Building solutions to reduce ambulance delays

The crisis in emergency care shows no sign of easing and Dr Adrian Boyle, President of the Royal College of Emergency Medicine, estimates that “somewhere between 300-500 people are dying as a consequence of delays and problems with urgent and emergency care each week,”

Delayed patient handovers inevitably result in slower ambulance response times, as queuing outside A&E departments means ambulances are unable to attend patients waiting in the community.

Modular Ambulance Receiving Centres

An innovative solution is being adopted by NHS Trusts to free up ambulance capacity and reduce waiting times. Ambulance Receiving Centres (ARC) provide additional space where patients are cared for while they are assessed. Whilst ARCs can be built using traditional construction methods, Health Spaces (an innovative healthcare design and construction company) is pioneering a modular ARC design, which can provide extra capacity for overstretched A&E departments in as little as 12 weeks.

Depending on a Trust’s individual requirements, Health Spaces have the expertise and experience to develop pre-constructed modules ready for rapid deployment. These modular ARCs can be delivered to the agreed site up to 95% complete. This rapid deployment minimises disruption to hospital sites.

Once opened, the ARC allows ambulance patients assessed by paramedics, to be brought in and cared for safely, until there is space in the Emergency Department. This ensures that patients do not need to be in ambulances any longer than necessary and releases crews to attend to other emergencies more quickly.

Space near to the Emergency Department can be rapidly transformed into an Ambulance Receiving Centre. This space could be a car park, a green area or an unused site and each ARC follows a bespoke design to suit the requirements of the Trust.

The recently updated 2022/23 NHS contract states a 15-30 minute deadline for patient handover, but around 11, 000 patients a week wait more than an hour to be admitted. This is the equivalent to about one in seven of all arrivals and is the highest since records began in 2010, [O’ Dowd, 2022].

A report from the Association of Ambulance Chief Executives (AACE) confirmed that delays potentially harm patients. More than eight in 10 patients delayed beyond 60 minutes were assessed as potentially having experienced some level of harm, and nearly one in 10 experienced severe harm, [Association Ambulance Chief Executives, 2021].

Based on its own August 2022 figures, the AACE estimated that around 35,000 patients experienced potential harm as a result of long handover delays in August, with just under 4,000 of these experiencing potentially severe harm.

Modular units for A&Es

Speaking earlier this week in parliament, the Secretary of State for Health and Social Care Steve Barclay gave an update on what the government is doing to help the NHS deal with immediate winter pressures. Modular units are once again front and centre of the conversation:

“From my visits across the country, I’ve seen and heard how they often need more space to enable same-day emergency care, and short stays post-emergency department.

“So our second investment today is in more physical capacity in and around emergency departments. By using modular units, this capacity will be available in weeks, not months.”

“And our £50 million investment will focus on modular support this year, and we will apply funding from next year’s allocation to significantly expand this programme ahead of the summer. We are giving Trusts discretion on how best to use these units to decompress their emergency departments.

“That might be spaces for short-stay post-A&E care where there’s no need for the patient to go to a ward for further observation, or for discharge lounges where previously they’ve not been able to take patients still in a bed – many of those are often simply chairs – and also additional capacity alongside the emergency department at the front end of a hospital.” – Steve Barclay.

Health Spaces is the UK’s only healthcare construction company dedicated to NHS fast-track design solutions and a commitment to Modern Methods of Construction (MMC), including modular construction. We have the capacity to support NHS Trusts across the UK with rapidly deployable modular solutions to support with Emergency Department pressures, including Ambulance Receiving Centres, Discharge Lounges and ED waiting areas. Get in touch to find out more today.

“Architecture is at its most rewarding when we work closely with building users.  We can solve difficult problems like lengthy ambulance hand over times and help to evolve new practices together” – Health Spaces.

 

References

O’ Dowd A, Around 11 000 ambulances are waiting more than an hour at A&E every week, analysis finds, BMJ 2022;379:o2911

https://www.bmj.com/content/379/bmj.o2911

Association of Ambulance Chief Executives, Delayed hospital handovers: Impact assessment of patient harm, November 2021

Association of Ambulance Chief Executives report released in November 2021.

The Guardian, 1st January 2023

https://www.theguardian.com/society/2023/jan/01/up-to-500-deaths-a-week-due-to-ae-delays-says-senior-medic

Steve Barclay’s Oral Statement to Parliament, 9th January 2023

Oral statement on new discharge funding and NHS winter pressures – GOV.UK (www.gov.uk)

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