A Norfolk hospital has vowed to take action and “mitigate risks” following the death of an NHS hip op patient who waited more than 14 hours for an ambulance transfer.
Geoffrey Hoad, 86, had undergone a routine operation at the private Spire hospital in Colney. But three days later, while still recovering at the site, his condition deteriorated.
Staff called an ambulance to transfer him less than a mile away to the emergency assessment unit at the Norfolk and Norwich Hospital (N&N).
It was a five-minute drive away, but it took more than 14 hours for paramedics to arrive.
He later died at the N&N on August 7, 2022.
Following a three-day inquest into his death earlier this year, the county’s senior coroner, Jacqueline Lake, raised serious concerns about the incident.
She described the delays as “unacceptable and continued”.
She added: “Waiting over 14 hours [for an ambulance] is not acceptable by any stretch of the imagination and these delays are continuing.
“The risk of future deaths continues.”
As a result of the findings, she issued a Prevention of Future Deaths (PFD) report to both Spire Healthcare and the East of England Ambulance Service Trust. She also contacted the secretary of state for health.
In its response to the coroner, the group clinical director of Spire Healthcare addressed the concerns via a letter dated November 6.
It read: “Although the delay was not found to be causative of Mr Hoad’s death, HM Coroner has expressed concerns that there is a risk of future deaths occurring in similar circumstances.
“Spire Healthcare and Spire Norwich Hospital (SHN) take the issue of inter facility transfer extremely seriously and it continues to strive to mitigate the risks associated with the same.
“Spire Healthcare is taking appropriate steps to try and ensure that, on the rare occasions that patients need to be transferred to higher acuity facilities, it is done in a timely and safe manner, without placing undue burdens on a service which is acknowledged to be experiencing severe capacity pressures.”
From October 2021 to October 2023, SNH had a total of 15,163 inpatients and day case admissions, of which approximately 15pc were NHS patients.
During these same periods, patients requiring a transfer out from SNH to the NHS were 0.2pc in 2021-2022 and 0.1pc in 2022-2023.
The group also acknowledged that while it is aware of continued pressures on the ambulance trust, there was “important clinical benefit” to continuing private elective care.
Since Mr Hoad’s death, the group has completed a risk assessment, which will be regularly reviewed, in respect of ambulance transfer delays – recorded as the highest risk on the hospital’s risk register.
It is also exploring the possibility of using alternative private ambulance services, which has so far been unsuccessful due to the providers’ lack of capacity.
The chief executive of the ambulance trust also sent a reply to the coroner’s court.
In a letter dated October 23, it outlined the current actions being taken.
This included additional recruitment of more than 300 frontline clinicians by March 2024, plus more within its control rooms.
It also highlighted the implementation of its Operational Performance and Improvement Plan to address concerns about efficiency.
It added: “We recognise that further improvement is still required, hence our continued focus on the range of actions identified.”
Mr Hoad was a retired company secretary from Wingfield, near Diss,
His medical cause of death given at the inquest in September was a heart attack, with coronary heart disease following hospital admission for post operative ileus.
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