or twice a year,” said Andy Downes, critical care paramedic. But increasingly, he said, “We see them on most shifts, if not at least once or twice a week.”
Not only the EAAA has noticed a change in the last two years. Daryl Brown, chief executive of Magpas Air Ambulance, which covers Cambridgeshire, Bedfordshire and the east of England, said the life-saving service has “filled the gaps in NHS care”.
Air ambulances can’t replace ambulances, but helicopters are increasingly “first line of action” and the “type of patients we’re going to treat is becoming broader,” he said.
Asked if patients with life-threatening injuries could not reach the hospital in time, Mr Brown said I: “Yes, that is my personal opinion. I think we’re starting to see patient outcomes and deaths that we wouldn’t have expected two years ago. This is the NHS which is now in an absolute crisis.”
Record numbers of people waiting more than 12 hours in emergency rooms in the past month and ambulances queued outside hospitals overnight, meaning they were unable to respond to new calls.
Nurses and ambulances are at the center of a bitter row with the government over pay and working conditions, with a series of strikes set to continue next month.
Air Ambulances are charities based alongside the NHS system, meaning they were not directly affected by the strikes and were able to look after critically ill patients during the industrial action.
Chris Bailey, chief of operations at Lincs and Notts Air Ambulance (LNAA), based at RAF Waddington, said the local service had been on call 24 hours a day during the ambulance strikes and provided an additional car-based critical care team during the first full strike Day. The LNAA would like to offer “the same additional service for future planned strike action in our region,” he added.
Air ambulances offer an additional level of care for critically ill patients in the event of medical emergencies such as cardiac arrest, severe asthma attacks or allergic reactions, as well as injuries resulting from traffic accidents or falls. According to Matthew Jones, executive director of the EAAA, crews are increasingly being sent to patients who have injured themselves.
He said patients being transported on air ambulances generally “skip the queues” at hospitals because they are often so seriously ill that they are whisked through emergency rooms and into surgery.
Air ambulances are run as charities which means they have to raise millions of pounds from the public every year.
This means organizations can buy state-of-the-art equipment and offer a 24-hour service without having to “fight tooth and nail for funding,” according to Mr Jones, but it leaves them vulnerable to the economic climate.
“Our ability to respond to these medical emergencies and support the NHS during this crisis depends entirely on donations from the public, which is a major challenge given the greatest cost of living pressures in living memory,” said Mr Brown of Magpas Air Ambulance.
“We can only go to more patients if we have the money to do it,” he said I. “But at the moment it’s really difficult to raise the money and we don’t have big reserves to fall back on.
“When the economic climate deteriorates and people are unable to support local air ambulance charities, this entire level of care is completely reliant on donations. it is not government sponsored. So this is a real danger.”
The LNAA’s Mr Bailey added that running out of funding “is an increasing risk and one that we as a charity are monitoring”.
For Magpas, the past year has been “one of the busiest on record”, with more patients cared for in 2022 than in the previous four years, Mr Brown said.
The service is being called out on “more serious medical incidents than ever before”, with more patients suffering from complex illnesses as NHS care has been delayed, as well as younger patients.
As NHS pressure mounts, air ambulance crews are increasingly the “first medical resource on the scene, which has been a rare occurrence given most of our patients are seriously injured and ill,” Brown said.
As a result, Magpas Air Ambulance has deployed additional rapid response teams in cars across the region, with one planned in Peterborough and another in Luton. This means that paramedics can drive to critically ill patients to provide life-saving treatments before an ambulance arrives to take them to the hospital.
“We see a severe trauma patient in most shifts”
When I Arriving at the East Anglian Air Ambulance, which has two bases in Norwich and Cambridge, the crew were already preparing for takeoff after being called to their second job of the day.
“A typical ambulance crew might see a severe trauma patient once or twice a year. We see them most shifts, if not at least once or twice a week,” said Andy Downes, an critical care paramedic I.
Already at noon, the crew was sent out to two cases of cardiac arrest from 7 a.m. and only just got around to having their “breakfast”.
“It’s not an easy job. It’s quite physically demanding at times, as well as mentally so,” said Mr. Downes, who has been with the EAAA for 13 years.
“We never know exactly where we’re going to end up. This morning we climbed sand dunes in the dark. And the next job we end up on a field next to a patient.”
He said his 12-hour shift should “in theory” end at 7pm, but if he’s traveling for work it could be much longer.
Kieran Smith normally works as an A&E doctor in Scotland but has been seconded to the EAAA for a year.
“It gives me a good insight into how the rescue service works,” he says, looking back on his previous experiences. “And all the different challenges that you don’t really appreciate when you’re in your nice, warm hospital with the lights on and everything else.”
For Mr Downes, the job can “take a toll” both mentally and physically, but he feels well supported by a “fantastic team environment”.
“We see people on the worst day of their lives. And sometimes they sit on the brink of survival or death,” he said, adding that the most memorable patients are those who come back to visit.
“A few years ago I had a patient who suffered a serious head injury after a fall,” he says. “We drugged her and took her to a major trauma center for neurosurgery, thought [survival was] extremely unlikely.
“A few months later they knocked on the door to say hello. They were back to normal. It’s those unexpected saves that make it worthwhile.”
EAAA chief Jones said that before 2022 it would be a “rare occurrence” for a helicopter to arrive before a land ambulance as there were 387 vehicles in the East of England Ambulance Service compared to just three helicopters covering the same area.
“Sometimes we don’t have an ambulance with us at the scene, which normally wouldn’t be the case at all,” Mr Jones said I.
Crews are concerned that some patients may not be able to travel to the hospital as the system becomes increasingly overloaded and air ambulances in rapid response vehicles handle incidents without assistance from an ambulance vehicle.
The car is equipped with advanced medical supplies for pre-hospital care but could still be left with a “deteriorating patient who really should be in the hospital”.
“The crew can provide advanced care, but if they don’t have transportation, that’s the really dangerous situation,” he said, adding, “It hasn’t happened yet, but that’s our fear.”
Each air ambulance service is an independent charity that operates slightly differently, meaning specialized services can be tailored to the needs of patients in each area.
According to Air Ambulances UK, there are 21 air ambulances and 37 helicopters across the UK making an average of more than 100 calls each day.
Responding to comments that air ambulances are increasingly on the scene first when incidents occur, a spokesman for the Department of Health and Social Care said: “This is not a fair comparison. Air ambulances can travel at much higher speeds than road ambulances and do not have to navigate through unavoidable problems like road traffic.”
They added: “We recognize the pressure our emergency services are facing and have announced additional funding of up to £250million to help immediately reduce hospital bed occupancy, ease pressure on A&E and free up much-needed ambulance handovers, on top of the £500m relief fund announced last year.
“The NHS will set out detailed recovery plans for emergency and emergency care over the next few weeks, including ambitions to improve Category 2 ambulance response times to 30 minutes and improve emergency department wait times.”