A coroner has urged the health minister to act to prevent unnecessary deaths after a woman died of heart failure while waiting in the back of an ambulance for four hours.
Lyn Brind, 61, was taken to Queen Elizabeth Hospital (QEH) in King’s Lynn, Norfolk, with chest pains and low blood oxygen levels, but could not be admitted because there was “no space” at the hospital. Instead, she lined up with ambulances outside the A&E, did not receive prompt diagnosis or treatment, and missed warning signs about her condition.
She was transferred to a ward after waiting four hours and 25 minutes, at which point she was “agitated and short of breath”. She was placed on life support but died 22 minutes later.
Blinder’s family believe the grandmother-of-four, who was the town’s dinner girl, “could be alive today” if she had been admitted to hospital sooner. “She didn’t stand a chance,” said her partner of 38 years, Richard Bunton.
Following the inquest into Brind’s death in May 2022 earlier this month, Norfolk’s senior coroner, Jacqueline Lake, took the unusual step of writing to England’s health secretary, Steve Barclay, expressing concern for the NHS and society. caring concerns.
She warned that unless action was taken, others could die in similar circumstances. “I believe you are capable of taking action like this,” Lake wrote in a report on Preventing Future Deaths released last week.
The coroner said QEH was often overwhelmed, with “overcrowded emergency rooms” and a lack of social care in the community preventing people from being discharged.
She said about seven ambulances were waiting outside A&E to unload patients when Brind died — a number that had risen to 17 during an investigation earlier this month, usually outside the department queue. A further 140 hospital beds were occupied by patients who were “in good health” but could not be discharged because of a lack of social care places, Lake wrote.
The report highlighted lapses in Brind’s care, including not being regularly observed in line with East of England Ambulance Service Trust guidance and, while under observation, her worsening condition was not informed to the hospital’s ambulance navigator, who assessed the beds. order of priority. According to hospital protocols, Blinder suffers from multiple medical conditions, including diabetes, and was not evaluated by the hospital’s senior physician within an hour.
But the coroner said the evidence suggested the problem was “wider and more complex” than a single NHS trust and required action at government level.
The warning comes amid reports of NHS backlogs and treatment delays. Figures released last week by the Association of Ambulance Chief Executives showed an estimated 57,000 patients were potentially harmed by ambulance handover delays in December, with 6,000 of those patients suffering “serious harm”.
The Royal College of Emergency Physicians estimates that 300-500 people die every week in the UK due to overcrowded emergency rooms and long waiting times. NHS England said it did not recognize the figures.
The government has yet to formally respond to reports of Blinder’s death, but has until March 13 to do so. A Department of Health and Social Care spokesman said it was taking “urgent action” to improve hospital backlogs, including “investing £250m to free up hospital beds, relieve pressure on A&E and eliminate delays in ambulance transfers”.
It previously announced a £500m discharge fund and said it had created the equivalent of 7,000 hospital beds. A spokesman added that in the week to January 22, the time lost to ambulance handover delays fell to the lowest level this winter.
This is not the first time the coroner has sounded the alarm about ambulance delays. In November, Cornwall’s senior coroner, Andrew Cox, wrote to Barclay expressing similar concerns about a shortage of hospital beds due to the social care crisis. He cited four cases where ambulance delays and hospital overcrowding caused or contributed to the deaths of patients in the county.
Helen Blanchard, interim head nurse at King’s Lynn QEH, said the trust had learned from Blinder’s death and had “implemented the NHS standard of care for patients waiting in ambulances, including with ambulance staff”. Cooperate to ensure patients are still seen by senior physicians if they cannot come into the department immediately” and complete a 30-minute observation.
The East of England Ambulance Service said it had met with the hospital’s serious accident team to discuss how it could “help prevent incidents like this from happening again”. A spokesman said: “The coroner has made clear the pressure on the NHS at this time and subsequently, which has led to delays in the handover of emergency departments in hospitals.”
