A woman died after waiting more than 15 hours for an ambulance
She said one of the main reasons for this was that people who can be discharged from the main hospitals, have to remain, because there is no social care provision or community hospitals to move them to.
She has now sent a Prevention of Future Deaths Report to the Welsh Government's Cabinet Secretary for Health and Social Care, Jeremy Miles, expressing her concerns, following an inquest she conducted into the death of Jeanette Sidlow Beech.
The inquest heard Mrs Beech had a history of alcohol withdrawal related seizures. On August 2, 2024, at her home address, she began to feel unwell. Her husband contacted the Welsh Ambulance Service Trust (WAST) at 12.52pm.
The call was categorised as Green 3 response with an estimated time of arrival given as two hours. A second call was made at 3:16pm, indicating increased pain and vomiting with an impending seizure and had been upgraded to an Amber 2 category after clinical review.
A third call was made at 3:51am when Jeanette was struggling to breathe, her body was seizing up and she was vomiting. The call was generated as red. A resource arrived at 4:05am and despite efforts to save her, Ms Beech was confirmed as having died at 4:50am. A narrative conclusion was given at the inquest.
In the report, Ms Robertson said: "It took a total period of 15 hours and 13 minutes for an ambulance to attend upon Jeanette, by which time she was in cardiac arrest and resuscitation efforts were unsuccessful.
"Whilst evidence was received and heard during the inquest that efforts have been and are still being taken by WAST to improve the situation regarding ambulance delays, there remains significant concerns with hospital handover delays.
"It is well known, having heard evidence in previous inquests, that the causes of ambulance delays are multifactorial. They do not rest solely with WAST."
Ms Robertson said many coroners in Wales have issued similar reports over the years, expressing concerns over the time it can take for ambulances to attend emergencies.
She said in the report: "It appears to remain the case that the lack of social care provision and/or community hospitals means that those fit to be discharged from district general hospitals are not discharged and those in emergency departments or on ambulances outside emergency departments are unable to be provided with a bed in the hospitals such that ambulances remain outside emergency departments for hours.
"Evidence was heard that between 2nd and 3rd August 2024 at Betsi Cadwaladr University Local Health Board the longest delays in ambulance handover times were in excess of 6 hours and 7 hours."
Ms Robertson said the issues identified were "pertinent to WAST, the health board and local authorities". She added: "There appears to be no improvement in these ongoing issues and I am particularly concerned that lives are being put at risk, and that deaths will occur into the future and will continue to occur where this situation persists."
The Cabinet Secretary for Health and Social Care has given until July 24, 2025 to respond.
Liam Williams, the Welsh Ambulance Service's executive director of quality and nursing, said: 'On behalf of everyone at the Welsh Ambulance Service, I would like to extend my deepest sympathies to Mrs Beech's family through what has undoubtedly been a difficult time.
'While we cannot change the outcome, we remain a learning organisation and are sincerely grateful to the coroner for her thorough examination of this case which identified and acknowledged the issue of handover delays, and the impact these have on our ability to respond to patients as we would want to.
'Unfortunately, the wait experienced by Mrs Beech reflects the impact of those delays along with the well-documented pressures across the entire NHS in Wales.
'We are working with Welsh Government and with our NHS partners to consider how we best alleviate these pressures and are taking steps to change the way we deliver our own services in future.
"We are in contact with Mrs Beech's family and will work closely with them to respond to any outstanding questions or areas that they would like to speak with us about.'
Tehmeena Ajmal, chief operating officer at Betsi Cadwaladr University Health Board, said: 'On behalf of the Health Board, I extend my deepest condolences to Mrs Beech's family.
'Ambulance handover delays and the consequent impact on response times are symptoms of well-documented pressures across the wider health and social care system, which the Health Board is working tirelessly to address alongside partner organisations, including the Welsh Ambulance Service and the six local authorities in North Wales.
"Despite the continued best efforts of all partners, this remains a hugely challenging area of work, with demand for services continuing to outstrip capacity.'
The Welsh Government said: 'We'd like to express our condolences to the family of Jeanette Sidlow Beech.
'The Cabinet Secretary for Health and Social Care will be responding to the Prevention of Future Deaths report by the Coroner's deadline.
'We have been clear with health boards of our expectations, and they are actively working on improving ambulance patient handover. We have recently established a national clinically led taskforce to support these efforts.'
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