Ambulance crews are spending hours waiting with patients outside full A&E departments as the NHS comes under intense pressure (Picture: Getty/EPA)

Emergency staff have told of ambulances effectively being used as hospital cubicles as exhausted crews wait outside A&E departments.

Two workers laid bare the pressures on the service – with waits after 999 calls at a record high – ahead of strike action due later this month.  

One described how frustrated crews sometimes spend entire 12-hour shifts waiting outside overburdened A&E departments.

Another told of how she apologetically tells patients that the ‘NHS is broken’ and said she had to be relieved by another crew while stuck outside a hospital with an elderly patient at the end of a shift.  

More than 10,000 ambulance workers in England and Wales are due to walk out on December 21 amid pressures that include the worst waiting times on record at A&E departments.  

Jeff Gorman, UNISON branch secretary for North West Ambulance Service, said: ‘We are queuing up outside emergency departments for hours on end and we have patients in the back of ambulances, which are being used as cubicles. On occasions sadly we have had patients die, which should never happen. I’ve been here 35 years and I never dreamed anything like this would ever happen.  

‘In normal times we take the patient to A&E, hand them over to hospital staff and we would turn round within 15 minutes and be clear for the next emergency. Now we get to A&E and we sit and wait for the hospital to find somewhere to put the patient. 

‘The hospital staff just don’t have the resources to look after the numbers of patients that are coming in. In effect, our ambulances are being used as cubicles outside.’ 

The ambulance service is on the frontline as the NHS comes under pressure on multiple fronts (Picture: Andy Rain/EPA)

Mr Gorman spoke as A&E and minor injury departments registered their worst performance on record, with 68.9% of patients being seen within four hours last month. The NHS target is for 95% to be admitted, transferred or discharged within the timeframe.  

‘It’s stressful, it’s a position that no clinician wants to be in,’ said Mr Gorman, a grade 2 emergency medical technician.

‘Nowadays we go out on a 999 call and we assess the patient and try and avoid taking them unnecessarily. A lot of patients are left at home with other pathways, such as GPs. So when we do take them in it’s because they are very unwell and need to be taken in. They should not be sat in the back of an ambulance for hours and hours.

‘We have had crews sat outside A&E for a full shift and then a night crew comes out and takes over, it’s just wrong. While the ambulances are sat there they cannot respond to other 999 calls, which puts patients at risk. 

‘It’s stressful enough with the type of incidents we go to because of the nature of the job and this just exacerbates the situation.’

Ambulance staff including paramedics, emergency care assistants and call handlers are due to join the industrial action but will respond to the most serious emergencies that cannot otherwise be covered. 

These include ‘life or limb’ Category 1 calls and some in Category 2, which covers emergencies such as burns, strokes and epilepsy. 

The action, which UNISON is co-ordinating alongside the GMB and Unite unions, follows the government saying that ‘economic circumstances’ mean an above-inflation pay rise is not affordable.   

Jeff Gorman said ambulance crews are sometimes spending entire shifts waiting outside A&E departments (Picture: UNISON NWAS Branch)

Mr Gorman said: ‘Nobody wants to go on strike but we haven’t got a choice. Every time we make an offer to get round the table and have a conversation about trying to get a reasonable resolution and a sensible pay offer the government has just refused.

‘The government needs to finally get round the table and come up with a pay offer that is acceptable to those joining the service and those of us who are here. A sensible offer would at least match inflation after 10 years plus of real terms pay cuts.’  

The Royal College of Nursing is also striking over pay, with walkouts involving around 100,000 members in England, Wales and Northern Ireland scheduled for December 15 and 20. 

The pressures on the ambulance service were further illustrated by a BBC Newsnight report on Wednesday which showed that 37 patients in the West Midlands have died so far this year after 999 responses were delayed. 

A part-time paramedic, who works for London Ambulance Service, gave a similar picture of logjammed hospitals and staff discontent.  

The responder, who spoke on condition of anonymity, said: ‘The staff, me included, are getting fed up with having to sit around in ambulances for hours on end. We constantly have to tell the hospital how the patient is doing, keep taking observations and making sure the patient is alright.

‘Sometimes the doctor will come on the back and have a look at the patient or someone will come and take their blood or some other kinds of tests.

‘At times, we have been asked to take them out, take them in for an X-ray and take them back out again because there are no beds. We are not porters, we are medics, it’s not what we trained for or want to do.

‘No one has died while I have been waiting but at times there have been patients I have been worried about and I’ve gone in and said, “will you please come and see them because I don’t feel equipped to take care of this person and they need a doctor, not me”.’ 

NHS staff want a pay settlement reflecting inflation as they come under increasing strain on the frontline (Picture: Peter Byrne/PA Wire)

The paramedic, who has been working in the service for almost three decades, spoke of being confronted by angry friends and relatives when arriving at emergencies.  

‘Sometimes people are angry and upset when we get there,’ she said.

‘You can understand it when they’ve been waiting hours for an ambulance to arrive while someone is lying on the floor.

‘I say I’m really sorry but this is the state of our NHS, it is broken and it needs to be fixed and to please write to your MP because they are the ones who hold the purse strings. Most people agree with me.

‘It’s terrible, it’s no way to treat people. It really makes me angry when the government talks about us holding them to ransom. They have had 12 years to sort this out with people suffering constantly and things getting worse.

‘Now, in the middle of a cost of living crisis, we are to blame.’ 

The paramedic is also a UNISON member who is joining the strike action.

‘We are getting off shifts later and later and you are exhausted,’ she said.

‘The longest we have to wait is five hours and we had to ask our control to send someone to relieve us, sometimes they can do that, sometimes they can’t. We had an elderly patient after a 999 call.

‘I feel upset and quite depressed after shifts, I feel sorry for the patients.  

‘I love my job but I feel I’m being pushed out.’ 

Nurses are calling on the government to provide a new pay settlement ahead of scheduled strike action (Picture: Jonathan Brady/PA Wire)

The government has pledged an additional £6.6 billion over the next two years to improve urgent and emergency care, with the NHS due to publish a recovery plan in the new year. 

Health and social care secretary Steve Barclay said: ‘NHS workers do an incredible job caring for our loved ones and it is disappointing some will be taking industrial action, ahead of a challenging winter. 

‘The economic circumstances mean unions’ demands are not affordable – each additional 1% pay rise for all staff on the Agenda for Change contract would cost around £700 million a year. 

‘We’ve prioritised the NHS with record funding and accepted the independent pay review body’s recommendations to give over one million NHS workers a pay rise of at least £1,400 this year, with those on the lowest salaries receiving an increase of up to 9.3% This is on top of the 3% award last year when wider public sector pay was frozen and on top of the wider government support to help with the cost of living. 

‘Our priority is to ensure emergency services continue to operate for those who need it and limit disruption, particularly at a time when NHS services are under huge pressure due to the impact of Covid.’

North West Ambulance Service monitors the impact of delays through Serious Investigations (SI) and any coroners’ inquests.

It is understood there has been no ‘abnormal’ rise in SIs or inquests where delays have been shown to be a ‘causative link’ in a patient’s death.

Do you have a story you would like to share? Contact [email protected]

For more stories like this, check our news page.

One paramedic told how she has apologised for the ‘broken NHS’ after arriving at 999 calls.