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Ambulance service in England ‘in meltdown’ as one in four 999 calls missed in October | Hospitals

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Ambulance crews could not respond to almost one in four 999 calls last month – the most ever – because so many were tied up outside A&Es waiting to hand patients over, dramatic new NHS figures show.

An estimated 5,000 patients in England – also the highest number on record – potentially suffered “severe harm” through waiting so long either to be admitted to A&E or just to get an ambulance to turn up to help them.

Ambulance officers warned that patients were dying every day directly because of the delays since the service could no longer perform its role as a “safety net” for people needing urgent medical help.

“The life-saving safety net that NHS ambulance services provide is being severely compromised by these unnecessary delays and patients are dying and coming to harm as a result on a daily basis,” said Martin Flaherty, managing director of the Association of Ambulance Chief Executives (AACE), which represents the heads of England’s 10 regional NHS ambulance services.

Flaherty added: “Our national data for hospital handover delays during October 2022 is extremely worrying and underlines the fact that in some parts of the country efforts to reduce or eradicate these devastating and unnecessary delays are simply not working.”

The association’s latest monthly handover delays report, published on Wednesday, reveals that the performance of ambulance services fell to its lowest ever level in October.

The report shows that 169,000 hours of ambulance crews’ time across the month was lost due to delays. It meant that paramedics could not answer 135,000 calls. That number represented 23% of ambulance services’ total “potential capacity” to respond to 999 calls.

All three totals are the worst in NHS history.

“The ambulance service is in meltdown. These figures show that it is on its knees and close to collapse as a result of vacancies, underfunding, morale being at a very low ebb and demand for ambulance care having doubled to 14m calls a year since 2010,” said Rachel Harrison, national secretary of the GMB union, which represents 15,000 staff in English ambulance services.

Ambulance services’ ability to respond rapidly to patients needing emergency and potentially life-saving care is being hampered increasingly by hospitals being unable to admit people to A&E fast enough. That is because they have almost 14,000 beds occupied by patients who are fit enough to leave but cannot be safely discharged, mainly because social care provision is inadequate to allow going home or entering a care home.

Steve Barclay, the health secretary, has identified handover delays as one of the greatest challenges facing the NHS. A&E doctors share AACE’s concern that patients are suffering sometimes serious harm, and even dying, as a result of long delays to their treatment.

The AACE report also discloses that:

  • 18% of ambulance handovers took more than an hour last month, when the NHS target is 15 minutes – a nine-fold increase on the 2% seen in October 2019.

  • The average handover time was 42 minutes, up 12 minutes from October 2021 and up 23 mins from Oct 2020.

  • The number of one, two, three and 10-hour handovers was the highest ever recorded.

  • Delays exposed an estimated 41,000 patients to potential harm, of whom about 5,000 were put at risk of, or experienced, “severe harm”, including death.

“These figures are a national disgrace but they only confirm what GMB members tell us every day,” added Harrison. “We’ve got ambulances waiting outside hospitals for more than a day, while terrified workers wait and hope their patients won’t die. In fact, a third of GMB ambulance workers think a delay they’ve been involved with has led to the death of a patient. It can’t carry on.”

The most recent NHS England data showed that ambulances were taking almost 10 minutes to reach patients facing a life-threatening emergency. The NHS target response is seven minutes.

Dr Sitso Amankwah, a GP in Kingston, London, tweeted on Tuesday about a patient who had taken an Uber ride to A&E rather than face a potentially long wait for an ambulance. “That’s good, so not unwell enough to need 999 then,” the GP told the patient. “No, I felt awful, but … Uber could get me there in less than four hours,” the patient replied. Amankwah added: “Ladies and gentlemen, I present you the NHS in 2022.”

A Department of Health and Social Care spokesperson said: “The government is clear that the NHS is a top priority and we are making up to £8bn available for health and social care in 2024/25.

“We are providing record-breaking funding which will help get us through the winter. This is on top of the action we’ve already taken including … delivering 50,000 more nurses, increasing the number of NHS call handlers, and creating the equivalent of at least 7,000 more beds, to improve patient flow through hospitals and get ambulances back on the roads quickly. We will publish a full recovery plan for urgent and emergency care next year.”

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‘It’s absolute hell’: a paramedic in England on why he backs strike | Emergency services

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Ambulance workers across England have voted to strike over pay and staffing levels, and action is expected before Christmas. Thousands of 999 call handlers, ambulance technicians, paramedics and others working for ambulance services are expected to take part. Joshua, a paramedic in northern England, shares why he’s striking.

“I’ve been a paramedic since 2016 and it’s absolute hell doing this job currently. I genuinely believe most of the public have no idea how bad the situation is. We’re being pushed beyond limits, constantly [having] dispatchers pleading for crews to come through. A massive part of the issue is that ambulances are just sat at hospitals for hours on end.

“We’re going to patients who have waited for 12-13 hours. Ambulance crews are seeing [patients die] day in and day out. I think to myself, god, please don’t let any of my family members need an ambulance. It’s terrifying.

“The cost of living is astronomical, as everyone well knows. [We’ve had] real-terms pay cuts year after year. I’ve gone from living a relatively comfortable life to just counting every penny that I have. I feel sick [when I] have to spend fuel on the car.

“I’ve seen co-workers crying, single parents who can’t afford to do this job any more. So many people are leaving because we’re treated [badly] and not paid anywhere near enough.

“Patient safety has fallen through the floor, paramedics can’t reach them in time, there’s simply not enough staff to get to those patients. If the government wanted to do something about that, they would pay paramedics properly and then people would see it as a good job that’s rewarding and consider doing a career in [it]. Patient safety is directly linked to pay. People are quitting at a time where staffing is below critical.

