Department of Health and Social Care
Central Government
Noted
The Department of Health and Social Care acknowledges concerns about ambulance demand and delays in Greater Manchester, highlighting national efforts to improve ambulance response times, increase hospital bed capacity, and ensure timely hospital discharge. (AI summary)
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Dear Ms Mutch,
Thank you for your letter of 4 February 2023 to the Secretary of State for Health and Social care, about the death of Patricia Grace Eileen Green. I am replying as Minister with responsibility for urgent and emergency care. Please accept my sincere apologies for the significant delay in responding to this matter. I would like to assure you that the Department is mindful of the statutory responsibilities in relation to prevention of future deaths reports and we are prioritising responses as a matter of urgency.
Firstly, I would like to say how saddened I was to read of the circumstances of Mrs Green’s death and I offer my sincere condolences to her family and loved ones. I am grateful to you for bringing these matters to my attention.
Your report raises concerns over the high demand and shortage of ambulances across Greater Manchester due to long delays at emergency departments.
In preparing this response, Departmental officials have made enquiries with NHS England (NHSE). NHSE recognise the significant pressure on ambulance services since the Covid-19 pandemic as well as issues associated with handing over ambulance patients in a timely way at some NHS Trusts. Further, my officials advise me that Greater Manchester Integrated Care Board wrote to you in August to provide information on the improvements being made locally supporting improved ambulance response times and reductions in handover delays.
As the Minister responsible for urgent and emergency care services, I recognise the significant pressure the urgent and emergency care system is facing. That is why we published our ‘Delivery plan for recovering urgent and emergency care services’ which aims to deliver sustained improvements in waiting times. Our ambitions for this year are to improve A&E waiting times to 78% of patients to be admitted, transferred, or discharged from A&E within four hours by March 2025, and to reduce Category 2 ambulance response times to 30 minutes on average across this fiscal year. The plan is available at https://www.england.nhs.uk/wp-
content/uploads/2023/01/B2034-delivery-plan-for-recovering-urgent-and-emergency-care- services.pdf
Your report highlights that NWAS were under high demand at the time of the incident. A primary aim of our delivery plan is to boost ambulance capacity. Ambulance services received £200 million of additional funding in 2023/24 to expand capacity and improve response times, and we are maintaining this additional capacity in 2024/25. This is alongside the delivery of new ambulances and specialist mental health vehicles. With more ambulances on the road, patients will receive the treatment they need more swiftly.
I recognise that ambulance trusts work within a health and care system and issues such as delayed patient handovers to hospitals can impact on capacity and response times. That is why a key part of the delivery plan is about improving patient flow and bed capacity within hospitals. We achieved our 2023/24 ambition of delivering 5,000 more staffed, permanent hospital beds compared to 2022-23 plans, backed by £1 billion of dedicated funding, and we will maintain this capacity uplift in 2024/25. Further, we also achieved our target of scaling up virtual ward bed capacity to over 10,000 ahead of winter 2023/24, and there are now over 11,000 beds available nationally. We have also provided £1.6 billion of funding over two years to support the NHS and local authorities to ensure timely and effective discharge from hospital. These measures are helping improve patient flow through hospitals, reducing delays in patient handovers so ambulances can swiftly get back on the roads.
At a national level, we have seen significant improvements in performance this year compared to last year. In 2023-24, average Category 2 ambulance response times (including for serious conditions such as heart attacks and strokes) were over 13 minutes faster compared to the previous year, a reduction of 27%. NWAS average Category 2 response times were over 13 minutes faster in 2023-24 compared to the previous year, a 32% reduction.
However, I recognise there is still more to do to reduce response times further, and the Government will continue to work with NHS England to achieve this.
I hope this response is helpful. Thank you for bringing these concerns to my attention.
Yours,
HELEN WHATELY
Thank you for your letter of 4 February 2023 to the Secretary of State for Health and Social care, about the death of Patricia Grace Eileen Green. I am replying as Minister with responsibility for urgent and emergency care. Please accept my sincere apologies for the significant delay in responding to this matter. I would like to assure you that the Department is mindful of the statutory responsibilities in relation to prevention of future deaths reports and we are prioritising responses as a matter of urgency.
Firstly, I would like to say how saddened I was to read of the circumstances of Mrs Green’s death and I offer my sincere condolences to her family and loved ones. I am grateful to you for bringing these matters to my attention.
Your report raises concerns over the high demand and shortage of ambulances across Greater Manchester due to long delays at emergency departments.
In preparing this response, Departmental officials have made enquiries with NHS England (NHSE). NHSE recognise the significant pressure on ambulance services since the Covid-19 pandemic as well as issues associated with handing over ambulance patients in a timely way at some NHS Trusts. Further, my officials advise me that Greater Manchester Integrated Care Board wrote to you in August to provide information on the improvements being made locally supporting improved ambulance response times and reductions in handover delays.
As the Minister responsible for urgent and emergency care services, I recognise the significant pressure the urgent and emergency care system is facing. That is why we published our ‘Delivery plan for recovering urgent and emergency care services’ which aims to deliver sustained improvements in waiting times. Our ambitions for this year are to improve A&E waiting times to 78% of patients to be admitted, transferred, or discharged from A&E within four hours by March 2025, and to reduce Category 2 ambulance response times to 30 minutes on average across this fiscal year. The plan is available at https://www.england.nhs.uk/wp-
content/uploads/2023/01/B2034-delivery-plan-for-recovering-urgent-and-emergency-care- services.pdf
Your report highlights that NWAS were under high demand at the time of the incident. A primary aim of our delivery plan is to boost ambulance capacity. Ambulance services received £200 million of additional funding in 2023/24 to expand capacity and improve response times, and we are maintaining this additional capacity in 2024/25. This is alongside the delivery of new ambulances and specialist mental health vehicles. With more ambulances on the road, patients will receive the treatment they need more swiftly.
I recognise that ambulance trusts work within a health and care system and issues such as delayed patient handovers to hospitals can impact on capacity and response times. That is why a key part of the delivery plan is about improving patient flow and bed capacity within hospitals. We achieved our 2023/24 ambition of delivering 5,000 more staffed, permanent hospital beds compared to 2022-23 plans, backed by £1 billion of dedicated funding, and we will maintain this capacity uplift in 2024/25. Further, we also achieved our target of scaling up virtual ward bed capacity to over 10,000 ahead of winter 2023/24, and there are now over 11,000 beds available nationally. We have also provided £1.6 billion of funding over two years to support the NHS and local authorities to ensure timely and effective discharge from hospital. These measures are helping improve patient flow through hospitals, reducing delays in patient handovers so ambulances can swiftly get back on the roads.
At a national level, we have seen significant improvements in performance this year compared to last year. In 2023-24, average Category 2 ambulance response times (including for serious conditions such as heart attacks and strokes) were over 13 minutes faster compared to the previous year, a reduction of 27%. NWAS average Category 2 response times were over 13 minutes faster in 2023-24 compared to the previous year, a 32% reduction.
However, I recognise there is still more to do to reduce response times further, and the Government will continue to work with NHS England to achieve this.
I hope this response is helpful. Thank you for bringing these concerns to my attention.
Yours,
HELEN WHATELY