Ambulance trusts suffer as calls jump 13% in London

In London, call volumes were 13 per cent higher than October last year while South Central Ambulance Service Foundation Trust and South Western Ambulance Service FT were both facing increased handover delays at some hospitals. HSJ has been told East and West Midlands and East of England areas are also under pressure.

This comes after average response times for category 2 calls rose sharply in September, making it increasingly unlikely the sector will meet the government’s target of an average 30m response time in 2024-25. October’s figures won’t be released until 9 November.

Pressure on ambulance services does normally increase as winter approaches but Daniel Elkeles, chief executive of London Ambulance Service, said demand has been growing at much higher levels than the trust had anticipated.

“We have seen significant increases in calls related to people with difficulty in breathing and respiratory illnesses, as well as additional calls for people with mental health conditions. We are already 13 per cent busier so far this October than we were in October last year,” he said.

“We are working closely with hospitals – who are also facing increased pressure – to continue to reduce handover times.”

Anna Parry, managing director of the Assocition of Ambulance Chief Executives, said they were looking at a “potentially very difficult winter”.

“Our members are telling us that hospital handover delays continue to be the biggest problem with delays over one hour increasing significantly, hours lost to handover delays increasing significantly, and average handover times increasing too. We know that these delays, as well as others experienced across the urgent and emergency care pathway, have a detrimental impact upon patient experience and outcomes,” she said.

“When our ambulances and crews are tied up at hospitals waiting to transfer patients, they are not free to respond to other patients in the community. At this time of year, we also tend to see call volumes increase.

Several acute trusts have also declared incidents this month. University Hospitals of Leicester Trust declared a critical incident because of a “higher than usual number of patients needing care” which it said was leading to a challenging ambulance handover situation. The incident was stood down on 10 October.

Wirral University Teaching Hospitals Foundation Trust declared an “internal critical incident” amid “unprecedented demand”. Local media reported ambulance handover delays reaching 10 hours.

Figures seen by HSJ show that September saw a sharp upturn in ambulance handover delays. The volume of 30m delays was 105,000 – the sixth highest ever recorded and 21,000 higher than September 2023. The number of 30m delays in the 12 months to September 2024 was nearly twice as many as the same period three years earlier – partly reflecting the pandemic but also the increasing pressures on both hospitals and ambulance trusts.

The hours lost by ambulance trusts to these delays was nearly three times that in the year to September 2021 and only slightly less than those lost from October 2021 to September 2022, when ambulance services saw dramatically rising response times.

And the number of three hour or more delays was 9,006 in September compared to 7,221 in September 2023.

Three trusts were also suffering from severe handover delays – East Midlands, West Midlands and South Western, all losing more than 20,000 hours to handover delays last month and South Western seeing average handover times close to an hour.

The winter before last was especially fraught for the urgent and emergency care system with a coroner in the South West saying the system in the region was unable to cope without increased national support. Coroners across England reported spates of deaths from ambulance response or handover delays.

The Association of Ambulance Chief Executives use these figures to estimate how many patients are likely to suffer harm from waiting to be handed over at accident and emergency. In September, it calculated 38,000 suffered some harm, rivalling levels in the middle of winter and 17 per cent of ambulance “job cycles” were lost because of handover delays.