Ambulance service in talks to use a 45-min handover limit for patients arriving at Bedfordshire hospitals

Bedford Hospital usually fares better than the Luton and Dunstable, but Bedford faced challenges yesterday (October 22), Luton Borough Council’s scrutiny health and social care review group was told.

Liberal Democrat Stopsley councillor Richard Underwood asked about “the bottleneck which occurs from the drop-off point from an ambulance to the hospital” and what the scenario is in Bedfordshire.

Head of clinical operations for Bedfordshire and Luton from the East of England Ambulance Service Trust Marc Stanbridge replied: “The situation is fairly tough currently, with Bedford seeing some challenges yesterday.

“We’ve transferred some patients who’d normally go through to the hospital in Bedford brought into the Luton and Dunstable instead, just so we can balance out an ambulance delay.

“We talked yesterday about the 45-minute process as to how we would implement that at both hospitals. We’re in very early discussions with BLMK integrated care board (ICB) and our hospital colleagues about the process.”

He continued: “We see the vision as to where we want to go, but we also need to be realistic about what the hospitals can then cope with from the extra demands going into their emergency services department.

“Looking at the position with the hospitals, we’re considering implementing the 45-minute process, so no ambulance is waiting more than 45 minutes to offload, but it’s in the very early stages around those talks.

“We’ve seen some challenges with our handovers at the hospitals. Of the two acute hospitals we look at for Bedfordshire, Bedford rarely have any challenges. It has less of a conveyance going into the hospital than Luton and Dunstable,” he explained.

“Luton has a very busy emergency department currently being renovated, which will provide extra bed space. But as well as the ambulances going in, Luton’s really different in a way as so many patients self-present there.

“These can be patients having a heart attack. We’d never see in some areas of our organisation where someone has been assaulted and stabbed, they then self-present in the hospital reception area.

“Anywhere else, usually a 999 ambulance would come and treat them and take them to a resuscitation area. With Luton it’s a random dynamic that we get so many poorly patients making their own way to hospital.

“That’s not linked to a 999 delay. Most of the time, they haven’t even called us and made their own way there. Luton do an absolutely amazing job on the prioritisation, but we’re seeing the delays.

“That’s because they’re so busy with patients making their own way there. On average, our times to offload a patients varies day-by-day,” he said.

“Sometimes we’ll see it up to an hour, while on other days it’s closer to 25 minutes. It all depends on the 999 activity, the hospitals and the discharges within that hospital.”

Councillor Underwood, who chairs the review group, added: “If we sort out the first point of contact, the GP and primary care access, that solves a whole load of problems downstream.”