To tackle 999 delays we must support NHS teams to work together

Staring as the seconds tick by. Straining to hear approaching sirens. Scouring the skyline for blue flashing lights. Talking from recent personal experience, when confronted with an emergency in the community, there’s nothing as excruciating as waiting for an ambulance to arrive on the scene.

But this is a scenario becoming all too common this winter, as emergency care delays spiral to unprecedented levels.

NHS data shows callouts for problems such as heart attacks and strokes are taking nearly three times as long as they should in England, with reports showing that some callers have had to wait up to nine hours for an ambulance.

This is a national crisis that is putting patient lives at risk. And with the winter far from over, the situation is only likely to worsen. Quick-fix solutions are failing to make a dent. It’s time we did what NHS staff have been crying out for: we must rip down silos and red tape and replace them with the infrastructure and tools for collaborative care delivery.

This is not an ambulance issue

Before we can implement sustainable solutions, we need to find clarity on the roots of today’s emergency care challenges.

The fact is that delays cannot be eliminated simply by putting more paramedics in more ambulances. The real problem lies at the other end of the chain: patients cannot be admitted for treatment if hospitals have no empty beds, or if there are no doctors to staff wards. This is the crux of the current crisis: hospitals are at maximum capacity and healthcare workers are stretched wafer-thin.

But I have faith in the creativity and determination of NHS staff. What we need is to make it easier for these exceptional people to deliver patient care, to work together and to support one another. This all boils down to a radical reimagining of collaboration within and between NHS teams.

The collaboration conundrum

The starting point is an obvious one for anyone with experience of working within the NHS. We need to fix the outdated and poorly integrated tech systems that are wasting valuable clinical time and stalling cooperative working.

The existing referral pathways and internal communication systems are extremely siloed and slow. Relying on voicemails, paper forms and email chains, it can take weeks for patients to access the support they need - often whilst their conditions worsen. When clinicians can’t easily obtain support and advice from colleagues, patients often end up being referred to the wrong clinic, sent to A&E unnecessarily, or stuck in hospital beds because the necessary care in the community is too complicated or time-consuming to arrange.

This is why delays and backlogs are growing longer, this is why staff are burning out and patients slipping through the cracks. And oft-used quick fixes - pouring money towards locum doctors, putting up beds in hospital corridors and cancelling yet more elective procedures - are merely sticking plasters.

From problems to solutions

Investment and ingenuity is pouring into the development of solutions to these glaring problems. From apps that connect GPs with hospital specialists at the touch of a button to secure image-sharing software that sends X-rays and MRI scans in seconds, we’re in the midst of a pandemic-driven communication renaissance. Digital tech has advanced so rapidly over the past few years that previously impossible or unimaginable capabilities have suddenly become not only possible, but affordable in the NHS. Speed of adoption is now the biggest barrier to progress.

However, navigating the plethora of options to determine which ones actually make clinicians’ lives easier - whilst guaranteeing safety and compliance - is another challenge. Regulation needs to keep pace with innovation.

So although the headlines and the scenes from the frontline are extremely worrying, I remain hopeful that we’re on the brink of achieving transformation in the way the NHS operates.

In the midst of this winter of discontent, we must double-down efforts to tackle care backlogs with tech-led collaboration. This is the first step to hitting ambulance call-out time targets that have disappeared out of sight: supporting hard-working clinicians to deliver excellent patient care, together.

Dr Owain Rhys Hughes is founder and CEO of Cinapsis

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