Hospital trusts are likely to face tougher penalties for keeping ambulances waiting outside accident and emergency departments, HSJ has learned.

HSJ understands Monitor and the Care Quality Commission were due to meet this week to discuss how to use their respective foundation trust compliance framework and quality regulation to address the problem.

They were asked to look at the issue by NHS deputy chief executive David Flory.

It comes after NHS chief executive Sir David Nicholson last week told the Ambulance Leadership Forum event he would like to see long ambulance handovers treated as seriously as patient safety “never events”, and was considering how it might be achieved.

Peter Bradley, national director of ambulance services and London Ambulance Service Trust chief executive, told HSJ there was a “rump” of 20-30 hospitals that had consistent problems with completing a handover in the required time.

Mr Bradley said: “There has been immense frustration about the lack of attention given to this by acute trusts so we were encouraged to hear what David Nicholson had to say.”

Details of any scheme have yet to be confirmed but are likely to include closer performance management, and possibly financial penalties. Never
events often incur a penalty for providers under their contract terms.

Hospital trusts are meant to allow for ambulance services to hand over a patient, clean the ambulance and get back out on the road within 15 minutes.

However, information collected by the Department of Health suggests that in January, only a third of trusts achieved a turnaround time of 15 minutes for at least 95 per cent of arrivals at A&E.

A further third took 15-30 minutes before handover while about 15 per cent regularly took more than an hour.

The College of Emergency medicine has stated it is unsafe to leave patients waiting in ambulances for longer than 15 minutes.

NHS Confederation Ambulance Service Network director Jo Webber welcomed the moves to address the issue. She told HSJ that any performance measure should ensure every organisation took responsibility for their part in the system.

She said: “It’s not good for the clinical care of patients for them to be waiting in the back of ambulances – but the other side of it is there are people waiting for an ambulance who have to wait longer because ambulances are held up at A&E.”