FIFTY patients were left waiting in ambulances outside the Royal Bolton Hospital’s A&E department for more than an hour during just one month, figures have revealed.

And a further 175 people were waiting with paramedics for more than 30 minutes before they were taken from the ambulance and into treatment at the hospital.

The figures were recorded in April.

Patients should be admitted to hospital within 15 minutes of an ambulance arriving at A&E, according to national guidelines — which also state nobody should be waiting more than 30 minutes before they are seen by hospital staff.

Barry Silvert, clinical director of commissioning at Bolton Clinical Commissioning Group, called on NHS England to implement fines on the North West Ambulance Service if they breach the 30-minute target.

He said: “We do seem to have an ongoing issue — a lot of discussions have taken place with the ambulance service and with the hospital trust to see what improvements could be made to try to make this process work more efficiently.

“There are two different ends to this issue. The ambulance service still doesn’t seem to understand it’s not a good idea to take an ambulance to a hospital when there are other hospitals around.

"Their argument for patient choice is something I take issue with.

“The other end of it is infrastructure within the hospital trust. When the handover takes place it needs to be appropriate from both ends, to make it work more efficiently.”

A spokesman from the North West Ambulance Service said staff constantly monitor the ambulance activity across all emergency departments in Greater Manchester.

He added: “It used to be that we took all patients to the nearest A&E, but with more specialist units now available, we now take patients to the hospital which best suits their clinical need — although in some cases in might be more appropriate to take to the nearest appropriate unit to stabilise a patient.

“In low level cases, we would take to the nearest A&E, and an alternative would be considered if the patient has explicitly expressed a desire to go elsewhere.

“Patients do have a right to choose where they receive treatment and we would have to respect that. However, in the majority of cases, we take patients to the most appropriate receiving unit that can treat their injury or illness.”

Heather Edwards, head of communications at Bolton NHS Foundation Trust, said improvements to the capacity and layout of the emergency department were needed to help reduce waiting times for patients.

She added: “There are a number of reasons why we are so busy, including our easily accessible site, and patients coming here who need not have come to hospital.

“Sometimes our staff can’t immediately take over the care of a patient newly arrived by ambulance and NWAS staff must stay with them for a while until A&E staff are able to do so safely.

“We recognise that we need to reduce these occasions and will be working with NWAS on this.”

The Royal Bolton Hospital is currently vying to be chosen as one of Greater Manchester’s “super hospitals” under the Healthier Together plans.

Health chiefs — who say the restructure could save up to 1,000 lives every five years — have already earmarked Salford, Oldham and Central Manchester as specialist centres.

The Royal Bolton has been shortlisted alongside Wigan, Stockport and Wythenshawe to become one of up to two other specialist hospitals in the region.

Bosses at the Royal Bolton are proposing to invest heavily in the A&E department, as well as maternity, children and obstetrics.

If the hospital does not become a “super hospital” it will still have an A&E department.

To complete the Healthier Together consultation questionnaire, visit

A “listening event” is being held in Bolton about the Healthier Together plans from noon until 2.30pm on Friday at the town’s Holiday Inn.