Ambulance transfer delays in England could harm a thousand patients a day
More than 1,000 patients a day are suffering ‘potential harm’ in England due to ambulance transfer delays, the Guardian can reveal.
It is believed that in the past year, 414,137 patients suffered some harm because they spent so long in the back of ambulances waiting to be admitted to hospital. Of those, 44,409 – more than 850 per week – suffered ‘severe potential harm’, where delays caused permanent or long-term damage or death.
In total, ambulances spent more than 1.5 million hours (the equivalent of 187 years) outside emergency departments waiting to offload patients in the year to November 2024, the Guardian’s research found.
Experts said the figures were ‘staggering’ and showed how the NHS was in a more ‘fragile’ state than ever before, amid a ‘perfect storm’ of record demand for emergency care, rising numbers of 999 calls and an increasingly sicker and aging population. .
The analysis of NHS data by the Guardian and the Association of Ambulance Chief Executives (AACE) highlights the enormity of the challenge facing Keir Starmer as he prepares to explain how he plans to save the NHS.
Anna Parry, the chief executive of AACE, which represents the bosses of England’s 10 regional NHS ambulance services, said the data “speaks for itself”.
She added: “These figures underline what the ambulance sector has been saying for a long time: that thousands of patients are potentially suffering harm every month as a direct result of delays in hospital transfers.”
Ambulance transfer delays occur when ambulances arrive at the emergency department but are unable to transfer patients to staff due to unit congestion. It also means that paramedics can no longer go out to care for other patients.
The delays mean patients must either wait outside in the back of ambulances or be taken to the emergency room, but hospital staff are not available to complete the handover by paramedics.
According to national guidelines, patients arriving at the emergency department by ambulance should be transferred to the care of emergency staff within 15 minutes.
However, the target is continually missed, according to the Guardian’s research. Crews often wait for many hours and sometimes entire twelve-hour shifts outside hospitals, with queuing ambulances unable to respond to other emergency calls.
Last week, almost a third of patients arriving by ambulance at hospitals in England – 32.1% – waited at least 30 minutes before being transferred to A&E.
The Guardian analysis is the first time a media organization has examined an entire year’s worth of data on ambulance transfer delays and the potential damage caused.
Ambulance staff lost 1,641,522 hours handing over patients to emergency staff due to delays of more than 15 minutes in the 12 months to November 2024. That figure is 18.5% higher than the same period the year before, it found from the research.
AACE estimates that 414,137 patients may have suffered harm due to delays of more than an hour in the past year – more people than the population of Coventry, England’s ninth largest city. That figure is 18.7% higher than the year before.
Of the patients who may have suffered harm, an estimated 44,409 have suffered serious harm. That number is also an increase of 18.7% from the year before.
Dr. Adrian Boyle, chairman of the Royal College of Emergency Medicine, said the Guardian investigation’s findings were “stunning” and reflected the “lack of capacity” in NHS emergency services.
“People are waiting for ambulances, waiting in ambulances and waiting for ambulance carts in hospital corridors because emergency departments are too full – causing potential harm.
“There needs to be an urgent focus on the ‘exit block’ – an increase in the number of beds to enable people to be moved from A&E to wards, and appropriate social care options to ensure people deemed medically well enough to go home go, can do this too. .
“Only then will we see meaningful changes at the front door of our hospitals.”
On Friday, NHS Cornwall and Isles of Scilly declared a critical incident due to long ambulance queues outside the Royal Cornwall Hospital in Truro and high numbers of A&E patients, with many people medically fit for discharge but waiting for appropriate care.
Rory Deighton, the acute network director at the NHS Confederation, said the Guardian’s revelations revealed a “crisis” in emergency care.
“As these figures show, patients unfortunately often have to wait too long for an ambulance, and when they reach hospital, as we have seen in recent days, transfers can also be delayed, with many emergency departments forced to use workarounds , such as corridor care in an effort to meet demand.”
Deighton said addressing “shortcomings in social care delivery” would be “critical” to reducing ambulance transfer delays by speeding up the discharge of hospital patients and helping more older people avoid admissions.
“But the reality is that years of underinvestment in the NHS and social care, alongside rising levels of ill health in the country, mean our local health and care services are more vulnerable than ever.”
Adam Brimelow, director of communications at NHS Providers, said the figures were “very worrying”. A “perfect storm” of very high numbers of the most urgent category of 999 calls, on top of record emergency attendances, had created “real capacity issues”, he added.
“In recent months, ambulance calls have been among the busiest on record, and overstretched teams face an uphill battle as demand skyrockets and exceeds available resources.”
Parry said a “high priority focus” on reducing transfer delays was essential to ensure ambulances were available to those most in need. The crisis was “not persistent,” she added.
NHS England and the Department of Health and Social Care have been contacted for comment.