Health
Ambulance delays linked to patient deaths, as local tragedy highlights crisis
PARAMEDICS across the UK are warning that patients are dying because ambulances are unable to offload them into overcrowded A&E departments — a situation tragically echoed in the death of a Pembrokeshire mother whose ambulance never arrived.
Charlotte Burston, 40, from Llanteg, began experiencing severe chest pains on Christmas Day 2023. Her teenage daughter called 999 twice, but was told it would be an hour and a half before help could arrive.
No ambulance was dispatched in time, not because of a lack of willingness, but because so many vehicles were already stuck in hospital bays, unable to hand over patients due to chronic delays and lack of space inside emergency departments.
With no other option, Charlotte’s stepfather drove her towards Withybush Hospital. She suffered a heart attack on the way and later died at Morriston Hospital on New Year’s Eve.
An expert report presented at a recent pre-inquest hearing concluded that had ambulance staff been present at her home, she would “on the balance of probabilities” have survived.
The case comes as a new report by Unison highlights the scale of the crisis facing ambulance services. A survey of almost 600 ambulance workers found that two-thirds had witnessed patients deteriorate during prolonged waits outside hospitals, and one in 20 had seen patients die in their care due to delays in handover.
More than half of respondents reported delays of over six hours, and one in seven had waited 12 hours or more outside emergency departments.
Unison General Secretary Christina McAnea said: “Ambulance workers want the best for their patients. But this is no longer the reality. Ambulances and hospital corridors have become makeshift treatment rooms. The pressure on the NHS is unsustainable.”
Unison is calling for urgent action to increase staffing levels across ambulance, hospital and community services, improve GP access, and expand social care capacity to free up hospital beds.
Pembrokeshire Coroner Mark Layton, who is overseeing the Burston inquest, said that had the 999 call been prioritised properly, paramedics would have been sent and the tragic outcome may have been avoided.
Community
Health chiefs to be questioned over Withybush hospital service changes
HEALTH BOARD members are to be quizzed by Pembrokeshire councillors next month over changes to services at Withybush Hospital.
At the March meeting of Pembrokeshire County Council, an emergency notice of motion by the council’s 11-strong Conservative Party group demanded that the Welsh Government immediately reverses the decision to cease emergency general surgery at Withybush Hospital.
Last year, Hywel Dda University Health Board consulted with its communities on options for change in critical care, dermatology, emergency general surgery, endoscopy, ophthalmology, orthopaedics, stroke, radiology and urology.
At a two-day meeting earlier this year, the board, amongst its many other decisions, backed changes into emergency general surgery which will see no emergency general surgery operations taking place at Withybush, but a strengthening of the same-day emergency care (SDEC).
At the March council meeting, the Conservative council group, led by Cllr Di Clements, proposed a motion which read: “This council requests that the Labour Welsh Government intervenes in Hywel Dda University Health Board’s recent decision to cease emergency general surgery at Withybush hospital and immediately reverses their decision.
“We believe removing this service critically undermines the sustainability of Withybush hospital’s A&E department.
“Also, the decision by the Health Board does not take into account the impact and potential serious risks it will have on Pembrokeshire residents.”
Cllr Clements’ supporting statement, which included a call for the-then Leader Cllr Jon Harvery to write to the First Minister and Welsh Government, said Pembrokeshire residents “have seen continual downgrading of services over the years, and this has been detrimental to all residents,” adding: “We believe this recent decision is life threatening to those who need emergency surgery and a matter of resident’s safety.”
At the meeting, Cllr Michael John said “there had been an erosion of services for many years,” supporting Cllr Clements’ call, but proposing the addition of calling on the health board to meet with councillors.
Following the request by Cllr Clements, Leader Cllr Jon Harvey agreed to any letter writing, saying he had “fought long and hard to return services to Withybush”.
Members backed Cllr Clements’ call, with Cllr John’s amendment added.
Since then an update was received at the May 14 meeting of Pembrokeshire County Council.
A report for members said, following the March meeting, Cllr Harvey, wrote to the-then First Minister Eluned Morgan on March 10, with Chief Executive Will Bramble also writing to the chief executive of Hywel Dda University Health Board advising him of council’s decision on the same date, requesting his and the Board chair’s attendance at the May council meeting.
It said, since then, Health Board Chair Dr Neil Wooding and Chief Executive Professor Phil Kloer have agreed to attend an Extraordinary Meeting of the council on June 15 to brief the council on service changes and specifically the issue of emergency general surgery, with members having the opportunity to ask questions on the presentation.
Members agreed to note the report ahead of the special June meeting.
