The hardest part of a 12-hour shift for an East Midlands Ambulance Service paramedic might not be what you’d expect.
It’s not a difficult patient, skipping lunch or a hoax call. Instead, medics say the toughest part is waiting in a hospital corridor to hand over a patient into A&E while hearing the life-threatening calls come through on the radio – and knowing you can’t respond to them.
This is just another day for paramedic Aimee Bates and her crewmate Jack Storey. Local Democracy Reporter Anna Whittaker joined them.
At 6:45am Aimee and Jack meet at Beechdale Ambulance Station ready for their shift on a rainy Thursday.The first job of the day is to check over the ambulance before letting control know they are ‘clear’ for a job.
The NHS is under pressure like never before. A&E delays, corridor care and ambulances not meeting response times are all symptomatic of a huge problem across the country.
As we set off on our first job of the day, Jack explains: “We’ve said year-on-year it’s the worst winter yet.
“The reality is we’re saying for the 10th year it’s the worst on record.
“It’s unprecedented beyond anything.
“I’ve never known QMC (Queen’s Medical Centre) like it is now. Queen’s is always the one that keeps its head above water but discharge is a massive problem.
“People are coming out of years of isolation, staff are tired, people are leaving.
“There will never be a time where nobody is waiting for an ambulance.”
Our first patient is a woman with sinusitis in Hucknall and our second is a pregnant lady with suspected endometriosis pain in Gedling, both on new build estates.
“There probably haven’t been new GP surgeries built on these new estates”, Aimee, who used to be a beauty therapist, says.
“We catch the overflow of what the GPs can’t do. You just do what you’re given now and come to accept it”, she adds.
Jack adds: “GPs are well beyond capacity. There are bottlenecks everywhere, and I have literally no idea how to fix them.
“It’s not what you come to work to do and it can be frustrating.”
By 11am we’re off to Cotgrave where 90-year-old Barry Wells is at home with his two daughters.
Barry has bowel cancer and is in palliative care. His stomach has swollen into the shape of a giant ball.
As we arrive at QMC, there are already six ambulances waiting outside the doors of A&E.
The paramedics try to reassure Barry’s daughter who has travelled in the ambulance with him.
Mr Wells is a ‘category two’ patient – meaning his case is an emergency.
‘Category one’ calls are for people with the most serious life-threatening injuries and illnesses and ‘category two’ is for other calls still classed as emergencies.
EMAS is not currently hitting its targets for category two calls, which should be responded to in 18 minutes.
In October, the average response time for category two calls was 52 minutes and 52 seconds.
The mean time for a category one call response was nine minutes and 13 seconds – which is two minutes above the target.
Aimee says: “I’d love to get to patients sooner but that’s beyond my control.
“We are trying to combat the evolving nature of the job.”
As Barry is pushed through the doors of QMC’s A&E on a trolley, he is placed at the back of a queue of ambulance patients.
He’s wincing in pain and the paramedics raise concerns with the resus team, who accept him onto a bed bay.
Once back in the ambulance, as soon as Jack clicks ‘clear’ on the screen, a new job immediately pops up.
It’s a category one call to a 54-year-old in suspected cardiac arrest in Lenton.
The blue lights are turned on and we arrive at the address within six minutes.
Phil Burns, a community first responder with EMAS and a University of Nottingham medicine student, is already at the scene.
He’s been alerted by an app called GoodSAM, which dispatches first responders to emergency situations.
The patient has collapsed and is showing some signs of sepsis, so he needs to be transferred to hospital.
Back at QMC with the patient at the back of the corridor queue, three category one calls come through one after another on Jack’s radio – and we’re only a seven minute drive from one of them.
But the paramedics cannot leave until their patient has been accepted by the hospital.
EMAS statistics show that in October 2023, the time ‘lost’ to paramedics waiting to discharge patients into hospital was the equivalent of 42
twelve-hour shifts.
“We’re available but unavailable – that’s quite routine now”, Jack says.
He adds: “If you were to get upset every time, you’d always be upset.
“If you stop and think it’s an unacceptable position to be in as a service.
“It’s a random Thursday it looks like a major incident has happened in Notts city centre.”
It’s getting so busy in A&E that EMAS start ‘cohorting’ – meaning that some paramedics are released to respond to calls while those in hospital stay to watch over a group of patients on the corridor.
“We’re late off regularly with delays at hospitals, it became worse and worse”, Jack says.
A rule is in place where paramedics can only respond to category one calls in the last 45 minutes of the shift, and only cardiac arrests in the last 15 minutes of the shift.
It’s a bid to reduce paramedic burnout and make sure they clock off on time.
We spend the last hour of the shift back in QMC’s A&E, where our last patient is waiting on a corridor to be handed over to hospital staff.
By the time we’re back at the ambulance station Aimee and Jack will be clocking off late – before another 7am shift the following day.
But they remain positive about the rewarding nature of the role.
Aimee says: “Every day is different and you make a difference to people’s lives in this job.
“There’s always something to learn. You see society at its best and its worst.”
Dr Tasso Gazis, Divisional Director at Nottingham University Hospitals, said the “significant pressure” is expected to increase over the winter months.
He said: “We have introduced a number of initiatives to improve wait times and flow through the hospital, like virtual wards, a 24/7 Transfer of Care Unit and a Same Day Emergency Care unit.
“Our staff are working incredibly hard to ensure patients with the most urgent medical needs are prioritised whilst demand on our services remains high.”
The Department of Health and Social Care says ambulance services are receiving £200 million of additional funding this year, alongside 800 new ambulances to grow capacity and improve response times.
They said: “We have started preparing for winter earlier than ever and have taken significant action since last year.”
