Patients in Kent calling 999 after suffering serious conditions such as strokes were left waiting an average of 39 minutes for an ambulance last month, shock figures reveal.
The South East Coast Ambulance Service (Secamb) recorded its worst response times on record in March.
It comes as health services in the county have been pushed to "breaking point" by the impact of Covid - with A&E waiting times at one hospital trust also the worst on record.
Hundreds of emergency patients in east Kent last month endured ‘trolley waits’ of more than 12 hours, with some forced to wait in corridors to be admitted.
Meanwhile, the ambulance service continues to struggle to cope with the high demand.
In March, it took paramedics nine minutes and 34 seconds minutes to reach life-threatening calls - against a target of seven.
And for category two calls, such as for stroke or major burns patients, the average response time was 39 minutes - more than double the target of 18.
While the figures make for grim reading, a similar picture has been seen across the country as all ambulance services are facing high pressure and not hitting performance targets.
A Secamb spokesperson said: “We have been extremely busy in recent weeks and continue to face high demand.
“We recognise that this means some patients are waiting longer than they should for a response and we are doing everything we can to reach those who need an ambulance response as quickly as possible, while prioritising our response to our most seriously ill and injured patients."
Secamb says the public can help it manage demand by only calling 999 in the event of an emergency.
Emergency units in Margate and Ashford recorded 17,596 arrivals in March - the equivalent of one person every 150 seconds.
And almost 43% of those were left waiting more than four hours to be seen, as pressure continues to mount on exhausted and depleted hospital teams.
It came as the number of patients with Covid across the trust’s hospitals in Canterbury, Margate and Ashford almost doubled in a month, hitting its highest level since February last year on April 11.
Most patients with the virus are being treated for something other than Covid, but the logistics of keeping infected patients away from others continues to stretch overworked hospital teams.
At the same time, the virus is impacting staffing levels, with 486 hospital workers off sick on April 6 - almost 40% of them with Covid.
One senior NHS leader says “sensible precautions” are needed to reduce the strain Covid is putting on the health service.
Chris Hopson, the chief executive of NHS Providers, says at its latest board meeting 20 experienced hospital trust bosses agreed this was “the longest and most sustained period of NHS pressure they had seen in their careers”.
He is urging the government to encourage measures such as social distancing and wearing face masks to ease the demands on hospitals.
“There is concern across the NHS that the government doesn’t seem to want to talk about coronavirus any more,” he said.
High levels of Covid cases locally have seen the number of hospital patients with the virus in east Kent rise from 124 on March 1 to 240 on April 11.
By Tuesday this week it had fallen to 125, following a welcome drop in infection rates.
Mr Hopson added that the NHS is facing the levels of pressure normally experienced in the “very depths of winter”.
Last month, 7,438 patients arriving at A&Es in Margate and Ashford waited at least four hours - more than 150 a day. It meant just 57.7% of all people attending the units were admitted or discharged within what was previously the government’s target time, compared to 78% in the same month last year.
Meanwhile, 372 emergency patients who needed admitting to hospital were forced to wait more than 12 hours - on occasion in hospital corridors.
A major factor is a delay in discharging patients, stalling the flow through hospitals and leaving ambulances queuing outside.
In a report presented to the East Kent Hospitals board earlier this month, its new chief executive, Tracey Fletcher, described the impact of Covid as “considerable”.
“With the complete lifting of societal restrictions and waning immunity, this has led to some of the highest levels of Covid-19 yet seen in the community,” she wrote.
“This is reflected in the number of patients in our hospitals who have tested positive for Covid-19 - as well as large numbers attending emergency departments and other ambulatory areas.
“In the majority this is an incidental finding and mortality, morbidity and need for critical care remain low, but the operational pressure created is considerable.
“There is limited scope for moving to a more ‘business as usual’ approach to managing Covid-19 until this peak passes.”
"The impact on staff absence, including clinicians, support staff and senior management, has been very significant..."
At the same board meeting East Kent Hospitals chair Niall Dickson told of the strain health teams are under.
“We continue to experience severely increased demand on our services, with our emergency departments under enormous pressure,” he said.
“The number of Covid inpatients has been very high at nearly 200, and although this variant mostly causes less serious illness, the impact on staff absence, including clinicians, support staff and senior management, has been very significant.”
East Kent Hospitals is hoping a £30 million expansion of its emergency departments at the William Harvey and QEQM will help improve care for patients, as well as a new £14 million 24-bed critical care bed unit at the Ashford site. A spokesperson added: "All NHS services are really busy and our colleagues continue to work incredibly hard to provide safe, high quality care and manage the impact of Covid-19 infections.
"As always, the NHS remains here for you when you need it."
MP demands action
Canterbury MP Rosie Duffield says the latest A&E waiting times show emergency services in east Kent “have been pushed to breaking point”.
“The fact that now only just over half of patients are being seen within four hours should set alarm bells ringing at all levels,” she added.
“The NHS entered the pandemic with waiting lists already at a record high, huge staff shortages, and fewer beds.
“Meanwhile, taxpayers are expected to pay more while waiting longer for treatment than ever before. This simply can’t go on, and it needs urgent intervention from the government.
“Covid levels in east Kent are still at a worryingly high level, so we must all continue to be careful.
“Cutting free testing while rates are still so high, along with the cut to sick pay, has been the wrong decision at the wrong time.
“While infections remain high and we face the risk of new strains, testing is crucial for keeping infections under control and preventing the return of restrictions on our lives, livelihoods and liberties.”
400 nurses to be recruited
East Kent Hospitals is to recruit 400 new nurses by spring of next year.
The trust has secured the funding for the additional posts to “help improve patient care and experience in our inpatient wards”.
With hospitals facing a nationwide issue of recruiting in the UK, bosses expect to fill some of the new positions with overseas nurses.
Already more than 100 foreign nurses have joined the trust, which has a dedicated programme to help them settle in.
The Foster Ward project has been running for more than a year and means all new overseas nurses are allocated to one of five specific wards for their first six to eight weeks with the trust.
"Our trust a great place to work for overseas staff and we are looking forward to welcoming more..."
These wards – Richard Stevens and Bartholomew at the William Harvey, Mount McMaster at the K&C, and St Margarets and Deal at the QEQM – were chosen because of their already good reputation for staff morale, inclusion and supporting student nurses.
Overseas nurses who have gone through the programme act as buddies, and there is an international nurse WhatsApp group to allow people to ask questions and share anxieties with others in similar circumstances.
Chief people officer Andrea Ashman said: “Our Foster Wards provide a compassionate and friendly attitude in helping new internationally educated nurses settle in the UK while acclimatising to our ways of working and the stressful time of sitting their OSCE.
“The teams also help with practicalities such as finding rental accommodation. Their warm welcome means our new overseas colleagues know they are valuable to us and that we care about their wellbeing and making them feel welcome.
“It helps make our trust a great place to work for overseas staff and we are looking forward to welcoming more internationally educated nurses this year to help us care for our patients.”
East Kent Hospitals has more than 9,000 staff working across its five hospital sites and in community clinics.