Man who waited nearly 10 hours for ambulance died just as it arrived

Grandfather, 63, who waited nearly 10 HOURS for an ambulance died as paramedics walked through the door despite his family making SIX calls to 999 – with two unanswered for 10 minutes

• Steven Iles, 63, from Bristol, died after waiting nearly 10 hours for an ambulance
• His family called 999 six times and said he died as paramedics finally arrived 
• Ken Shadbolt, 94, told ambulance ‘get me an undertaker’ in final phone call
• Investigation finds ambulances have spent more than a million hours waiting outside A&E departments in England this year 
• Analysis found longest wait time for an ambulance in September was 26 hours 

A grandfather who waited nearly 10 hours for an ambulance died as paramedics walked through the door after his family dialled 999 six times. 

Steven Iles, 63, from near Bristol, died from a strangulated hernia in his bowel which cut off the blood supply to his heart after two of the six calls for an ambulance went unanswered for 10 minutes, a File on 4 investigation found. 

Mr Iles’ devastated family told The Ambulance Crisis: 24 Hours on the Front Line, which aired last night, that he died as two paramedics finally walked through the door.

His wife Jean previously told ITV News West Country after his death in March: ‘I will never forget it, I see it all the time when I try to sleep it just goes round and round.’

‘I never said goodbye and I never told him I loved him. It didn’t happen, I didn’t have chance.’ 

She added: ‘If they would have come out when I rang, the outcome might have been a lot different.’

BBC Radio 4’s investigation found ambulances have spent more than a million hours waiting outside A&E departments in England this year because of delays in handing over patients and more than 300,000 patients have experienced potential harm as a result of handover delays, which happened between January and September. 

Steven Iles, 63, from near Bristol, died from a strangulated hernia in his bowel which cut off the blood supply to his heart

Mr Iles’ devastated family said he died as two paramedics finally walked through the door – he was a much loved husband, father and grandfather

Steven’s wife Jean said she never got a chance to say goodbye – pictured (left) with her daughter Claire (right)

Jean says she didn’t get a chance to tell her husband she loved him before he passed away – Steven and Jean pictured on their wedding day 

The last phone call made by 94-year-old Ken Shadbolt, from Chipping Campden in the Cotswolds, was played on the show, during which he appeared to lose hope and finally asked for an undertaker. 

‘I’m getting worse by the minute,’ he said. ‘I’m laying on the bathroom floor because I have had a bad fall.

‘I feel terrible sick. I’m in terrible pain.

‘If it’s going on another half hour I’ll probably be dead…oh my headache.

‘Send me the undertaker, that would be the best bet.’

It took more than four more hours for an ambulance to reach his home, by which time he had lost consciousness. He was rushed to hospital but died that day. 

The show analysed the latest National Ambulance data published by the Association of Ambulance Chief Executives for the period covering January to September 2022.

The analysis found the longest wait in September was 26 hours and that every single day last month nearly 400 patients and crews waited for longer than three hours outside a hospital in England.

Dr Adrian Boyle, President of The Royal College of Emergency Medicine has called the situation ‘dire’ and has said the system is failing patients.

He added: ‘This data signals the depth of the crisis facing urgent and emergency care. Our emergency departments are full. There are no beds into which we can move patients from the Emergency Department.

‘While Emergency Departments are overcrowded, ambulance crews are unable to handover patients. As a result, more patients face dangerously long waits that we know are associated with harm and even death. It is a dire situation; the system is failing patients.’

Ken Shadbolt, 94, from Chipping Campden in the Cotswolds, called an ambulance and asked for an undertaker in his tragic final call 

Association of Ambulance Chief Executives (AACE) Managing Director Martin Flaherty OBE QAM said: ‘These unprecedented delays at hospital emergency departments are a twin threat; they cause significant harm to patients who are forced to wait in the back of our ambulances, while those resources are tied up and therefore unable to respond to patients who need us out in the community.

‘The ultimate safety net for the NHS is the fact that patients who are severely ill or injured can access an emergency ambulance in a timeframe appropriate to their clinical condition. 

‘It is no exaggeration to admit that this safety net is now severely compromised and patients are dying and coming to harm as a result on a daily basis.

South Western Ambulance service says it’s sorry for delays patients and their families experience. It says these are caused by huge pressure on the service – and that staff always strive to give their best to anybody they treat. 

The trust is also recruiting extra call handlers to help with demand. It says its performance has not returned to pre-pandemic levels, partly due to handover delays at emergency departments.

The programme went out on shift with the West Midlands Ambulance Service and heard about the steps which are being taken to try to reduce delays in handing over patients at hospital. This includes a new cohort scheme where patients are dropped off to an area in A&E staffed by paramedics, allowing ambulances to get back on the road.

