NHS delays turned a perforated colon into a race against time
A perforated colon can become fatal quickly. For Diane Jones, the danger deepened as she moved through a stretched system that delayed 111 advice, ambulance response, emergency department triage and consultant review before lifesaving surgery finally began.
Her husband Andrew Jones said the family had to fight for help at every step after she fell suddenly ill at the end of September with a colon that burst and began poisoning her body. He described a woman in severe pain who worsened while calls were unanswered and while the emergency department at Derriford Hospital in Plymouth struggled to see her. The sequence matters clinically because bowel perforation is not a condition that pauses while systems catch up; infection, contamination and shock can accelerate by the hour.
From unanswered calls to an overrun emergency department
The Jones family phoned NHS 111, but the call went unanswered for seven minutes. They then dialled 999 three times before deciding they could not wait any longer and drove to hospital in their daughter’s pickup truck, taking the 24-mile journey from near Launceston in Cornwall to Plymouth over bumpy roads in an effort to keep Diane as steady as possible.
On arrival, the emergency department was already under heavy strain. Andrew Jones said it felt like a war zone, with a waiting room full of distressed patients, including people with toothache, broken fingers, intoxication and police escort cases. His account captured the practical effect of crowding on emergency care: when departments are saturated, the sickest patients can sit unseen while staff try to make the queue function around the available space, beds and clinicians.
Diane Jones was assessed by a nurse 48 minutes after arrival. Hospital guidance says patients with signs of potential serious illness should be triaged within 15 minutes, then seen by a doctor within an hour. Instead, it took about four-and-a-half hours before a consultant saw her. By then, her husband said she looked grey and was deteriorating in front of them. He repeatedly asked for help and at one point was told it would be at least eight hours before she could be seen by a doctor.
One sentence from the family captures the bedside reality: if they had accepted the queue as it stood, she might not have survived.
A perforation, sepsis and the narrow window for surgery
A burst colon can trigger septicaemia, and that is what made this case so dangerous. Once bowel contents leak into the abdominal cavity and bloodstream, the body can spiral from pain and infection into organ failure. In that setting, early recognition and rapid surgical control of the source are decisive, because antibiotics alone cannot stop ongoing contamination from a perforated bowel.
The consultant who finally reviewed Diane Jones recognised the seriousness of her condition, and within a few hours she was in surgery. Andrew Jones said the operation had been expected to last about three hours but took six, and the surgeon later told the family it was one of the most difficult of his career because of the damage done. The long delay before specialist review likely allowed the inflammatory and infectious burden to worsen, which is exactly the kind of progression emergency pathways are supposed to prevent.
Diane Jones is now recovering at home. Even so, her husband said the emotional toll will take time to process, and the family’s account makes clear that the most dangerous part of the episode was not only the disease itself but the loss of time before the right clinician saw her.
What the trust and ambulance service said about pressure
University Hospitals Plymouth NHS Trust said it was sincerely sorry that Mrs Jones did not receive the timely assessment and care she needed, adding that her care fell short of what she should have received. The trust pointed to significant pressure in the emergency department, including staffing challenges, limited space and delays moving patients onward. It also said care should be prioritised by clinical urgency, not order of arrival, and that improvement work and winter planning were aimed at reducing delays.
The South Western Ambulance Service said it was sorry too, explaining that at the time of the first 999 call it was experiencing high demand and had to prioritise ambulances for life-threatening conditions. It added that hospital handover delays and wider NHS and social care pressures compounded the problem. HUC, which provides the 111 service in Cornwall, said calls are answered as quickly as possible, though delays can occur during periods of high demand.
These explanations point to a familiar chain of failure in emergency care: the call system, the ambulance fleet, the handover process and the emergency department can all become bottlenecks at once. When that happens, each link in the chain pushes the next link closer to collapse, and patients with surgical emergencies pay the price.
Persistent crowding at Derriford and across the South West
The scale of the pressure was visible in the regional performance figures. In September, only 36.2% of patients at Derriford’s emergency department were seen within four hours, well below the England average of 60.6%. The hospital sat at the bottom of the national rankings for emergency care for the eighth consecutive month. The South Western Ambulance Service also remained among the three worst services for the most serious incidents in September.
The Royal College of Emergency Medicine warned that emergency departments are operating under such strain that staff are being pushed to focus on the least sick patients in an effort to improve headline statistics rather than on those who need urgent care most. In a perforated colon with evolving sepsis, that type of distortion can be lethal. Triage systems exist to reverse the natural pull of the waiting room; when the system itself becomes overwhelmed, triage loses the power it is meant to have.
Andrew Jones said he remains a supporter of the NHS but believes something is wrong with the system. His criticism was aimed not at the doctors and nurses trying to help but at the structure around them. In this case, the structure failed to protect a patient whose condition demanded immediate escalation, and the cost was hours of preventable danger before surgery could begin.