Crisis escalates as target time missed in more than half of life-threatening cases here last year
Paramedics in Northern Ireland were delayed getting to the most critically ill patients 5,628 times last year, it can be revealed.
Category one calls are those considered to be immediately life-threatening, such as cardiac arrest, drowning, or major blood loss, and the target time to attend is eight minutes.
However, figures released by the Northern Ireland Ambulance Service (NIAS) have revealed the potentially life-saving target was missed in more than half of category one calls last year.
The longest wait endured by a category one patient in 2021 was one hour and nine minutes.
In 2020, the longest wait for a patient deemed to be at immediate risk of death was one hour and 43 minutes.
NIAS was unable to say whether any patients died as a result of the delayed response times.
The delays being experienced by some of the sickest people in Northern Ireland have been blamed on paramedics spending hours at emergency departments (EDs) waiting to hand patients over to hospital staff.
It can be revealed that one NIAS crew waited longer than 14 hours outside an ED last year as the pressures caused by the pandemic snarled up the health service.
The longest handover time has spiked during the pandemic — up from nine hours in 2019, to 13 hours in 2020 and 14 hours and three minutes in 2021.
The situation has become so severe that paramedics are frequently only attending one or two calls during a 12-hour shift.
At the same time, NIAS can now contact EDs directly to ask them to urgently find space for a patient waiting in an ambulance when there are no paramedics available to attend a category one call.
One paramedic said: “It’s not unusual to work one or two hours after you’re supposed to finish because you’re waiting to hand over your patient to hospital staff.
“It’s the worst I’ve ever seen it and it’s difficult to see that it’s going to get better anytime soon.
“I know they called a potential major incident a few weeks ago because of the pressures but, to be honest, we’ve been operating in a major incident for months now.
“It’s really tough for crews, especially when you’re delayed getting to a call and you go away feeling like the patient has been let down, or they may have had a better outcome if you’d been there sooner.”
Figures from NIAS have highlighted the ongoing crisis facing health service staff and their patients.
In 2020, 116,075 calls were assigned a category two status. These are deemed serious medical conditions, such as stroke or heart attack, which may require rapid assessment and urgent transfer to hospital for treatment.
Despite the potentially time critical nature of the calls, NIAS has said it only attended 45,775, or 39%, of such 999 calls within the target of 18 minutes.
The longest category two wait last year was more than nine hours and 39 minutes.
The longest overall wait for an ambulance was just short of 23 hours for a call that was given a category three priority in 2021 — which has a target time of two hours.
Head of the British Heart Foundation in Northern Ireland Fearghal McKinney has expressed alarm at the statistics.
“Minutes matter when someone has a cardiac arrest or heart attack, which is why we’re seriously concerned by these latest ambulance response times,” he said. “Cardiac arrests and heart attacks are medical emergencies, and a fast response ambulance response could be the difference between life and death.
“Our health and social care system is under exceptional pressure, and this is forcing the health service into impossible situations and putting lives at risk, despite staff doing all they can for every patient.
“It is devastating to hear paramedics were unavoidably delayed in getting to many of the most seriously ill patients. My heart goes out to those patients and their families, as well as the staff who are working their hardest every day.”
Rosie Byrne, director of operations at NIAS, apologised for waits endured by patients and also paid tribute to staff who she said have worked tirelessly throughout the pandemic.
However, she said challenges experienced by NIAS prior to the pandemic have been exacerbated by the arrival of Covid-19 in Northern Ireland.
For example, a shortage of community care and nursing home staff, through sickness, burn-out and self-isolation rules, means it has become increasingly difficult to discharge medically fit patients from hospital.
Meanwhile, diverting resources away from tackling hospital waiting lists to cope with Covid-19 patients has resulted in more people attending EDs as medical emergencies.