Health
Nursing warning over ‘deadly mix’ of staff shortages and complex care
RCN says patients are at growing risk as nurses report unsafe staffing levels
NURSING leaders have warned that collapsing growth in the registered nurse workforce, combined with increasingly complex patient needs, is creating a “deadly mix” for patients.
The Royal College of Nursing said staff across hospital and community settings are being left struggling to keep people safe, with more than a quarter saying nurse numbers on their last shift were so far below what was needed that there was a high risk of harm.
The warning comes from the RCN’s latest Last Shift survey, which gathered responses from more than 13,000 nursing staff across the UK.
Professor Nicola Ranger, the RCN’s General Secretary and Chief Executive, is expected to tell more than 3,000 frontline nursing staff at the union’s annual Congress in Liverpool that governments are failing in their duty to keep patients safe.
She will say that widespread registered nurse vacancies are always unsafe, but that the risk is now being made worse by an ageing and sicker population with more complex needs.
Four in five nursing staff said clinical complexity had increased over the past two years, while only one in ten said staffing was at the right level to meet all patient needs. More than two thirds said they were being forced to make difficult decisions about which care to prioritise.
In Wales, nurses and health care support workers described growing pressure across wards and community services.
A nurse working on an older people’s ward in the NHS in Wales said: “We need to increase the agreed establishment; nurse to patient ratio due to increasing acuity, dependency and complexity of patients’ condition and presentation.
“More and more patients are now presenting with worsening cognitive function and often display challenging behaviour.”
A health care support worker from an inpatient mental health unit in Wales said: “Our ward has been bombarded with high acuity for around a year now and staffing levels have barely seen an increase.”
The RCN said the findings also show the toll on staff wellbeing. More than three quarters of respondents said they felt emotionally exhausted on their last shift, with exhaustion highest among those who said their shift was understaffed.
RCN Wales Executive Director Nicola Williams said: “Nursing staff across Wales are telling us clearly that staffing levels are not matching the complexity and intensity of care patients now need.
“Too many shifts are operating without enough registered nurses to deliver safe and effective care.
“When more than a quarter of nursing staff describe staffing levels as unsafe and nearly half report compromised care, we need to listen and take action to address it.”
She said members were “going above and beyond every day” but were demoralised, missing breaks and having training time cancelled.
Ms Williams added: “They cannot continue carrying the burden of workforce shortages indefinitely. Emotional exhaustion is becoming normalised across the profession and that is dangerous for staff, patients and the future sustainability of services.
“The newly elected Welsh Government must urgently invest in growing and retaining the nursing workforce, ensure they have the training they require, alongside delivering safe staffing levels that are properly planned and enforced.
“Without action, patient safety risks will continue to grow.”
The RCN said the survey showed an urgent need for workforce investment, robust nurse staffing plans based on patient need, and action to improve recruitment and retention across Wales.
Health
Occupational therapists urge Welsh Government to act before NHS crisis deepens
More than 300 professionals sign open letter calling for prevention-focused care and urgent reform
OCCUPATIONAL therapists across Wales are urging the new Welsh Government to act before pressure on the NHS and social care system deepens further.
More than 300 members of the Royal College of Occupational Therapists in Wales have signed an open letter calling for a major shift towards prevention, early intervention and care closer to home.
They say too much support is currently arriving only after people have reached crisis point.
The therapists argue that earlier help in the community could reduce hospital admissions, ease pressure on overstretched services and improve lives across Wales.
Occupational therapists work across the health and care system, supporting premature babies and families in neonatal care, helping children take part in school, enabling adults to stay in or return to work, and helping older people live safely in their own homes.
The Royal College says the profession is often overlooked, despite playing a vital role in keeping people independent and reducing demand on hospitals.
Its members are calling for five key changes, including embedding occupational therapists in every community healthcare cluster, improving workforce planning, putting prevention at the heart of health policy, ending inconsistencies in provision, and opening leadership roles to occupational therapists.
Paul Smith, RCOT Policy and Public Affairs Lead for Wales, said: “Wales can’t afford to keep waiting for a crisis to happen.
“Occupational therapists are already preventing hospital admissions, easing pressure on stretched services and supporting people to do the occupations they want and need to do.
“But they need to be positioned to provide the right support at the right time to make maximum impact.”
The call comes amid continued concern over waiting times, delayed discharges and pressure on hospitals, including in rural parts of Wales where patients often face long journeys for care.
RCOT says ministers, health boards, councils and sector leaders must now work with the profession to ensure people receive the right support earlier, closer to home, and before problems spiral into crisis.
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