Part of Backbench Business – in Westminster Hall at 3:00 pm on 6 March 2025.
I thank the hon. Gentleman for his intervention. I will come to that point a little later.
With the stark realities facing people in an emergency and the distressing sight of ambulances backed up at hospitals now commonplace, leaving my constituents in Glastonbury and Somerton in despair, it is time to properly address these failures. The NHS standard contract states that handovers between ambulance and emergency departments should be 100% within 60 minutes, 95% within 30 minutes and 65% within 15 minutes, but these targets are left unmet. Between October 2023 and June 2024, 3.7 million handovers took an average of 35 minutes and one second, resulting in over 900,000 hours lost. It is even worse in the south-west. In January 2025, over half the handovers took over 30 minutes, which is nearly 30% higher than the England average.
We in the south-west face specific issues due to our rurality. Analysis by the Liberal Democrats revealed that waits for life-threatening calls were 45% longer in rural areas than in urban areas. The South Western Ambulance Service has responsibility for the provision of ambulance services across 10,000 square miles, covering an incredible 20% of mainland England. Rural regions have a lower capacity to divert ambulances to other hospitals during periods of significant pressure, largely due to the vast distances between emergency departments.
We may now see ambulance teams in Somerset adopt a “drop and go” policy, which involves leaving patients in certain areas in a hospital without an official handover to A&E staff. The nationally defined target for hospitals included in the NHS standard contract states that after 15 minutes of waiting, the patient in the ambulance becomes the responsibility of the hospital. If no formal handover to A&E happens within 45 minutes, the ambulance crews can just leave the patient within the department and get back on the road.
The South West Ambulance Service is moving towards this approach with hospitals from Swindon and Bristol to Cornwall and Plymouth. Although this policy might alleviate some of the pressure on ambulance crews, it would fail to ease the struggles that underfunded and overstretched A&E departments in Somerset are facing. Somerset has an ageing population: within the next decade, one in three people in Glastonbury and Somerton will be 65 or older. That may make it harder to quickly discharge patients, as some may also require onward social care provision. It is inevitable, therefore, that delayed discharge due to internal processes such as waiting for pharmacy diagnostics and therapy assessments, and a lack of capacity in adult social care, will lead to poorer ambulance service performance. The social care crisis has a devastating effect on the healthcare system.
Last year, Care England said that
“over 45% of hospital discharge delays are linked to social care”.
One in seven hospital beds are taken up by people who are medically fit to be discharged. For patients, delayed discharge can lead to an increased risk of hospital infections and the loss of mobility or cognitive function, and can make it harder for them to regain their independence. The problems in the healthcare system will never be fixed unless we urgently address the social care crisis. Only last week, social care providers felt the need to protest against Government inaction for the first time ever.
The Liberal Democrats have been campaigning to fix social care by introducing free personal care based on the model introduced in Scotland, so that provision is based on need, not ability to pay. We also welcome the cross-party commission to forge a long-term agreement on social care, but we believe it can be completed within a year, not three. We cannot afford to kick this can any further down the road, and I urge the Government to listen to the Liberal Democrats’ calls.
We also need to solve the hospital bed shortage in the UK. The lack of available beds negatively impacts hospital flow. As a comparison, the OECD EU nations have about five beds per 1,000 people, whereas the UK has only 2.4. The Royal College of Physicians revealed that four out of five doctors were forced to provide corridor care in the past month due to a lack of hospital beds. According to the Royal College of Emergency Medicine, bed occupancy is at a staggering 93%. The Liberal Democrats want to bring that down to a safe 85% by increasing the number of staffed hospital beds.
We are waiting for the Government to publish the urgent and emergency care improvement plan soon, along with the 10-year health plan. It is vital that we urgently wrestle with the problems that the Conservatives left behind to ensure the safety of patients. Over the past seven years, the previous Conservative Government were forced to find an average of £376 million of emergency funding each year to tackle the NHS winter crises. Under the Liberal Democrat proposals, a new winter taskforce would instead manage a ringfenced fund of £1.5 billion over the next four years to build resilience in hospital wards, accident and emergency departments, ambulance services and patient discharging. That would allow integrated care boards and NHS trusts to plan their budgets more effectively to prevent winter crises, instead of just receiving emergency funding from the Government at the last minute.
We urgently need to give our healthcare services the ability to forward plan. They must not be forced to deal with crises on the fly as situations unfold. Somerset’s ambulance services, like all services across the country, desperately need and deserve support. Localised data must be published to help pinpoint specific improvements that can be made in rural areas. The Government have outlined their desire to improve urgent and emergency care—they accept that ambulance waiting times are unacceptable—but now is the time to act to achieve those objectives; otherwise, more people will suffer and sadly some lives will be lost. That must be part of a serious rethink about the way we fund social care; otherwise, we will never move towards a solution that works.