By the time Caroline was finally stretchered into the Grange university hospital in south Wales, it had been more than seven hours since she dialled 999.
The 46-year-old, who lives in a one-bedroomed bungalow up in the hills, woke with severe chest pain. She thought she was having a heart attack and called for help at 3.30am. An ambulance crew reached Caroline at 8am and drove her down the valley to the Grange. She then spent the best part of two hours in the back of the truck in the hospital car park before a bed could be found.
The shocking thing is that this sort of timescale has become routine. Lee Davies, the paramedic who cared for Caroline, conceded that the time it took for the ambulance to reach her was seen as “quite respectable”.
Recently he attended a patient who had been lying on a floor for 12 hours. “Four or five hours is quite common,” he said. And they were lucky, he said, to have waited in the car park for less than two hours. “You can be there for a whole shift sometimes.”
Military personnel began helping ambulance crews in Wales last week. The service is busier now than it was at the height of the coronavirus – and this before winter has begun.
The Guardian joined Davies and his colleague Keith Rogers, an emergency medical technician (EMT), on a 10-hour day shift. Caroline was their first call. In her living room they checked her heart with an ECG kit, a machine that checks the heart’s rhythm and electrical activity, and they administered a spray under her tongue that took her pain down before heading to the Grange, arriving at 9.10am and joining a queue of ambulances.
“It’s impossible to say how long we’ll be here,” said Davies. “We could be here half an hour, we could be here the entirety of the shift. It’s frustrating. We are prevented from attending other patients. It’s not what we joined up to do. The system is overwhelmed. The hospitals are using ambulances as extra bed space.”
There was time to swap stories with other crews. Nigel Jones, an EMT based in Monmouth, said he had attended a 16-year-old horse rider who lay in wet sand for nine hours after a fall. “We feel terrible about that sort of thing.”
Another paramedic said they used to do eight jobs in a shift – and still had time to watch “half a Rocky” film back at base. Now two jobs a day is the norm.
Caroline got into the hospital at 10.53am. “She’ll be OK,” said Rogers, and the crew drove back to base in Pontypool for its meal break.
Sitting in the ambulance station was Simon Davies, a paramedic who had just taken three months off sick. “It was stress,” he said. “I couldn’t sleep, didn’t want to come to work. It wasn’t the nasty things you see. It was frustration building up.”
Davies said the whole system needed to be fixed, not just capacity at hospitals but social care in the community. “Or the newly qualified guys won’t stay as long as we have.”
The second job for Lee Davies and Rogers was picking up 62-year-old Anthony from Pontypool to take him to Nevill Hall hospital in Abergavenny, 12 miles away. Anthony had an infection, shortness of breath and had had a couple of falls, but when the crew arrived he was up and able to pack his own bags.
This was another frustration. Davies doubted Anthony needed an emergency ambulance but a GP had ordered it. “We’re not doing the things we are on the road for,” he said.
Bosses at the Welsh ambulance services NHS trust recognise the frustrations. Jason Killens, the chief executive, said the pressure on the workforce was more acute now than at any time in the pandemic, with 999 calls up by about 25% this year compared to normal.
He said that out of a frontline workforce of 3,000, about 200 people a day were unavailable because they had Covid or for other reasons connected to the virus. General absence because of sickness was double what would be expected, with about a quarter suffering from stress and anxiety, much of it because of the agony of the waits outside hospitals.
A spokesperson for Aneurin Bevan University health board, which runs the Grange, said it was experiencing the same “unprecedented” demand as hospitals throughout the UK. “Unfortunately, this has meant that patients are waiting longer to be transferred into the emergency department than we would want.”
It was 2.25pm before Davies and Rogers wheeled Anthony into hospital. The crew told control and were sent back to Pontypool for Howard, an 88-year-old who had fallen and may have cracked a rib. By the time they got him to the Grange there were 11 ambulances waiting.
With 5pm and the end of shift approaching, Howard was moved to a spare ambulance and a staff member on a later shift “babysat” him so that Davies and Rogers could finish.
A satisfactory day? “You’re always satisfied when you’ve helped patients,” said Rogers. “They’re always glad to see us.” Davies agreed. “But we’d just like to be able to help more of them.”