Paramedics warn of 'tents in car parks' amid mental health crisis
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The ambulance service in the east of England is in an unprecedented state of crisis, this newspaper can reveal today, with staff predicting “tents in the car park” to treat patients this winter as they warn “the wheels are going to come off.”
Burned-out paramedics are taking sick leave for their mental health at twice the rate of the peak of the pandemic, with eight per cent of the workforce off sick, and one in thirteen staff leaving the service.
Whistleblowers, who work for the East of England Ambulance Service Trust (EEAST), said they were waiting up to six hours to unload patients at the Norfolk and Norwich University Hospital (NNUH) and data reveals staff are working shifts of up to 18 hours straight.
The findings come as part of this newspaper's NHS On The Brink series, exploring the state of the region's health service as it heads into winter.
Several paramedics have told this paper that morale is at an “all time low” and Unison branch chairman Glenn Carrington warned things will only get worse as flu season bites.
Mr Carrington, who works as a paramedic, said: “Morale is at rock bottom.
“We go into hospitals and we’re queuing for five or six hours with a Covid patient on board.
“We’re all working hard, we’re all trying our best, but there’s a dwindling workforce and with the stress of it all, it is hard.
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“There are people leaving, you can’t blame them. They’re burned out. We’ve been working through this pandemic like Trojans and you can only work like that for a certain amount of time before you’re burned out.”
He blamed “11 years of under-investment in the health service” for the severity of the crisis, warning the worst might be yet to come.
“This isn’t going anywhere soon," he said. "And we’ve got flu season next month, and then we’re going to know about it.
“I think the wheels are going to come off. I hope I’m wrong, but there’s no slack in the system.
“I can see tents going up in hospital car parks and special ambulances people can be left in.”
His comments were echoed by other paramedics who wished to remain anonymous.
Sick leave doubles
Responses to Freedom of Information requests by this newspaper show that mental ill-health among ambulance workers has doubled.
Before the beginning of the pandemic around 600 to 700 staff days per month were lost at EEAST due to mental ill health - that is, sick leave for which the stated reason was mental health.
According to the latest figures that has increased to 879 in April, 1074 in May, 1289 in June and 1361 in July.
One paramedic, who spoke on condition of anonymity, said: “That’s only the tip of the iceberg, because it takes a lot to stand up and say ‘I’ve got a mental health issue and I need some time off’ - it’s much easier to say ‘I’ve got diarrhea’ because that guarantees you at least 48 hours off.
“There’s still a lot of stick around mental health, and people don’t want the person who’s their manager to contact them to talk about it - and a lot of the time the manager is the issue.”
The source, who has worked for EEAST for close to 20 years, said workforce dissatisfaction with management was a major problem.
“It’s the constant, almost harassment by managers - ‘Why haven’t you done this or done that, why weren’t you out on this job?’
“It’s very impersonal, it‘s done by email, people aren’t working alongside you.
“No-one asks you ‘how was that job’, or ‘that might have been a hard job for you’, it’s all ‘why weren’t you quick enough?’
“I do think genuinely people are burnt out with it now."
The latest Board papers show the Trust is monitoring “the percentage of staff saying they have felt pressure from manager to come to work when not feeling well enough” on an on-going basis, but has not set an internal target.
The source added: “To cope with operational pressures caused by staff being off sick, they’ve cancelled training because they want staff on the road because of sickness or the number of vacancies they’ve got.
“But that further decreases morale, and burns people out, and it becomes a vicious circle.”
'Tactics aren't working'
The service has been at its highest level of alert, Resource Escalation Action Plan (REAP) Level 4, since August.
This allows EEAST to increase use of private ambulances and consider requesting support from police and armed forces.
One member of staff told this newspaper: "For us it means breaks just don't happen and we are chronically late finishing shifts. It would be laughable if it was not so tragic."
Tom Burton, EEAST’s strategic planning director, told the Essex Health Overview and Scrutiny Committee on October 7 that the "unprecedented" situation was exacerbated by acute levels of staff sickness, with as many as 50 staff off at any one time.
He said: “Our response times are getting slower because that’s the knock-on effect of demand and our pressures.”
Meanwhile a separate FOI request has revealed that staff are working shifts of 16, 17, and 18 hours straight.
Another Norfolk paramedic, who spoke on condition of anonymity, said: “The word pressure is an understatement.
“This week there has been a wait of between four and six hours to unload patients at A&E the NNUH. That has become routine.
"The worst I have seen is more than 30 ambulances queuing at the NNUH. The hospital is unable to fully staff A&E - that has been the case for weeks - and it means paramedics end up having to effectively staff it.
“It is called "cohorting" and basically, we have to look after patients either in rooms in A&E or in the back of our ambulances. It means we can't get away for the next call.
"We are meant to be in and out of the NNUH in 15 minutes."
He said dozens of his colleagues had gone off with mental health issues and the longest shift he had worked was 18 hours.
"The system is breaking and winter hasn't started yet," he warned. "EEAST keeps trying the same old tactics but it has not worked."
EEAST chief executive Tom Abell said: "We have a range of support in place for our staff, including confidential counselling services, a wellbeing hub providing rapid assessment and access to local mental health services, as well as specific support for any colleagues who have experienced traumatic incidents.”
Tomorrow: Is there a single dentist in the county taking new NHS patients?