Tag: Health Foundation

The press release issued by the Health Foundation on 4 November 2022.

Increase in handover delays – the time an ambulance spends waiting outside a hospital before transferring a patient – is a major cause of the decline in ambulance response times, new analysis finds.

• In July 2022, more than 1 in 10 ambulances waited over an hour with patients outside hospitals – up from 1 in 50 in July 2019.
• Patients with the most critical calls are waiting 18% longer than in 2018/19. For less urgent cases, waits have doubled to an average of 3 hours.
• The Health Foundation calls for urgent ‘whole system’ focus ahead of a challenging winter for the NHS.

A sharp increase in handover delays between ambulance services and hospitals has resulted in patients waiting longer than ever for ambulances to arrive, new analysis warns.

Analysis by the Health Foundation on ambulance service performance in England has found that the percentage of handover times exceeding 60 minutes was seven times higher in July 2022 than in 2019.

The analysis also shows that patients are facing record-breaking ambulance waiting times, with patients in April to March 2021/22 waiting 18% longer than they would have waited in April to March 2018/19 for the most critical calls. For less urgent cases that still require an ambulance response, waits have more than doubled to an average of over 3 hours. Because ambulance services are stretched, the increases in handover times are magnified, leading to far greater increases in average response times.

Long ambulance handover times signal system-wide challenges and have devastating consequences for patients and their families. Rising times suggest different parts of the system – from social care to hospitals – are under severe strain, putting patients’ lives at risk.

The increase in ambulance handover delays is largely being driven by the lack of hospital bed capacity and delays in discharging patients. To ease this pressure there needs to be greater investment in social care and community services.

To address increasing ambulance waiting times, the Health Foundation is calling for a whole system approach with greater investment in:

• hospital capacity and flow through hospital with more beds and more staff
• out of hospital care, including social care
• community services, such as mental health services, which can prevent health conditions becoming crises.

Charles Tallack, Director of Data Analytics at the Health Foundation, said: 

‘The sharp increase in handover delays is a major cause of the increase in ambulance waiting times. The cumulative effect of demand returning to pre-pandemic levels, the need to catch up with backlogs, and the ongoing impact of COVID-19 has resulted in the pressures we are now seeing right across the system – putting patients’ lives at risk.

‘Delays at the front door of the hospital are a consequence of wider challenges hospitals are facing in discharging patients. Getting a handle on this must be a priority for the new Secretary of State for Health and Social Care. Tackling ambulance performance will require further investment in NHS and social care capacity and a comprehensive, funded workforce plan to ensure services have the staff they need.’

The press release issued by the Health Foundation on 26 October 2022.

Analysis published today by the Health Foundation reveals that the public health grant has been cut by 24% on a real-terms per capita basis since 2015/16. 

The cut falls more heavily on those living in the most deprived areas of England, who also tend to have poorer health. For example, in Blackpool – the most deprived local authority in the country – the per capita cut to the public health grant has been one of the largest at £42 per person per year.

The public health grant is used to provide vital preventative services that help people to stay healthy. The reduction in overall funding for the public health grant affects some services more than others. Stop smoking services and tobacco control have seen the greatest real terms fall in funding, with a 41% reduction. There have also been significant real terms reductions for drug and alcohol services (28%) and sexual health services (23%).

The authors argue that a whole-government strategy to improve health and reduce health inequalities is desperately needed. A commitment to a health disparities white paper by the new Secretary of State for health would be an opportunity to set out a strategy to reduce health inequalities that considers the role of every department.

The way in which the public health grant is administered should change. Allocations have been made just before the start of the financial year for the past three years. On top of the significant real-term reductions in the grant, the lack of certainty can make it difficult for local authorities to effectively plan and implement services for the longer term.

Reinvesting in public health is also vital to ensure that services can meet increased needs arising from both historic trends of worsening health and increased risks to health due to people’s experiences of the pandemic and the cost-of-living crisis.

Jo Bibby, Director of Health at the Health Foundation, said:  

‘The UK is in the midst of an economic crisis that has significant consequences for the nation’s health. As the government scrambles to balance the books ahead of the fiscal plan, there are worrying signs that public services could face further cuts. Any more cuts could have long-lasting impacts on people’s health and further entrench health inequalities. There is a 19-year gap in the number of years a girl born in the most deprived 10% of areas can expect to live in good health compared with a girl born in the least deprived areas.

‘Opportunities to prevent the early deterioration of health are being missed. If the government fails to fund vital preventive services, people’s health will continue to erode, and the costs of dealing with this poor health will be felt across society and the economy.’