Ambulance worker speaks about Wrexham Maelor Hospital delays

The Leader has reported on the issue several times in recent years.

But an ambulance worker, who does not wish to be named, has spoken of their first-hand experience - and the experiences of their colleagues - of waiting for hours on end outside the site while beds can be found for patients.

The worker said: "We literally can't go anywhere until we've offloaded our patient, but the flow through the Maelor is stagnant.

"There are people on wards waiting to be discharged but they can't be because there is nowhere else for them to go - they're waiting for other community services to get involved.

"That's literally what's causing the issue; the Maelor's full to capacity. In fact, it's over [capacity.]"

The issue of patient flow through the hospital results in long queues of ambulances outside the site, tying up both the vehicles and staff for very long periods of time.

"The longest wait I've heard of this year is 40 hours," the worker said.

"That was one patient waiting to get into A&E."

And with ambulances stuck outside the hospital, the worker explained, patients calling for help face longer waits.

They continued: "When we're waiting outside the hospital, the 999 calls list gets bigger and bigger because we're basically unable to respond.

"We're not able to clear jobs in a timely manner.

"When people ring 999, they assume help will be there soon.

"That should be the case, but at this moment in time it's not.

"It's disgraceful and it shouldn't be the case, but it became an acceptance some time ago.

"I just think the public should be aware of this - they deserve to know.

"When an ambulance crew arrives for the patient, they give 110 per cent - but the delivery of service is completely unacceptable.

"I want people to understand the crews have every good intention of getting to them in a timely manner, but we're simply unable to because of hospital delays."

Ambulances queuing outside Wrexham Maelor Hospital (Image: Megan Donoher) (Image: Staff) Dr James Risley, deputy executive medical director at Betsi Cadwaladr University Health Board, said: “Handover delays between ambulances and our Emergency Departments are a symptom of the significant pressure across the health and social care system.

“We continue to face challenges discharging patients from hospital to suitable accommodation or care services. 

"This impacts flow through the entire hospital system, and on our ability to bring patients into and through the Emergency Department in a timely manner and we continue to work with our health and social care partners to improve this.

“At Wrexham Maelor Hospital we have taken a range of actions to improve the situation, including the introduction of an Urgent Treatment Centre (UTC), which provides care and treatment for patients with minor illnesses and/or minor injuries.

“Our Urgent Primary Care Centre is also based alongside the UTC that treats patients with urgent primary care needs on the same day between 10am – 6pm.

“While we are seeing improvements in reducing the pressure on the Emergency Department at Wrexham Maelor Hospital we accept there is much more to do as handover delays remain unacceptably high across all our Emergency Departments.”

Lee Brooks, executive director of operations at the Welsh Ambulance Service, said: "The impact of hospital handover delays is well-documented, not just in Wales, but across the UK and beyond.

"In June we lost 21,630 hours, which is 3,500 more hours than last June, despite ongoing efforts across the NHS system to address this issue in a collaborative way.

"The challenge presented by the ongoing pressure across urgent and emergency care requires leadership, focus, and all parts of our system to support efforts to see handovers managed effectively including the holding and balance of risk across multiple health and social care settings. 

"We are seeing positive results in some parts of Wales whereas in others handover delays remain a significant challenge. 

"These delays impact our ability to respond to other community calls and do contribute to avoidable patient harm.

"This situation also affects our staff, whose exposure to patients is restricted given the amount of time waiting outside the emergency department with a single patient.

"We continue to work closely with local health boards and the Welsh Government to find solutions to these complex and deep-seated issues. 

"Additionally, we are rethinking how we deliver ambulance services in the future.

"Our vision is to evolve from being seen solely as a traditional ambulance and transport service. This means providing more care remotely and more care closer to home as we better connect patients to both new and existing care pathways. 

"This approach will help alleviate pressures on hospitals and reduce avoidable harm in the first place."

Wrexham and Flintshire Councils were invited to comment on the provision of social and community care services.