“Risk of future deaths”: Forensic medicine issues a rare warning to the Minister of Health about the hospital crisis | NHS

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The coroner has urged the health minister to take action to prevent unnecessary deaths after a woman died of heart failure after waiting four hours in the back of an ambulance.

Lane Brind, 61, was taken to Queen Elizabeth Hospital (QEH) in King’s Lynn, Norfolk, with chest pains and low blood oxygen levels but was not admitted because the hospital “didn’t have room”. Instead, she remained in a line of ambulances outside A&E without a timely diagnosis or treatment, and where warning signs about her condition were missed.

After four hours and 25 minutes of waiting, she was transferred to a ward, by which time she was “restless and short of breath”. She was put on life support but died 22 minutes later.

The Brind’s believe that the grandmother of four, a former dinner lady from town, “might still be alive today” had she been accepted more quickly. “She wasn’t given a chance,” said Richard Ponton, her partner of 38 years.

Following an inquest earlier this month into Brind’s death in May 2022, Norfolk’s chief coroner, Jacqueline Lake, took the unusual step of writing to England’s health secretary, Steve Barclay, to raise concerns about the NHS and social care.

She warned that others could die in similar circumstances unless action is taken. “I believe you have the capacity to take such an action,” Lake wrote in a Prevention of Future Deaths report published last week.

The coroner said the QEH was regularly overwhelmed, with “too many patients in the emergency department” and a lack of social care in the community preventing people from leaving the hospital.

At the time of Brind’s death, she said, there were approximately seven ambulances waiting to offload patients outside the emergency and ambulance department – a number that rose to 17 in queues outside the department at the time of the investigation earlier this month. Lake wrote that there are 140 beds occupied by “medically fit” patients who cannot be discharged due to a lack of social care spaces.

The report highlighted deficiencies in Brind’s care, including that notes were not taken regularly as per East of England Ambulance Services Trust guidelines and that when she was transported, her deteriorating condition was not reported to the hospital ambulance navigator, who assesses family priority. Brind, who had multiple medical conditions including diabetes, was also not evaluated by a senior physician from the hospital within an hour, per hospital protocol.

But the coroner said the evidence suggested the problem was “much broader and more complex” than a single NHS fund and that action was needed at government level.

The warning comes amid reports of NHS backlogs and delays in treatment. Figures released last week by the Ambulance Chief Executives Association show an estimated 57,000 patients experienced potential harm due to delays in ambulance deliveries in December, with 6,000 of them being “severely hurt”.

The Royal College of Emergency Medicine has estimated that there are 300-500 excess deaths across the UK each week due to overcrowding and long waiting times in emergency departments. NHS England said it did not recognize these figures.

The government has not yet officially responded to the report on Brind’s death, but it is obligated to do so by 13 March. A spokesperson for the Department of Health and Social Care said it was taking “urgent measures” to improve hospital backlogs, including “investing £250m to free up hospital beds, reduce pressure on emergency and accidents and eliminate delays in delivering patients from ambulances”.

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It had previously announced a £500m drainage fund and said it had created the equivalent of 7,000 extra hospital beds. The spokesman added that hours lost due to delays in the delivery of ambulances fell in the week ending January 22 to their lowest levels this winter.

This is not the first time the coroner has raised the alarm about ambulance delays. In November, Cornwall’s chief coroner, Andrew Cox, wrote to Barclay to report similar concerns about a welfare crisis that had led to a shortage of hospital beds. He cited four cases in which it caused or contributed to the death of patients in the province due to delays in ambulances and overcrowding in hospitals.

Helen Blanchard, interim head nurse at QEH, King’s Lynn, said the trust had learned lessons from Brind’s death and had “implemented NHS standards of care for patients waiting in ambulances, including working with ambulance staff to ensure patients can still be seen by a senior doctor. If They couldn’t come right away to the department,” completing 30-minute notes.

The East of England Ambulance Service said it had met with the hospital’s critical incident team to discuss ways to “help prevent this from happening again”. A coroner’s spokesperson said: “The coroner wrote clearly of the pressures the NHS was under at this time and subsequently, which resulted in delays in deliveries in hospital emergency departments.”

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