Ambulance handover delays still harming tens of thousands each month

The data (see chart below) shows more hours have been lost to handover delays lasting more than 15 minutes in most of the first five months of 2024 compared to the same period in 2023. In May, more hours were lost than in May 2022 and May 2023. 

The Association of Ambulance Chief Executives told HSJ the problem remained severe and the government needed to act to improve it.

AACE, which represents all of England’s ambulance providers, said the total hours lost in May to waits over 60 minutes stood at 48,000, 10 times the figure five years ago. It estimates 32,000 patients suffered harm as a result of delays in May, with 148 waiting more than 10 hours to be transferred into accident and emergency — double the figures for May 2023. The delays amounted to 101,000 “job cycles” or almost one in six of all face-to-face attendances, it said.

There has been a big effort to improve handover delays since winter 2022–23, when they caused outcry over a huge increase in ambulance response times. Late last year, many hospitals kept delays lower than 2022, under pressure from government and NHS England, in part by agreeing to move emergency department patients into corridors and filling wards beyond their proper capacity. But last month, NHSE warned corridor care “must not be the norm”.

May is often seen as a quieter month for ambulance services as they recover from winter pressures, but this year there were around 10 per cent more calls than April and the highest number of category 1 incidents (the most serious and life-threatening) on record.

There are indications the heightened demand continued into June. 

AACE managing director Anna Parry said it had consistently warned about the ongoing risk of handover delays.

She said: “This is why one of our key requests of the new government has been that they proactively support the ambulance sector’s aim to ensure patients universally receive high-quality, timely care and no longer experience unacceptable delays in response or handover of care, for example, at hospital emergency departments.

“This problem is not intractable. We have demonstrated that in areas where there is a strong leadership focus and true system-wide support, handovers can be managed effectively, despite the significant pressures and constraints our health and social care system is under. However, it remains vital that we see more demonstrations of excellent leadership to get to that point across the country.”

Ms Parry also highlighted AACE’s vision for the NHS ambulance sector, which argues “government could extend and formalise a much wider remit in urgent and emergency care for ambulance services”.

The Department of Health and Social Care said: “The NHS is broken. But getting it back on its feet and building an NHS fit for the future is the mission of this government. We are determined to meet the ambulance response time standards set out in the NHS Constitution.”

The NHS Consitution mentions the standards for category 1 calls — 7 minutes — and category 2 calls — 18 minutes. Outside of the pandemic, the category 2 target has never been consistently hit nationally, and ambulance trusts have been asked to instead aim for 30 minutes, a target they missed in 2023–24 and will struggle with on current trends in 2024–25.