Ambulances 'left stuck at casualty and out of action for many hours'
Under-pressure ambulance crews are being held up at overcrowded A&Es and can't respond to emergency calls, a paramedic has claimed.
The whistleblower was speaking out after it emerged that one crew was delayed for over 10 hours during the festive period.
The paramedic, who does not wish to be named, said that the situation at the Ulster Hospital in Dundonald over Christmas was "particularly bad", with ambulance staff waiting for several hours to hand over patients.
The Northern Ireland Ambulance Service (NIAS) confirmed that the longest ambulance turnaround at an A&E here between the peak holiday period from December 22 until yesterday afternoon lasted 10 hours and 28 minutes.
It took place at the Ulster Hospital over January 2 and 3.
A turnaround time is based on an ambulance crew arriving at a hospital, handing over a patient to a health and social care professional, and clearing the hospital location.
The NIAS whistleblower, an experienced paramedic, described the situation here over Christmas as "unprecedented".
"Ambulances are arriving at the Ulster Hospital bringing patients, but the patients are remaining on ambulance trolleys for hours, which means the crews can't leave," he revealed.
"We are stuck in the corridor of the Ulster Hospital and can't respond to 999 calls.
"It would be standard practice to transfer patients to hospital trolleys if available - but there is nowhere to transfer them to.
"Recently I stood in the corridor of the Ulster Hospital's A&E for four-and-a-half hours with a lady in her 80s who was on an Ambulance Service trolley.
"Figures released by health trusts show the number of patients treated, but NIAS figures show that crews have been stuck at A&E departments for up to eight hours or more, and no one seems to be addressing this.
"My job is supposed to be to go out and help people, but we are going to 999 calls that have been waiting for hours as no one was available." The paramedic believes that A&E closures and reductions to opening hours are contributing to the pressure.
"You have A&Es which have been downgraded and close earlier, and it's over six years since the City Hospital's A&E department was closed, which was supposed to be temporary," he said.
"Ambulances from several hospitals are being diverted to the Royal, but it was designed years ago when the other A&Es were still open to provide support."
He said some NIAS staff were going on sick leave due to the stress, and crews routinely went without breaks for up to 12 hours.
"Staff morale is at breaking point," he said.
"Crews aren't getting breaks for 12 hours, and they need to look after their own health.
"I go home after a shift and end up snapping at my kids for silly things, then I go back into work and have to sit with patients in corridors for hours when I should be responding to 999 calls. The Ambulance Service can't cope and the patients are suffering.
"I believe that the health trusts need to declare major incidents more frequently to help us deal with the situation, but they probably don't want to do that due to the bad PR.
"I don't think that the NIAS could cope with a major incident at the minute."
Meanwhile, Linsey Sheerin of the Royal College of Nursing's Emergency Nurse Network said that nurses here were facing "intolerable conditions".
She said that all hospitals here are "under acute pressure" and that while this is manifesting during the winter, it is being felt throughout the year.
"It's a massive, system-wide problem," she said.
"Patients waiting long times on trolleys is really demoralising for nurses.
"Sometimes you leave a patient at the end of your night shift and you come back the next morning to find them still waiting. We have a national, regional shortage of nursing staff, and the ability to open extra beds is limited as the staff aren't out there.
"We are finding it hard to retain nurses. People are working very hard, with a smile on their faces, trying their best, but it is relentless.
"I have heard of nurses breaking down in tears.
"They are in moral distress - what's the best thing to do for multiple patients? People are having to make difficult decisions the best they can.
"The demands are unprecedented. There are a number of factors, such as the older population and a delay in community care packages. Discharges were also delayed over Christmas due to the lack of care packages.
"This is manifesting in the ED (emergency department), but it's a system-wide issue across all hospitals, trusts and the NIAS. They are all under acute, severe pressure."
A concerned Lisburn man who attended the eye casualty department at the Royal Victoria Hospital on Tuesday morning said he had been shocked to witness the pressure on the service. "The department was overflowing, and there were more and more people coming in," he revealed.
"There were people sitting in corridors and nurses bringing out extra chairs. I only saw three to four different doctors, and they were inundated.
"We were there for five hours, but there were people waiting far longer than us."
The South Eastern Trust said: "Every hospital across Northern Ireland, the rest of the UK and the Republic of Ireland is under extreme pressure, largely due to an increasing elderly population.
"The Ulster Hospital, which serves a particularly elderly population, is under the greatest pressure it has ever been under.
"Despite full escalation measures in place including opening additional beds and fantastic work by our staff, who have volunteered for extra shifts and stayed beyond their rostered hours, there was regretfully a period when demand was so significant there was a backlog of ambulance handovers.
"It is important to stress that patients were fully cared for during this time."
It said that the trust had been unable to open four beds on one ward "due to nursing staff shortages" and had been "actively trying to recruit additional nursing staff".
The Ambulance Service said: "In normal times, we expect to turn our crews around within 30 minutes and achieve this in the majority of instances.
"Delays experienced by ambulance crews being unable to turnaround at emergency departments do have an impact on NIAS capacity to respond.
"The NIAS prioritises its workload based on the information provided by the callers.
"It responds to immediately life-threatening situations and the sickest patients as a priority.
"Increase in turnaround times has in some instances delayed response to these calls, but primarily to the lower acuity calls."
It also revealed that only five ambulance crews had been covering the Belfast area on New Year's Eve, but that the NIAS "normally aim to have seven crews covering this area".
Responding to concerns that the NIAS would be unable to respond to a major incident, it added: "In the event of a major incident, the NIAS would implement its major incident plan and would be confident of being able to respond."