Patients in England face ‘postcode lottery’ over ambulance services, say MPs

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Urgent and emergency care services in England have fallen “far below the standard the NHS says patients should expect and receive”, according to an influential cross-party group of MPs.

The House of Commons public accounts committee said on Wednesday that despite the NHS having more money and staff “than ever before”, the public is facing a “postcode lottery” when it comes to ambulance response times. 

The government launched its long-awaited workplace plan this year in an attempt to tackle a staffing crisis in the NHS and record waiting lists for treatment.

MPs said the NHS workforce plan, the first long-term staffing strategy for the health service published in June, was “unfunded and uncosted”. 

Under the plan, the government has pledged £2.4bn towards education and additional training places over the first five years of the 15-year road map, which the committee said was insufficient and risked “future unsustainable financial pressures”. 

Access to quality urgent and emergency care for life-threatening conditions “depends too much” on where patients live, MPs said. The average ambulance response time was 6 minutes 51 seconds in London in 2021-22, compared to 10 minutes 20 seconds in south-west England. 

“The NHS has not met targets for ambulance handovers since November 2017 and for A&E waits since July 2015, with wider declines in performance across the board,” the committee said. 

“Against this background, we asked how effective the department has been in holding NHS England to account for the declining performance.” 

Despite NHS England “having more money and staff than ever before”, it “has made poor use of it to improve access for patients when they are in urgent need”, it added. 

The report also raised concerns over the speed at which the NHS is discharging medically fit patients from hospital to free much-needed bed space. An average of 13,623 patients were discharged in the last quarter of 2022-23, up from 12,118 during the same period the previous year.

“Not enough is being done to address the systemic issues with discharges that lie within the gift of the NHS and its hospitals, and which cannot be blamed on external factors,” the committee said. 

Dame Meg Hillier, chair of the committee, said: “Anyone who has had recent contact with the NHS knows it is in crisis.

“The government and health system need to be alert to the serious doubts our report lays out around the workforce crisis, both the approach to tackling it now and the additional costs funding it in the future.”

Julian Redhead, national clinical director for urgent and emergency care, said the report included data that was more than two years old when the health service was grappling with the Covid-19 pandemic. 

However, he acknowledged the NHS had been “under increasing pressure with staff experiencing record A&E attendances, hospitals fuller than at any point in their history and with thousands of beds taken up each day, in part, due to pressures in social care”.

The Department of Health and Social Care said: “There are record numbers of staff working in the NHS and our historic long-term workforce plan, backed by over £2.4bn will train, retain and recruit hundreds of thousands more staff which will put the NHS workforce on a sustainable footing for the future.”