Last winter, ambulances queued outside Norfolk and Norwich University Hospital 1,400 times: this winter, it has happened nine times - so how has dramatic improvement been achieved?

PUBLISHED: 09:37 03 February 2014 | UPDATED: 09:37 03 February 2014

Ambulances parked up outside A&E at the Norfolk and Norwich University Hospital. Picture: Denise Bradley

Ambulances parked up outside A&E at the Norfolk and Norwich University Hospital. Picture: Denise Bradley


Health chiefs have pledged not to get complacent on addressing winter pressures after new figures revealed a big reduction in ambulance handover delays in Norfolk.

Figures released by NHS England show that the number of patient handover delays of more than one hour at the front doors of Accident and Emergency departments have been slashed.

The Norfolk and Norwich University Hospital - the busiest A&E in the East of England - had more than 1,400 ambulance delays of more than 60 minutes last winter, between November 6 and February 28. The hospital has only had nine handovers of more than an hour so far this winter, according to new figures.

The introduction of extra staff at A&E departments, including hospital ambulance liaison officers (HALOs), has helped speed up patient handovers at the N&N, James Paget University Hospital in Gorleston, and Queen Elizabeth Hospital in King’s Lynn.

The introduction of a new three-bay immediate assessment unit (IAU) has helped reduce delays at the N&N, which has around 750 ambulance arrivals a week.

Helen May, associate medical director at the Colney hospital, said: “Our team of A&E nurses, doctors and support staff have designed and implemented the new immediate assessment service through which they make a very rapid and comprehensive assessment of patients on arrival, enabling our clinical teams to make earlier decisions about discharge or onward referral within the hospital.”

The James Paget University Hospital has only had one 60 minute or longer ambulance delay this winter, compared with 109 last winter.

Sue Watkinson, director of operations, said closer working with the East of England Ambulance Service had helped speed up patient handovers.

“There has been a significant improvement in performance as a result of this joint working and through specific and targeted action by each organisation individually. A number of actions to further improve handover are on-going including an expansion of our A&E department to provide more space to care for our sickest patients,” she said.

The Queen Elizabeth Hospital has seen long ambulance delays reduce from 203 last winter to 44 between November 4 and January 22 this year.

Manjit Obhrai, chief executive, said new measures had reduced the number of A&E admissions.

“We have seen a 78pc reduction in these [handover] delays and this is providing a much better experience for our patients. This has been achieved by introducing new ways of working, which include GP colleagues referring their patients to our Ambulatory Emergency Care service, or our Medical Assessment Unit, for prompt assessment, diagnosis and treatment. It is much better for our patients who will be seen, diagnosed and treated before returning home. While this improvement is very good news, there is no room for complacency. There is still a lot of work to do to ensure we consistently maintain our performance and improve the experience of all our patients,” he said.

The West Suffolk Hospital in Bury St Edmunds has had no 60 minute or more ambulance handover delays this winter. It had 98 last winter.

A spokesman for the East of England Ambulance Service said: “We have worked hard with commissioners and hospitals to get the whole patient care system working as efficiently as possible, and as a result we’ve seen handover times fall. This is better for patients as they get to see hospital staff sooner and it frees up ambulances to get back on the road responding to patients.”

“Hospital ambulance liaison officers (HALOs) work with ambulance crews and hospital staff to reduce the time an ambulance is at A&E and so free up more quickly and available for their next patient. Since HALOs have been introduced, delays across the region have reduced significantly. We will continue to work closely with the hospital trusts in order to keep this momentum up.”

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