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The NHS backlog might have decreased but ambulance waiting times are still high

Although waiting lists for hospital treatment have reduced, access to emergency care is getting slower.

By Harry Clarke-Ezzidio

Victoria Atkins, the Health Secretary, was in a buoyant mood on social media yesterday morning (11 January), when the latest NHS waiting list figures showed that the overall patient backlog was down by 95,000 in November, compared to the previous month. “Our plans are delivering for patients,” she posted on X. But data on the time it takes for ambulances to reach people following a 999 call reveal that the government’s plans are still leaving patients waiting too long.

The latest figures from NHS England reveal that ambulance waiting times across all “categories” (which denote the seriousness of medical emergencies) rose in December. The British Heart Foundation (BHF) said the new data revealing increased ambulance waits was “unacceptable”, adding: “Patients and their families need to see an end to this crisis.”

Category one incidents deal with life-threatening conditions; category two situations include suspected heart attacks, stroke and severe chest pain; category three includes “urgent” problems that require treatment and transport to an acute setting; and category four incorporates non-urgent problems where patients need transportation to a ward.

For category two calls, the average wait time for an ambulance is 45 minutes and 57 seconds, up from 38 minutes and 30 seconds in November. The official government target for responding to such calls is 18 minutes, meaning the average wait is now more than double what it should be.

“Heart attacks and strokes are life-threatening emergencies. Every minute lost increases the risk of permanent brain or heart damage, and even death,” says Dr Sonya Babu-Narayan, a consultant, and associate medical director at the British Heart Foundation. “That’s why it is so dangerous that average ambulance response times rose again this December.”

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The data covering December shows that the response time for category one incidents went up by 12 seconds on the previous month, and now averages 8 minutes 44 seconds (with a target time of 7 minutes); category three incidents went up by 20 minutes on the previous month; and category four calls are waiting an extra 19 minutes for an ambulance to arrive.

The government and NHS England have set new targets for ambulance response times. For category two calls, the target is 30 minutes – but targets for these health emergencies have only been met in one month since April 2023, the BHF notes. “Every minute counts when someone has a heart attack – a minute can be the difference between permanent heart damage or even survival,” said Babu-Narayan. “Changing the target to 30 minutes was a step taken to try and improve the situation in the immediate term, but the sooner we see a return to the 18-minute target the better.”

And while the government celebrates a drop in the overall NHS waiting lists – Atkins noted that it is “the biggest fall since 2010 outside of the pandemic” – there is still a mixed picture in the provision of specialist treatments, including for cardiovascular conditions. The latest figures show that the heart conditions waiting list fell by 4,667 people in November 2023, compared to the month before. But the waiting list for heart care is still 72 per cent larger than in February 2020, according to the BHF.

“We have seen real damage to every stage of heart care – from prevention and diagnosis through to treatment and aftercare,” said Babu-Narayan. “This has inevitably had a major impact on patient health in recent years – from the people who have missed checks for high blood pressure, through to someone having a heart attack that could have been avoided because of a delay in having a stent fitted.”

[See also: Do healthcare guidelines prioritise consistency over patient care?]

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