The program led to patients being delivered much faster to a hospital that was one of the worst in England for sick people being stuck, sometimes for hours, in the back of an ambulance. Queen’s Hospital in Romford, east London, has set up an ambulance reception center (ARC) near its main casualty unit, where two London Ambulance Service paramedics are on duty around the clock to help care for patients who would otherwise were trapped outside or inside. a corridor, waiting to see you. Patients who end up in the new six-cabin unit behind the A&E nurses station have a better experience while they wait and are more comfortable – and safer – because they can have their relatives with them, eat and drink and use the toilet more easily . Almost 2,000 patients have passed through the ARC since it opened last November, saving almost 13,000 hours of time for ambulance crews and enabling them to respond to emergency calls more quickly. Some A&E doctors see the scheme as a mere ‘band-aid’ as ambulance queues have become commonplace outside many hospitals and trauma units are treating the lowest proportion of patients within four hours on record. Matthew Trainer, chief executive of the Barking, Havering and Redbridge Trust, which runs Queen’s, admits “we still have too many delivery delays”. But, he pointed out, ARC also led to a big improvement in the hospital’s previously terrible delivery times. The number of people arriving by ambulance at Queen’s A&E rose from 1,529 in February to 1,788 in May. However, during the same period the percentage who had to wait at least an hour for them to be delivered fell from 27.4% to 19.4%, Trainer added. Last Wednesday afternoon all six wards were full, mostly with elderly people who had fallen or suffered a flare-up of an existing illness. However, there were no ambulances outside waiting to drop off a patient. Some doctors think of the shape as a simple adhesive plaster. Photo: PA Images/Alamy In the fourth ward of the ARC, 71-year-old Makhan Singh was jubilant. He had been quickly triaged and given antibiotics for his persistent cough and a series of tests to help doctors assess him. “This arrangement is good. It’s better than waiting in A&E, which was my main concern coming in today,” he said. Daniel Elkeles, chief executive of London Ambulance Service (LAS), said: “ARC means patients benefit, the ambulance service benefits and people waiting for a response to a 999 call benefit too.” NHS England bosses believe the partnership could be adopted elsewhere. Whipps Cross Hospital in east London has introduced a similar facility and managers from other NHS trusts have been to Romford to see how it works. However, not everyone is impressed. The Royal College of Emergency Medicine, which represents trauma doctors, branded the ARC “short-sighted”. Katherine Henderson, president of the college, said: “Pre-emergency ward delivery models are not recommended by RCEM. Instead of focusing on demand management at the front door, we need to look at solutions around flow and discharge [of hospital patients].” He likened the plan to NHS England’s plan, introduced in March but never implemented, for patients to be treated in tents in hospital car parks to relieve pressure. “Not only did they make no difference, they were impossible to staff and presented serious safety risks. The initiative was just taking care of the runway under a different name.” Improving social care, freeing up beds by allowing older patients who are medically fit to leave but need support afterwards, would do more than anything else to end long queues, Henderson added. “Short-sighted ‘temporary’ solutions do nothing to address the crisis,” he said. However, Martin Flaherty, chief executive of the Association of Ambulance Directors, hailed the ARC as “a positive example of what can be achieved when a whole-of-system approach is taken to reduce hospital delivery delays to emergency departments. “Tackling unnecessary delays – and the consequent impact they have on ambulance service turnaround times, staff wellbeing and patient harm – is the primary action that can be taken to relieve pressure on the ambulance sector and we can get back on the road. we can respond to more patients who need our life-saving care,” he said. However, a senior ambulance official said that while the ARC “is a step in the right direction, it still requires ambulance staff to be present to care for the patient, thus keeping them off the road elsewhere”. The ideal, he added, would be an ARC-style facility in each hospital, but staffed entirely by A&E staff so that all paramedics could leave once the handover was complete.
