Heart attack patients in Portsmouth are now waiting an average of almost 80 minutes between calling an ambulance and reaching hospital for life-saving treatment, according to research presented at the British Cardiovascular Society (BCS) Conference in Manchester.
Researchers at Portsmouth Hospitals NHS Trust have revealed the concerning trend that some patients are waiting an average of 25 minutes longer compared to 2011, with the growing pressures on the ambulance services, changing of targets and use of first responders seen as the most likely causes.
For patients who suffer an acute ST-elevated myocardial infarction (STEMI) – the most serious type of heart attack – getting treated quickly is essential to minimise the damage to the heart muscle. Around four in five of STEMI patients reach hospital thanks to the ambulance services, which means understanding any delays is critical to improving survival and outcomes.
The researchers looked back at 1,347 cases between 2011 and 2017 and measured the mean time taken from the moment the call was received through to the point the patient arrived at hospital – known as call-to-door time. In 2011, the average call-to-door time was 53 minutes. But the average time in 2017 was 78 minutes, an increase of 47 per cent.
Although the study didn’t look at the fate of these patients, the authors say that the extra time is likely to worsen outcomes as the heart muscle spends longer starved of oxygen. However, there has been an overall improvement nationally in outcomes for patients suffering both STEMI and out-of-hospital cardiac arrest since 2011.
Services under pressure
The study author, Dr Fazlullah Wardak, was quick to defend the paramedics who attend emergencies, instead citing the growing pressure on services and change in targets for the lengthening delays.
“This is no reflection on the hard-working paramedics in Portsmouth,” said Dr Wardak. “The ambulance service is doing the best job it can under the circumstances, but pressure is now starting to show. Although first-responders can play a hugely important role, quickly getting patients into the hospital so we can unblock the artery has to be our primary goal.
“Our brave paramedics do an incredible job but they need more support and we have to create targets that put patient outcomes first. A delay of nearly 80 minutes is costing the patient in damaged heart muscle, and that means it’s also costing the health service in the long term.”
Our Associate Medical Director, Professor Metin Avkiran, said that audits such as this can be incredibly helpful for local services to identify issues, improve planning and to better understand the picture in their region.
“We know that ambulance services across the country are under pressure and they’ve been doing a remarkable job despite this. But when it comes to the treatment of heart attacks, early intervention is essential. If this proves to be part of a nationwide trend then urgent action will be needed to prevent unnecessary deaths.”
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