Karina who has been a paramedic for eight years told File on 4 she feels frustrated but is optimistic about the scheme: ‘Sometimes we’re sat there for 10, 12 hours and you can hear call outs for category ones [the most urgent calls] and they’re round the corner from where you are. And there’s nothing you can do about it because you’ve got to stay with this patient.

Mr Shadbolt was rushed to hospital when an ambulance finally did arrive but he died later that day

Ambulances have spent more than a million hours waiting outside A&E departments in England this year, a File on 4 investigation has found (stock image)

Handover delays outside hospitals are one of the biggest factors behind the NHS ambulance crisis, experts say. 

Paramedic crews are expected to pass all patients over to emergency departments within 15 minutes of arriving at hospital.

But a lack of space inside A&Es has forced medics to wait up to 24 hours before handing patients over to hospital staff.

Patients are either forced to wait in the back of the vehicle itself or pass the time in overstretched casualty department corridors. Paramedics cannot leave until A&E staff are able to take over.

As a result, they are unable to take other 999 calls while they wait.

The Royal College of Emergency Medicine says handover delays are ‘almost entirely caused by crowding in emergency departments’.

This itself has been blamed on a the lack of available hospital beds, due to both the Covid backlog and the social care crisis. 

An estimated 10,000 patients are currently occupying hospital beds, even though they’re fit enough to be discharged. Many are elderly patients who cannot go home because extra council-funded support is not available or find no nursing home places are ready.

Critics say patients are finding it difficult to see their GP and crippling staffing shortages have also overrun A&Es.

At the same time, the demand on ambulance services themselves has skyrocketed. 

Data shows ambulance calls in England have increased by more than six million in the past decade, rising from 7.9million call-outs in 2009/10 to 14million in 2021/22.

All 999 calls are initially answered by a BT operator, who transfers requests for an ambulance to the local trust. NHS England expects trusts to answer the calls within ten seconds.

However, a damning Daily Mail analysis earlier this year revealed people in parts of the country are waiting more than nine minutes for their 999 calls to be answered.

And the number of paramedics responding to the calls has also fallen, with unions fearing the situation is only going to get worse in the aftermath of the pandemic.

Thousands of ambulance workers have left their jobs since 2018 in pursuit of a better work-life balance, more pay, or to take early retirement.

Paramedics were increasingly facing burnout before Covid, which was exacerbated by the pandemic. This has led ‘droves’ to quit the service, according to the GMB union.

‘So I was very sceptical about [cohorts] because I thought why are paramedics coming off the road to sort out a hospital’s problem? But actually what it’s done is resolved the ambulances issue. So if they can continue to work together and get the patients in and free us up to carry that’s all I really care about. If that works, fantastic.’ 

Janie Richardson from Suffolk phoned 999 after she became worried her husband, Tim, was having another stroke.

She was put in a queue where an automated message played which suggested they should make their own way to hospital, if it was safe to do so. In desperation, she managed to get Tim dressed and into the car but two minutes into the journey to their local A&E, his condition deteriorated. Tim began to have a seizure which left him with a broken back due to his seat belt.

East of England Ambulance Trust says an automated message is played when the service is extremely busy – and if a call hasn’t been answered within three minutes. They also say they’re very sorry – and have trained more than 100 call handlers this year, to help cope with demand.

Dr Adrian Boyle, President of the Royal College of Emergency Medicine, added: ‘The government must face this reality and understand the scale of patient harm occurring, and the burnout, distress and moral injury facing staff. 

‘To mitigate this harm and these waiting times, we urgently need a social care workforce that can support patients being discharged for hospital and provide care in the community.

‘Freeing up beds will promote flow throughout the hospital and allow ambulance crews to handover patients quickly and get back out in the community responding to calls.’

An NHS spokesperson said: ‘Latest figures show the immense pressures on ambulance services with staff dealing with a record number of the most serious callouts this summer, up a third on pre-pandemic levels, and this trend continued into September with over 13,000 more of the most urgent calls than in the same period in 2019.

‘The NHS is announcing plans to enable better handover of patients so ambulances can get back on the road quickly, a new falls response service alongside the recruitment of more call handlers and so the public should continue to come forward for the care they need – by using services like 111 online, local pharmacies and calling 999 if it is a life threatening emergency.’

A Department of Health and Social Care spokesperson said: ‘Our heartfelt sympathies are with these families.

‘The Health and Social Care Secretary is focused on delivering for patients and will do this through her ABCD priorities – including easing pressure on ambulances, clearing the Covid backlogs, supporting the care sector to ensure people can leave hospital and ensuring improved access to doctors and dentists.

‘Our Plan For Patients sets out a range of measures, including an extra £500 million to speed up discharge and free up beds.

‘This is alongside NHS plans to rapidly boost capacity and resilience ahead of winter, including increasing the number of NHS 999 and 111 call handlers and creating the equivalent of at least 7,000 more beds.’

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