St John has defended its response time, saying it must prioritise the most life-threatening calls and balance this with available resources and patient demand. File photo Photo: Supplied / St John Ambulance
A 90-year-old man was left bleeding from his head on the bathroom floor for over two hours this week, despite paying for a St John ambulance emergency alarm.
The man's relative is upset about the delay, with doctors saying he could now be forced into rest home care for his own safety.
St John has defended its response time, saying it must prioritise the most life-threatening calls and balance this with available resources and patient demand.
On 10 January, the man, who wishes to remain anonymous, was getting ready for bed in his Birkenhead home when he fell and hit his head.
After falling, the man used his medical alert bracelet to call for an ambulance just after 8.30pm, which also alerted his sister-in-law and main carer Heather Braae.
When she arrived at his home, she found the pensioner curled up on the bathroom floor, bleeding from his head.
Braae said she was deeply concerned for her brother-in-law, and sat there with him waiting for an ambulance which she thought would never arrive.
"They called every hour to see if his condition had gotten any worse, and they told me to not move him and to not give him anything to eat or drink," Braae said.
The ambulance finally arrived at 11.10pm, with the elderly man left lying injured for two and a half hours.
Braae said her brother-in-law remained in the hospital yesterday and was being closely monitored by doctors.
She also said this was not the first time he'd had a prolonged wait for an ambulance.
In July last year, he had to wait four hours after becoming trapped in his bedroom, tangled in sheets.
But Braae said she wasn't angry with St John. She instead felt pity for stretched paramedics who were inundated with callouts.
"I feel so sorry for the drivers, I'm sure it's not their fault.
"I'm sure they're overworked and very stressed, the system isn't working for anyone."
A St John spokesperson said the service was experiencing high demand at the time of the man's latest callout and the patient was advised there may be a delay in getting an ambulance to the property.
"St John will always prioritise the most life-threatening calls first," the spokesperson said.
"This means that when someone requests an ambulance for a non-life or limb-threatening problem, there may be a delay."
The length of this delay was reliant on many factors, including the patient's geography and the number of ambulances and ambulance officers already offering critical care in the community at that time.
"Any delay is always regrettable, and we acknowledge the added distress it may have on someone who is already facing a worrying or traumatic situation."
Statistics from St John show that for urban Auckland in the year to June 2022 there was a higher proportion of callouts in life-threatening situations where paramedics failed to arrive within the targeted response times than the prior year.
The annual report says 2021/22 "saw increased pressure on the ambulance service as all health services came under increasing pressure".
St John had implemented new measures to mitigate high demand and pressure on service delivery, including rolling out additional ambulances, introducing centralised crisis and operation centres, and bringing in a remote clinical telehealth triage system to help manage increased demand.
The man's case comes amid a health system crisis that has seen hospitals under massive pressure on the back of winter illnesses and Covid-19, with claims of serious under-resourcing and burned-out medical staff.
National's health spokesperson Dr Shane Reti said he's heard variations of similar narratives over the last three weeks, which is a consequence of a health system that is very clearly in a crisis.
National's health spokesperson Dr Shane Reti said this was a consequence of a health system that he believed was "very clearly in a crisis". Photo: RNZ / Samuel Rillstone
He described the issue with ambulance wait times as a "logistics chain" which blocks up at either end, with A and E being the centre of that chain.
"When you look outside A and E at the moment, what you'll see is ambulances doing something called ramping," Reti said.
"They have patients in the ambulance but A and E is so full, they can't receive them, so they sit on the ramp for hours."
Because the ambulances are sitting on the ramp full, they can't be dispatched out to the community to pick up urgent cases.
He also said he is aware that St John has their own workforce issues, with a number of ambulances officers with Covid 19 at the moment, causing mass staff shortages.
"I have concerns for what this winter might bring across the whole sector," Reti said.
"Primary care, secondary care, they're just so exhausted."
Age Concern chief executive Karen Billings-Jensen she said was concerned if anyone was waiting and asking for assistance but unable to receive it quickly.
Aged Concern was fully aware of how overburdened all health services currently were, she said.
National's health spokesperson Dr Shane Reti said he'd heard other examples in recent weeks of patients waiting longer for ambulances.
Reti said it was a consequence of a health system that he believed was "very clearly in a crisis".
He described the issue with ambulance wait times as a "logistics chain" which blocks up at either end, with accident and emergency departments being the centre of that chain.
"When you look outside A&E at the moment, what you'll see is ambulances doing something called ramping," Reti said.
"They have patients in the ambulance but A&E is so full, they can't receive them, so they sit on the ramp for hours."
Because the ambulances are sitting on the ramp full, they can't be dispatched out to the community to pick up urgent cases.
He also said he is aware that St John has its own workforce issues, with a number of ambulances officers with Covid-19 at the moment, causing mass staff shortages.
"I have concerns for what this winter might bring across the whole sector," Reti said
"Primary care, secondary care, they're just so exhausted."
- This story was originally published on the New Zealand Herald