“The issue is absolutely systemic across the entire NHS. Staff going off sick with burnout, stress and suicidal thoughts is endemic across the ambulance service. I feel completely burnt out currently – I’ve been considering calling in sick every night shift this week. I don’t want to come to work because you don’t know what you’re going to come across. It’s stress beyond stress. We’re finishing hours late every shift. And the government is saying you don’t deserve to be paid properly.

“The GMB has a policy of no harm to patients. And there’s already catastrophic harm being done to patients by the government. [The ballot gives a mandate for full strike action but the form it takes will be decided by a committee of GMB ambulance members, according to the union.]

“No one [in the NHS] wants to walk away from patients. We’re in a caring profession for a reason. But we’re not listened to by [people] with no idea of the reality of what it’s like out on the road.

“Most paramedics don’t want to strike. We want a government that respects us, values our work and cares about the public we look after.”

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China’s failure to vaccinate makes giving up on zero covid a huge risk

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Widespread protests against China’s zero-covid policy have led the country to ease some restrictions, but its failure to vaccinate older people means this could lead to millions of deaths



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| Analysis

1 December 2022

There have been protests against China’s strict covid-19 restrictions in cities including Beijing and Shanghai

JEROME FAVRE/EPA-EFE/Shutterstock

In response to protests in many parts of the country, China is easing some of the draconian measures it imposed to prevent the spread of the coronavirus. But the government’s failure to vaccinate the most vulnerable people means that the relaxation of restrictions risks causing a vast number of deaths.

A big wave of infections in the country could lead to between 1.3 million and 2.1 million deaths, according to UK science analytics company Airfinity. …

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How Blacks and Jews can come together again – New York Daily News

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We have just finished an election that underscored sharp division in our country. Among those divisions have been race-based attacks on both Blacks and Jews. We have all received an earful of the controversy concerning the ignorant statements made by Kanye West and the misguided social media post of Kyrie Irving. Both are emblematic of what is wrong with the discourse surrounding Blacks and Jews. Both controversies center around a divisive, distorted and flat-out incorrect characterization of history. We believe our nation will be served by setting the record straight and healing those divisions.

One of us, Markus Green, is Black, the other, Victor Schwartz, is Jewish. We have worked together on challenging civil justice problems for over a decade. We devote most of our professional time toward prevention of unjust liability claims. More important than our professional link is our friendship based on unyielding mutual respect. It cannot be broken.

Our experience in life and our study of history strongly suggests that Blacks and Jews in general should foster such feelings. They have had both adversity and success.

Both Blacks and Jews have suffered the ignominy of slavery. For nearly 400 years, millions of Africans were forcibly placed on slave ships and sent to America. The Bible tells us that the Jews were slaves in Egypt for hundreds of years. Each Passover holiday, Jews relive that history and celebrate their liberation. That story was a powerful one for enslaved African-Americans, who sung the spiritual, “Go Down Moses.” Harriet Tubman is said to have used that song to announce her arrival when she helped people escape on the Underground Railroad. Tubman herself is referred to as the “the Moses of her people.”

Blacks and Jews have a shared history of being attacked because they are considered different. For a long time, the United States ignored its founding premise of “Equal Justice for All.” But even after the Civil War ended slavery, for generations, Blacks had essentially no civil rights. Jews can relate to the horrors of post-Civil War Black experience in America. Jews fled other countries to escape death from Nazi concentration camps only to experience continued anti-Semitism in America.

Fortunately, many of these barriers have been overcome. Joint efforts by Blacks and Jews have been part of those accomplishments. Jews were allies with Blacks in the fight for civil rights. Several Jewish people were among the founders of the NAACP and Jewish lawyers helped successfully battle Jim Crow legislation.

Martin Luther King Jr. recognized the mutual interest of Blacks and Jews.

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“My people were brought to America in chains,” King said in a 1958 speech to the American Jewish Congress. “Your people were driven here to escape the chains fashioned for them in Europe. Our unity is born of our common struggle for centuries, not only to rid ourselves of bondage, but to make oppression of any people by others an impossibility.”

In 1965, the Civil Rights Act outlawed many forms of discrimination in public places and in employment, but racism and anti-Semitism persist. Both Blacks and Jews understand that prohibiting blatant discrimination is only a partial victory. Today, racism toward Blacks and Jews takes place in many more subtle ways.

Blacks and Jews have seen so-called spokespersons utter remarks against each group. But such folks are a minority in a minority. Without a doubt, both of us as lawyers know that legal battles won for Blacks have helped Jews, and legal battles won for Jews have helped Blacks.

Finally, and often overlooked, is the fact that Black and Jewish culture can be a bond between the two groups — one that includes humor, emotion and love of family.

So at a time where many are planting and growing seeds of division, we ask that Black and Jewish leaders, and ordinary men and women in each group, build a united wall of mutual respect. After all, racism and anti-Semitism racism are two ugly cousins. Anti-Semitism is racism and racism is anti-Semitism. Jews and Blacks must be united against hate and bigotry.

Jews and Blacks have far more in common than we will ever have differences. Both have suffered and survived monumental atrocities and the aftershock is still being felt. We both understand survival and perseverance. But most of all, we both understand the power of love in the face of hate. We are one people. Unity, not divisiveness, is our path forward.

Green is vice president and assistant general counsel at Pfizer. Schwartz is a former law professor and law school dean, and current co-chair of the public policy group of the law firm Shook, Hardy & Bacon, L.L.P.

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