West Midlands Ambulance Service University NHS Foundation Trust

4. Mr P complains about the delay with West Midlands Ambulance Service University NHS Foundation Trust (the Trust) sending an ambulance to him on 11 May 2025. He says:

• it took over two and a half hours for the ambulance to arrive despite his partner contacting the Trust a further two times • he was originally categorised as a category 3 call but should have been category 2.

5. Mr P says when the ambulance arrived, he was told by the paramedics he was having a heart attack and was taken straight to hospital where he had surgery and two stents inserted.

6. Mr P says if he had received treatment within 40 minutes, he would not be suffering from heart failure now, he would not need to be on medication for life and would not have needed surgery.

7. He says he now suffers from stress, anxiety and depression and worries all the time about having another heart attack. He says this is impacting his job due to time away from work and also his social life and relationships.

8. Mr P says he has tried to go on antidepressants but cannot due to interactions with his other medications. He is currently waiting for his talking therapy sessions to begin.

9. He also said it has had a profound impact on his partner Miss T, who had to witness him so poorly while they waited for an ambulance.

10. Mr P is looking for service improvements and a financial remedy.

11. Mr P is in his mid-thirties.

12. On 11 May 2025 at 22.19pm, his partner, Miss T, rang an ambulance as Mr P was suffering from severe chest pain, was hot, sweating and was vomiting. During the phone call Mr P confirmed he had no previous diagnosis that impacts his heart, could talk in sentences and whilst he had shoulder pain this was not radiating from his chest. The Trust advised a clinician would contact him and an ambulance could take up to 60 minutes.

13. At 22.41pm, he was contacted by a clinician who asked if he could get himself to hospital, which he could not. The clinician referred him for an ambulance.

14. At 23.17pm, Miss T rang 999 again as an ambulance had still not arrived. Miss T told the Trust that his condition had not deteriorated but he was agitated. The Trust advised he was in a queue for an ambulance and it could be a little while longer.

15. At 00.16am, Miss T contacted 999 again as an ambulance had still not arrived. During this call, Miss T advised his condition had worsened as the pain was now under his armpit. The Trust completed another triage assessment. The Trust advised a clinician would contact them and an ambulance would be with them as quickly as possible.

16. At 00.31am, Mr P was contacted by another clinician at the Trust and he was categorised as a category 2.

17. An ambulance arrived a few minutes later.

Delay with ambulance

22. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications that something has gone wrong.

23. Mr P has raised concerns it took over two hours for an ambulance to arrive despite his partner, Miss T contacting the Trust several times.

24. We acknowledge this is a long wait especially when Mr P was suffering with chest pain and vomiting, and had small children upstairs. We fully understand why Mr P is so upset and concerned with this wait time.

25. The Trust says it was well resourced on 11 May 2025 however, at the time of the call there were no available ambulance resources in the area, due to significant delays at hospital handovers. Some hospital handovers that evening were taking five hours.

26. Miss T contacted 999 at 22.19pm on 11 May 2025, as Mr P was suffering from chest pain, left shoulder pain and was vomiting. An ambulance arrived at Mr P’s home at 00.44am on 12 May 2025

27. During the initial call to the Trust on 11 May 2025, Mr P was categorised as a category 3 (CAT3) call. The NHS England guidance describes a CAT3 call as ‘urgent but not life threatening’. The response time for an ambulance is, in at least nine out of ten cases an ambulance arrives in 120 minutes.

28. Following the phone call with a clinician at 22.41pm, there was no indication of an immediately life threatening emergency and the reason an ambulance was requested was because Mr P could not transport himself to hospital. Our adviser says this would not have been the case if the Trust suspected a heart attack at this point and would have sent an ambulance regardless of whether Mr P could make his own way to hospital.

29. As the initial call was made at 22.19pm, the ambulance for Mr P arrived over two hours later making it one of the 10% of cases where the ambulance does not arrive within 120 minutes. While this is unfortunate for Mr P, ambulance response time standards are not applied to individual cases but are applied to all cases over a 24 hour period. The Trust has told us on 11 May 2025 the average wait time for CAT3 calls was 55 minutes and 13 seconds, meeting NHS England guidelines. Though Mr P was not provided with an ambulance within 120 minutes this is not an indication of a failing by the Trust as guidance says it is expected that 10% of cases will have a longer response time.

30. We understand following a call with a clinician at 00.40am, Mr P was upgraded to a category 2 (CAT2) call. The NHS England guidance describes this as an ‘emergency call’ and these should be responded to within 18 minutes. As Mr P’s ambulance arrived at 00.44am, well within these timeframes.

31. We do not consider there is any indication of a failing by the Trust with how quickly Mr P’s ambulance arrived. We understand our decision may not be what Mr P expected given he waited over 120 minutes for an ambulance. We hope he understands the reasons for our decision.

Categorisation of call

32. Mr P has also raised concerns he should not have been categorised as a CAT3 call and should have been CAT2 from the start.

33. We are sorry to hear Mr P feels he was not categorised correctly when he made his initial 999 call on 11 May 2025.

34. The Trust says within the calls made by Miss T at 22.19pm, 23.17pm and 00.17am, Mr P met the criteria for CAT3. It was not until a call by a clinician at 00.41am which identified some ‘red flag’ symptoms that Mr P was categorised as CAT2.

35. We have previously mentioned the NHS England guidance defines a CAT 2 cases as an ‘emergency call’ and CAT3 as an ‘urgent call’.

36. To categorise a call, the call handler at the Trust conducted a review of Mr P using the NHS Pathways, which is a triage system used for 999 calls. The NHS Pathways works in a reductive manner, meaning it rules out possibilities in order of severity until it reaches a point where it cannot proceed any further and an outcome is reached.

37. Our adviser has listened to the calls made to the Trust by Miss T and says the correct categorisations were made and there was no specific factors which would suggest a CAT3 response was inappropriate.

38. The NHS Pathways says not all chest pain presentations require a CAT2 response and our adviser agrees this was the case here.

39. We consider there has been no identification of a failing here. We understand this will be frustrating for Mr P especially as after a call at 00.41am he was categorised as a CAT2 response. We hope he feels reassured following a review of all the calls prior to this, he has been correctly categorised as a CAT2.

40. We have listened to Mr P and Miss T and are saddened to hear how drastically life has changed for them and their family since the decline in Mr P’s health. We recognise how terrifying the events during this night must have been for them and thank them for sharing their experience with us.

1. We have carefully considered Mr P’s complaint about West Midlands Ambulance Service University NHS Foundation Trust (the Trust) and we have seen no indication that anything went seriously wrong.

2. Mr P has raised concerns about the delay in an ambulance arriving at his home and he also feels he was categorised incorrectly as a category 3 call when he should have been category 2. We do not consider there is any indication of a failing here and consider the Trust appropriately categorised Mr P’s call and whilst there was a slight delay with the ambulance arrival, we cannot hold this against the Trust.

3. We understand this will be disappointing to Mr P considering everything he has gone through since 11 May 2025. We recognise the impact these events have had on him, his partner and young family. We have provided answers to his concerns and hope this helps to reassure him about the care he received.