‘It feels like a war zone’: exhausted ambulance service workers in England tell their stories

Paramedics in England cannot respond to 3,500 urgent 999 calls every day because they are stuck outside hospitals waiting to hand over patients, putting other lives at risk, a Guardian investigation has found.

Here two ambulance service workers describe their experiences on the frontline that they say “feels like a war zone at times” amid the worst NHS winter crisis in years.

Reena Farrington, an ambulance control room supervisor based in the West Midlands

“I feel emotionally exhausted at the end of a shift, despite my 26 years in the service. You never, ever stop caring, and I often end up in tears.

“Talking to patients and their loved ones as they deteriorate is so upsetting. People call back, desperately trying to get help. And, sadly, some people die while they’re waiting for an ambulance.

“This can’t go on. The tough emotional strain is relentless and deeply affects staff in the control room and crews out on the roads, too.

Reena Farrington lays a wreath during a pandemic anniversary remembrance event and minute’s silence at National Memorial Arboretum at Alrewas in Staffordshire in March 2022. Photograph: PA Images/Alamy

“Delays in hospitals hold up crews, and people are calling 999 because they can’t get to see a GP. We’re everyone’s last resort.

“In the West Midlands, we have a great triage process, which often allows us to find alternative, more appropriate help for those with nowhere else to turn. But managing these calls is challenging and time-consuming too.

“Often, we have to ask people to make their own way to A&E as safely as they can. It never sits comfortably saying those words, and it’s awful being in this position because we know it’s far from ideal.

“Some call three or four times, hoping we can get them an ambulance, but we can’t. It’s really hard.

“On Monday, we had calls waiting for up to 19 hours. We ring people back; we do everything we can to look for other ways to get them to hospital.

“It’s soul-destroying and overwhelming in equal measure. Sometimes, people get aggressive out of frustration, that’s understandable.

“The whole situation is just horrible. I’m here to do my best for my patients, and it’s heartbreaking I can’t do more.

“Not being able to help critically ill people affects staff deeply. Watching the calls pile up on the dispatch desk, with hundreds of people waiting for ambulances, is horrific.

“It feels like a war zone at times. Due to delays, some crews manage only one job per shift, sometimes two if they’re lucky.

“It can feel very degrading for patients to be cared for in the back of an ambulance for hours on end. Staff must ensure patients can go to the bathroom, have food and are as comfortable as possible. But that’s difficult given they’re likely in pain or feeling terrible.

“After my last shift, there were just under 400 people waiting for help. How can I switch off from that?”

Lyndsay Hewitt-Brown, a paramedic based in Leeds

“I’ve worked for the Yorkshire ambulance service for 10 years and this is the worst I’ve seen it. In the past fortnight, some of my colleagues have waited with patients outside hospitals for up to eight hours.

“There’s been queues of maybe 17 ambulances outside A&E departments at times.

“The worst wait I’ve had up to now has been three hours for a patient with a critical illness. The hospital staff were obviously aware of the situation but there were no beds available.

“This meant the patient had to be seen in the corridor, but we couldn’t leave them because they were still on our stretcher, which was needed for the next call.

“Patients have to be constantly monitored from the moment they’re in the care of an ambulance crew and treated accordingly. But supplies of medication and oxygen are limited.

“So if we have to wait for any length of time, there are concerns we’ll run out, unless we can borrow from other ambulance staff.

“We’re conscious there are capacity issues in A&E as we hand patients over. There aren’t enough staff, beds aren’t available and the hospital corridors and waiting areas are full.

“But we can’t get to other patients when we’re being held up, and that’s frustrating. We know there could well be a detrimental effect upon their health if there’s a long delay before people are treated or admitted to hospital.

“When we do finally get there, we have to make sure patients know to expect a long wait at the hospital. Sometimes, rather than wait for hours, they choose to self-discharge before being treated.

“Often that means they go home, their condition worsens, and they end up having to be brought back all over again. By which time they’ve deteriorated further.

“The situation got far worse last month as respiratory conditions and norovirus cases increased.

“The current pressures mean we often work after our shifts are meant to have ended so it can be extremely tiring. But I don’t ever think about leaving.

“I feel part of the NHS and finding another job isn’t going to improve the situation. It’s all about making sure patients get the best care we can give.”

Hewitt-Brown and Farrington are volunteer workplace representatives for Unison, the UK’s largest health union.

• In the UK, Frontline19 is an independent non-profit service offering free and confidential psychological support to NHS frontline staff