Five NHS trusts singled out by Health Secretary for worst ambulance queues and long delays at A&E

The heads of the NHS trusts with the worst ambulance queues and most chaos in A&E have been hauled in front of the Health Secretary and ordered to “buck up their ideas”.

Victoria Atkins made the intervention amid concern about the number of patients facing waits of as much as 10 hours in ambulances parked outside A&E units.

The meeting came as the NHS braces for three weeks of extreme disruption.

Junior doctor walkouts were due to start at 7am on Wednesday and last until Saturday, with their longest strike yet in the new year, while rates of flu, norovirus and Covid hospital admissions are rising.

On Monday, the heads of University Hospitals Plymouth Trust, Royal Cornwall Hospitals Trust, Gloucestershire Hospitals Foundation Trust, The Shrewsbury and Telford Hospital Trust and Worcestershire Acute Hospitals Trust were summoned for a dressing down from the Health Secretary.

It was sparked by unpublished data showing a deterioration in performance in areas which already had appalling records for ambulance and A&E delays.

One of the trusts on Tuesday announced that one of its  A&E units will close for weeks because of junior doctor’s strikes.

The closure of Cheltenham A&E will mean emergency patients are diverted to other hospitals.

NHS officials said both the unit and its minor injury service would be closed until Saturday, when the latest round of industrial action ends. The A&E unit will remain closed until Jan 1, with the unit only treating minor injuries. Even when it reopens it will close at 8pm every night for a further week under plans drawn up by Gloucestershire Hospitals Foundation trust.

With scenes of chaos even before strikes start in some parts of the country, health chiefs have ordered a crackdown on 10-hour waits outside casualty units.

Under new protocols, national teams must be alerted and extra help sought when the clock reaches eight hours.

NHS figures show average handover times of five hours for ambulance arrivals at University Hospitals Plymouth Trust and Royal Cornwall Hospitals Trust on Dec 8.

On the same day, average waits reached almost three hours at Gloucestershire Hospitals Foundation Trust.

A source close to the Health Secretary said the chief executives of the five trusts were told in no uncertain terms that their performance was not acceptable and that they will be kept under close scrutiny from now on.

Health Secretary Victoria Atkins is targeting failing NHS trusts – Ian Davidson/Alamy

The source said: “The Secretary of State made it abundantly clear to senior management that they should buck up their ideas this winter.

“The managers accepted they had all the resources they needed from the department and NHSE but were not hitting their targets and failing their local communities.

“It is frankly, not fair that patients in these areas are facing the longest delays due to poor management – whether that is stuck on an ambulance, sat in A&E or waiting to be discharged from the wards to go home for Christmas.”

In the week ending Dec 10, 83 per cent of ambulance arrivals to the Plymouth and Cornwall trusts faced delays of at least half an hour, along with 69 per cent of those at the Gloucestershire trust, 64 per cent of those at the Shrewsbury trust and 59 per cent of those at the Worcester trust, where problems are focused at Worcester Royal Hospital.

Across England, one in three ambulances had such a delay in handing over to A&E.

The five called in were Ann James, chief executive of University Hospitals Plymouth Trust since 2012, Steve Williamson, chief executive of Royal Cornwall Hospitals Trust since January 2022, Deborah Lee, chief executive of Gloucestershire Hospitals Foundation trust since 2016, Louise Barnett, chief executive of The Shrewsbury and Telford Hospital Trust since 2020 and Glen Burley, who became chief executive of Worcestershire Acute Hospitals Trust in August 2023.

On Monday, Amanda Pritchard, the head of the NHS, set out new protocols to attempt to prevent patients being held in ambulances for 10 hours.

The new “escalation process” reported by the Health Service Journal means national teams will be contacted when any wait reaches eight hours, in an attempt to find extra help to resolve the situation.

Doctors’ strikes which start on Wednesday mean there are just four days when the NHS is fully functioning in the next three weeks.

Junior doctors will walk out until Saturday, just ahead of Christmas and return to picket lines for their longest strike yet in the new year.

The prolonged action surrounding the holidays means hospitals will be forced to scale back most routine care and focus on emergencies for a three-week stretch.

University Hospitals Plymouth NHS Trust has reported handover times of five hours for ambulance arrivals – Paul Slater/Alamy

On Tuesday, the Prime Minister’s official spokesman said: “We would encourage junior doctors to consider carefully the extremely significant impact striking at such a challenging time will have, both on the NHS and for individual patients, and to return to talks. I know the Health Secretary is very open to continuing discussion.”

Prof Sir Stephen Powis, the NHS national medical director, said the strikes would cause “huge disruption to the NHS” with services already under strain, and likely to see a significant rise in demand as the new year approaches.

Officials said almost all routine care will be affected.

Sir Stephen said: “Over the holiday period, I would encourage anyone who needs medical help to continue to come forward – in a life-threatening emergency, call 999 and use A&E in the usual way. For everything else, use 111 online.”

The next set of strikes begin at 7am on Wednesday finishing at 7am on Saturday Dec 23.

In the new year, doctors will strike again for six days from 7am on Jan 3 to 7am on Jan 9.

Officials said this means that in the coming three weeks, just four weekdays are unaffected by holidays or industrial action.

One Gloucestershire Integrated Care System health and care partners, which represents NHS organisations in the county, said: “It is a source of great regret that patients continue to experience waits longer than any of us would wish and our staff are working unrelentingly to reduce the length of time patients wait in an ambulance.”

A Royal Cornwall Hospitals spokesman said: “Staff across Royal Cornwall Hospitals work incredibly hard to provide the most rapid handover possible from our ambulances.

“The significant demand on our services and the ongoing challenges associated with timely discharge of patients does inevitably lead to long waits for people in our emergency department or on ambulances.

“None of us want our patients to experience delays at any point in their care and colleagues in Royal Cornwall Hospitals and across our wider health and care system are committed to taking all possible actions to support rapid handovers for ambulances.”

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