Charles Rothwell was initially told it would be 11 hours before an ambulance arrived
A man died coughing up blood after he was told it would be an 11-hour wait for an ambulance during the first of multiple calls made to 999. Charles Stephen Rothwell, 69, died in Chester on the evening of January 6.
Despite the first of four 999 calls being made at 4.26pm, an ambulance did not arrive until 7.37pm and paramedics were unable to resuscitate Mr Rothwell. An inquest held in Warrington on October 4 gave a medical cause of death of 1a Lobar pneumonia and a conclusion of natural causes.
A prevention of future deaths report was penned by the area coroner for Cheshire Claire Welch. While she said the delayed arrival of paramedics did not contribute to his death, she did raise concerns that ‘ongoing lack of resources’ across NHS services meant there was a ‘risk that future deaths will occur unless action is taken’.
According to the report, a GP had diagnosed Mr Rothwell with a chest infection on January 5 and he was prescribed oral antibiotics. However, his condition ‘significantly deteriorated’ the next day.
During the first 999 call made at 4.26pm, Mr Rothwell was ‘correctly triaged’ as category three, which is classed as an ‘urgent call’. A response time for this category is usually within 120 minutes, according to NHS England’s ambulance standards, but Mr Rothwell was told it was ‘likely to be a minimum 11-hour wait’.
A second emergency call was made at 5.26pm and he was again graded as category three and reminded it would be an 11-hour wait. But a third call at 7.05pm stated he was ‘coughing up blood and struggling to breathe’, so he was re-graded as category two – an emergency call with an average response time of 18 minutes.
The fourth and final call was made at 7.30pm when he was ‘no longer breathing’. He was re-graded again as category one – calls about people with life-threatening injuries or illnesses – and paramedics arrived seven minutes later but Mr Rothwell was pronounced dead.
Ms Welch said North West Ambulance Service (NWAS) ‘continues to experience exceptionally high demand’ and that the demand ‘completely outstrips the capability they have got’.
She was told during the inquest that category two responses, which ‘should attract attendance within 18 minutes’, were seeing an average response time of 75 minutes. Meanwhile, category three responses had an average of 10.5 hours when it ‘should be within 120 minutes’.
She added: “With the approach of winter, NWAS are also beginning to see an even greater increase in demand on top of the existing demand.
“The problem is not due to a shortage of NWAS ambulances or staff but instead is the result of a wider issue linked to the lack of resources in primary, secondary and social care.
“This results in demand for ambulances outstripping supply and a backlog of ambulances waiting to handover patients at A&E departments because of a shortage of A&E beds, which in turn is because of a shortage of hospital beds, which in turn is because of shortages in social care.”
The prevention of future deaths report has been sent to: the Secretary of State for Health and Social Care; the chief executive of NHS England; and the managing director of the association of ambulance chief executives. They must respond by the deadline of November 30.
A North West Ambulance Service spokesperson said: “Our sincere condolences go to Mr Rothwell’s family at this difficult time. We acknowledge the coroner’s report, and we are sorry we didn’t get to him as quickly as we would want.
“We’re working hard to ensure that everyone who needs an ambulance gets one as quickly as possible; unfortunately, emergency medical services remain under significant pressure, and while the next available resource is dispatched for life-threatening calls, some other patients are waiting longer than we would like.
“To mitigate this, we have increased the numbers of frontline ambulance crews and introduced more clinical staff into our emergency call centres to oversee all those waiting. They will call patients back to offer medical advice or recommend appropriate pathways to receive medical care and can crucially upgrade the response required if needed. We’re also working closely with NHS colleagues to reduce hospital handover delays.”
A Department for Health and Social Care spokesperson said: “No-one should have to wait longer than necessary for emergency care and the Health and Social Care Secretary has set out her priorities of A, B, C and D – ambulances, backlogs, care, doctors and dentists.
“Our Plan For Patients sets out a range of measures to help ease pressures, including an extra £500 million to speed up discharge and free up hospital beds, reducing waits in A&E and getting ambulances quickly back out on the road.
“This is alongside NHS plans to rapidly boost capacity and resilience ahead of winter, including increasing the number of NHS 999 and 111 call handlers and creating the equivalent of at least 7,000 more beds.”
- 15:42, 17 OCT 2022
- UPDATED07:37, 18 OCT 2022