A SENIOR doctor usually deployed to major disasters was called to Worcester's hospital for the first time in its history as patients including one with chest pains lay in pain on hospital trolleys.

Ambulance bosses dispatched a medical incident officer (MIO), a senior consultant doctor, to Worcestershire Royal Hospital last Friday evening.

The MIO is only called to major incidents which can include serious car accidents involving multiple casualties, explosions and large fires.

The surge in patients at Worcester began at around 3pm and only by 12.30am the following morning did they begin to get patients off the trolleys and either discharge them or admit them into beds.

A&E beds were full as the hospital was at capacity.

Chris Tidman, the hospital trust’s deputy chief executive, said there were seven patients being treated on trolleys at any one time but stressed that no patients came to harm.

The decision to send in the MIO was taken due to the refusal of the hospital to accept a number of patients into the emergency department for an extended period, despite some of those individuals being in considerable pain and displaying very serious conditions said the ambulance service.

A West Midlands Ambulance Trust spokesman said: “The trust had repeatedly asked clinical staff within the emergency department to triage the patients so that the most serious could be given pain relief or taken to wards to receive appropriate care.

"This was refused on a number of occasions. Due to the number of patients being cared for by ambulance staff in the hospital, the trust had outstanding 999 calls in Worcestershire that we had no ambulances to send to, which potentially put those patients at risk.

“Working with ambulance crews and managers, the MIO oversaw seven patients in the hospital corridor, with a further patient on an ambulance outside.

"Intravenous drugs were administered and patients were cared for whilst West Midlands Ambulance Service escalated the situation to the hospital management team, Commissioners and NHS England.

“In addition, we have raised our concerns about the hospital with the Care Quality Commission on a number of occasions. The ambulance service has insisted that the hospital formally record this as a Serious Incident and that a full investigation is conducted by them.

“One patient was cared for by ambulance staff on the corridor for over five hours despite complaining of cardiac related chest pains, another patient who was recovering after an epileptic fit waited over four hours and a third patient was cared for by ambulance staff despite suffering from a suspected pulmonary embolism.

“This is the first time the trust has taken the decision to send an MIO to a hospital. It was a decision not taken lightly.

The West Midlands Ambulance Service understands that Worcestershire Royal Hospital and its staff are working exceptionally hard, however, at a recent risk summit it was agreed that the ambulance service should not have to look after patients in the corridor and that the hospital would flex its staff to ensure a rapid handover is achieved so that ambulance crews can then be dispatched to those patients still in the community.”

There has been a 9.3 per cent rise in patients being taken to Worcestershire Royal Hospital by ambulance between 2013-14 and 2014-15.

However, ambulance bosses stressed this had not been at a steady rate across the year with a recent drop year on year in March.

The ambulance trust claims the number of hours lost at Worcester while patients are turned over to the trust had increased from 1,368 lost hours (2013/14) to 1,952 (2014/15). The clock starts after the ambulance has been at the hospital for 30 minutes.

Delays of over an hour have increased from 103 in 2013/14 to 351 in 2014/15 (clock starts after 30 minutes).

In February 2015, the ambulance trust had to look after 434 patients on the corridor of Worcestershire Royal Hospital.

In total this accounted for 687 hours of ambulance time that could have been used to get to patients in the community.

The longest period of looking after patients was 8.3 hours. The greatest proportion of those affected are patients over the age of 80 years.

Hospital deputy chief executive Chris Tidman said they had increased the number of A&E cubicles from 18 to 30 and increased A&E staff from nine to 11 to deal with the pressure.

The trust is now getting 75,000 emergency patients a year through the doors when it was only built for 45,000 when it opened in 2002.

He said the one patient with chest pains was given an ECG and ‘came to no harm’.

He confirmed the trust had also been given a notice to improve by the Care Quality Commission, the independent regulator of all health and social care services following a visit in March.

The hospital trust has been told they must focus more on triage and observation of patients.

At least 95 per cent of patients should be admitted, discharged or transferred within four hours of coming to A&E. The trust has missed the target for the last 27 weeks consecutively. The figure has been around 82 per cent for the last three weeks.

On any given day the trust said about 70 patients are waiting to be discharged but only about 15 are going, because of delays getting home and nursing care packages in place for after they leave.

Mr Tidman said: “We need that back door of the hospital to flow out more steeply. Of the seven patients none of them came to harm.

“I would like to offer apologies for the unacceptable long waits and stress our teams are doing everything they can under really difficult circumstances. We’re just pleased no patients came to harm. Obviously we’re upset and frustrated.

“No-one can give guarantees about A&E. By their nature they have the most serious cases coming through the doors."

He stressed that no patients were left in ambulances.