Independent review into ambulance service delays ‘does not tally’ with front line staff, whistleblower claims

Speaking to the Health Service Journal (HSJ) a senior paramedic with the East of England Ambulance Trust (EEAST) questioned the robustness of a review carried out after a previous whistleblower claimed at least 40 patients died or were harmed due to delays over Christmas and New Year.

And they called for a full public inquiry into the winter delays.

They told the HSJ: 'The review's findings simply do not tally with what myself or my colleagues have dealt with on the frontline. We don't know which 22 serious incidents were included. We don't know why it was whittled down to so few. We don't know why so many deaths were not investigated. How can we know if the report is credible when it's not been published?

'What we need is a full public inquiry so the frontline staff can say what they saw, the families can give their experiences, and those in charge can explain the actions they took and why they took them.'

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EEAST announced last week that the review found no patients died as a result of winter ambulance delays, but three people did suffer severe harm.

The trust said there were 15 cases where patients were 'harmed as a direct consequence of ambulance delays' in total.

Seven of these were low harm (requiring additional monitoring or minor treatment as a result of the delay), four were moderate harm (directly attributable to the delay requiring treatment) , and three were severe harm (significant harm directly attributable to the delay requiring treatment), the review found.

In an additional seven cases the review, which was carried out by led by senior clinicians from local NHS services outside EEAST, found there was no harm suffered.

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This newspaper asked for a copy of the review and was told by a spokesman a six-page redacted document published on the Ipswich and East Suffolk Clinical Commissioning Group (CCG) website was the full report.

But no further information would be given about the investigated cases, including where in the trust's six-county area they happened, due to patient confidentiality.

Ed Garratt, the chief officer of Ipswich and East Suffolk CCG - which represents the 19 CCGs covered by the ambulance service area - said the trust was 'open and honest' and the review was conducted 'in a rigorous manner without any prejudice'.

But the HSJ said other trust sources had raised concerns, and north Norfolk MP and former health minister Norman Lamb asked why only some cases were looked at.

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He pointed to a case of one of his constituents who he claimed was left with a permanent disability after waiting hours for an ambulance and suffering a stroke.

He said: 'I don't think their case is one of the three where severe harm was identified. If that's the case, we need to know why it wasn't investigated.

'I don't dismiss the report, but it's really important to listen to these dissenting voices.'

He also raised conflict of interest concerns over the review being led by consultant in emergency medicine David Kirby, who works at the same trust as Mark Patten, EEAST's medical director at the time of the delays.

Mr Lamb told the HSJ: 'I would like clarity over what could be a conflict of interest. When there is a conflict of interest, it does not mean the conclusions are wrong, but it does raise questions about the validity of the report.

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'We all want to believe that this is an independent report and to trust it. But this casts doubt over that and I think that needs to be explored by the regulators as well.'

Neither EEAST nor the CCG responded to the whistleblower or Mr Lamb's concerns over why just 22 cases were examined.

But an EEAST spokesman said: 'Every case that is highlighted by staff or picked up through the normal reporting systems every day is taken seriously. We have said for some time that there have been delays in ambulance responses which mean patients wait much longer than they should.

'More investment to recruit more people and ambulances – which was announced last week – will support improvements in responses. The NHS is working hard together to help ambulance crews see patients as quickly as possible.

'Serious incidents must be declared internally as soon as possible, with immediate action taken to establish the facts, ensure the safety of the patient(s) and others, and to secure all relevant evidence to support further investigation. Of all incidents reported in the 2017/18 financial year, 98.9pc were graded as no harm or near miss incidents.'

Dr Garratt added: 'Although the review found that no patient died as a result of the ambulance delays, it has highlighted that some patients did experience harm. We deeply regret this and our thoughts are with the families of those patients who suffered.

'EEAST and the wider health care system are already acting upon the lessons from the review, such as reducing handover delays at our emergency departments, and are committed to avoiding such a situation again.

'Additionally, commissioners from across the east of England recently committed to significant additional investment for more staff and ambulances to boost the service and deliver lasting improvements.

'The commissioning of this review was an important and necessary action which has enabled us to best understand the consequences this very busy winter had on patients who used EEAST services.

'EEAST was open and honest in its dealings with the review panel, which was made up of healthcare professionals who approached their task in a rigorous manner without any prejudice, and whose knowledge of the healthcare landscape in the eastern region gave them enhanced insight into the issues raised by the review.'