Can someone who works inside the NHS explain the root cause of such a slow service in recent years. Is it over population? Rise in elderly people? Lower numbers of ambulance crews?
Ageing population, understaffing... plus many more aspects.
Example: Dorris lives until she is 89 but develops mobility issues. She now needs assistance getting to her appointments (Ambulance patient transport service), she will likely have long term conditions which mean she needs more treatment and resources*, eventually her health deteriorates to the point where she ends up on a hospital ward. The hospital is keen to discharge her but she lives in a semi-detached house and her only toilet is up a flight of stairs. Before she can be discharged the hospital now has to engage with community nursing staff and the local authority. It can take months to find her a home, so Dorris spends the time sat in the bed on the ward.
Months later Dorris is due to be released but she's now got bed sores (pressure ulcers) and requires more than basic visits from district nurses. This further impacts her ability to move around and complete basic tasks such as making food. Enter the role of the Occupational Therapist and Physio to help her get back to some normality.
She may develop dementia, become a falls risk, mental health.. the list is endless. All of these long term conditions require additional resources and equipment. Let's assume she doesn't make it out of hospital for a few months, that bed is "blocked".. your nan comes in with a health issue, "sorry no beds". Rinse and repeat.
In a nutshell (apologies for this post, I'm rushing a bit) the ageing population means health issues increase, the level of support required increases and ultimately the money decreases. If they do not meet targets budgets can be cut which further turns the screw.
In Wales (not sure how it works in England) the NHS Ambulance trust is it's own separate entity to those of the local health boards. I've had a situation where I was teaching (in a major acute general hospital!) when a student had a CARDIAC arrest mid session. The ambulance service told me that she was fine as she was "in a place of safety" and quoted me 1hr to arrive. I would somewhat agree given I was at a hospital but this was a postgraduate centre with no AED (defibrillator). It may as well have been a local Tesco, with the resources I had to hand.
Running as it's own entity but serving multiple health boards means they work within their own limited budget and resources which means overall service suffers. Another example: the Welsh neonatal transfer service has ONE specialist ambulance for the whole of Wales. If your neonate/premature baby needs emergency surgery, you better hope your health board has been assigned the ambulance or you are facing a wait
