PUBLIC bodies across north-east Wales are to be asked what steps they are taking to help eliminate the problem of ambulances having to queue outside the region’s three main hospitals.
At an inquest in Ruthin John Gittins, coroner for North Wales East and Central, said he was taking the “scattergun” approach of writing to the Betsi Cadwaladr University Health Board, Wales Ambulance Services and Wrexham, Conwy, Denbighshire and Flintshire councils because they all had a part to play in finding a solution.
His comments came at the end of an inquest into the death of 95-year-old Lily Baxandall, who died on September 5, 2015, four days after being admitted to Glan Clwyd Hospital.
She had injured her head in a fall at her home in Heol y Fedwen, Belgrano, near Abergele, but the inquest heard how it took 42 minutes for an ambulance to arrive and she was kept in an ambulance outside the emergency department for almost four hours.
When she arrived fully conscious at the hospital at 5pm there were 11 ambulances outside. She was kept under observation and was finally admitted at 9.40pm, by which time her condition had deteriorated and she was unconscious.
A post-mortem examination found the cause of death to be pneumonia and a subdural haematoma - bleeding on the brain – due to a fall.
Her great-niece Dr Kate Thomas told the hearing that it was clear that there had been a bleed on the brain but she felt it was too late to give treatment to reverse the blood-thinning effects of warfarin she was taking for a heart condition.
Former consultant Dr Geoffrey Phillips, called as an expert witness, said that although Miss Baxandall, who had made it clear previously that she would not want to be resuscitated in the event of a heart attack, might have had a CT scan earlier the outcome would probably have been the same.
Frances Millar, the on-call matron that night, said it was a very busy day and it became “exceptional”. Huge efforts were made to improve the flow of patients but even Wrexham and Bangor hospitals were full to capacity and unable to assist.
“Everybody was working very, very hard,” she said.
Adam Griffiths, head of nursing for unscheduled care at Glan Clwyd, said things had improved but were still “nowhere near” where they wanted them to be.
Since Miss Baxandall’s death, he said, all patients waiting outside were triaged within 15 minutes and seen by a consultant within 30 minutes.
Asked by the coroner what the current situation was, Mr Griffiths said that on Monday this week there were seven ambulances waiting.
“Luckily for us there was no harm done,” he said.
Both Mr Griffiths and Dr Phillips said one of the problems was finding places for patients to be discharged into social care.
Gary Doherty, who took over as chief executive of the Health Board 12 months ago, also outlined the improvements being made and pointed out that the number of patients kept waiting for over an hour fell by 23% in the first three months of this year compared with the previous quarter.
Asked by the coroner to say what he saw as the answer to the problem had he been able to wave a magic wand, Mr Doherty replied: “Recruitment and retention of staff.”
After recording a conclusion of accidental death on Miss Baxandall, a former catering supervisor at Heathrow Airport, Mr Gittins said that despite having heard about the steps already taken he felt that more needed to be done and he had to issue a Regulation 28 report to try to prevent future deaths.
He stressed that it called for co-operation among the various agencies, adding: “I am not prepared to allow a situation to arise where it becomes the norm for ambulances to park outside. There is a danger we could come to accept the situation.”
They could not afford to be complacent, he said, but he added: “We have light at the end of the tunnel but we have to ensure that we all work together to reach it.”