CRITICALLY ill patients have faced longer 999 waits since before the pandemic, while Covid pressures have led to 'recent' instances where A&E staff were unable to admit emergency cases.

Dr Jim Ward, medical director of the Scottish Ambulance Service  told MSPs that the pandemic had placed huge pressures on the front door of hospitals and said that there had been occasions, recently where they ‘had been unable to process patients”.

The Royal College of Emergency Medicine has previously warned that there had been cases where paramedics have had to wait for several hours outside hospital  doors because there was insufficient room in A&E departments.

Dr Ward did not provide any figures but said the ambulance service was working with hospitals to find solutions to avoid ‘blockages’ in the system which result in patients facing  ‘unhelpful and unsatisfactory’ delays.

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He said: “Often things go exceptionally well, particularly for our most critically ill patients, who have to go straight to resuscitation.

“Generally our experience of that has been positive. However, the reality of working within the Covid-19 restrictions...it has put huge pressure on the front door of hospitals in terms of the changes that have had to be made in terms of how patients are processed.

“With the aim of social distancing and trying to make sure those patients who are known to be or risk for Covid are taken through separate pathways.

“That has resulted on occasion and particularly in the more recent wave of hospitals experiencing delays and being unable to process our patients.

“We are working very closely at both national and local levels with our hospital managers to look at solutions in terms of managing flow, in terms of anticipating and processing demand to avoid and manage what we have been seeing more recently which is patients having to wait in ambulances for times that we would all consider unhelpful and unsatisfactory.

“This is not just a Scottish issue, it’s being faced by ambulances not just across the UK but across Europe and the answer has to be whole system collaboration.”

The Scottish Ambulance Service faced questions from MSPs yesterday about the pressure of maintaining services during the pandemic but was also asked by Glasgow MSP Sandra White to explain why response time targets for life-threatening calls were missed in 2019.

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The service's annual report for 2019.2020 said 64.7% of calls were responded to within 8 minutes, well below the target of 75% .

Pauline Howie, chief executive of the Scottish Ambulance Service said:  “Response times have gradually been increasing and from Summer of 2019 we have seen them go above our median aims both in terms of responses for the most critically ill and for other patients.

“Response times are only one component part in the chain of survival. However, we continue to focus on reducing response times where we can.

“I’m pleased to report that we have managed to maintain our outcomes for cardiac arrest response times during this time despite particular challenges because of the enhanced infection control arrangements.”

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Ms Howie said ambulance call-outs dropped dramatically after the first national lockdown - from April 2020 there was 13% decrease in 999 calls. Levels did not return to normal until August and have she said they had dropped again as more restrictions were introduced.

However, while call-outs dropped overall, there has been a  9% rise in mental health related emergencies during the pandemic.  A paramedic based in Livingston said a number of her colleagues had “responded to increased calls for deaths by suicide”. 

The chief executive said the service was implementing a number of changes to improve hospital turnaround times while £10.7million of additional funding announced by the Scottish Government last year would be used to recruit an additional 148 full-time employees by March.