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The response to the ‘unprecedented’ crisis in ambulance delays and the hope guidelines will protect patients

Reports of significant delays in ambulance response and handover times have led to national concerns being raised regarding patient safety. Ambulance delays result in delays in assessment and treatment of the patient and can result in a decline in the patient’s condition.

An article in The Independent stated that almost 200,000 patients were estimated to have come to harm so far this year due to ambulance delays, as NHS leaders are forced to act on the “unprecedented crisis”. An estimated 20,000 are estimated to have experienced severe harm this year due to ambulance delays.

Victoria Vallence, director of secondary and specialist healthcare at the Care Quality Commission told The Independent of the CQC’s concerns about the severe pressure on the NHS which is impacting its ability to treat those in a serious condition in a timely manner.

Ambulance response times

The NHS has sought to improve ambulance response times and recently set out new performance targets for the ambulance service in the addendum to the Handbook to the NHS Constitution.

Response time targets are set for four different categories of calls, with Category 1 being life threatening and therefore the most urgent, and Category 4 being non-urgent but requiring assessment.

Ambulance response times for all categories of calls increased during 2021, and in March 2022, response times were all higher than targets set.

Ambulance handover times

NHS targets provide that all handovers between ambulance and A&E must take place within 15 minutes and that none should be after more than 30 minutes. However, handover delays have increased significantly over the last year.

The article in The Independent also states that since January 2022, ambulance handover delays have continued to increase with 19,000 in June delayed outside hospital for at least two hours. This has led to reports of some paramedics saying ambulances are being treated like extra wards for emergency departments under significant pressure.

Increased ambulance response times have also raised cause for concern after leaked data showed some stroke patients were waiting for four hours. Lengthy wait times in A&E departments are also increasing the risks to patient safety and outcome.

Delays in ambulance handover times also compromise the safety of patients waiting for ambulances to respond by reducing the availability of ambulances to respond to emergencies.

Increased risks of handover delays during high temperatures

The recent heatwave has also exacerbated the existing pressure on NHS ambulance services as patients and paramedics remained waiting outside A&E departments in ambulances. This led to concerns over patient safety due to the temperatures being reached inside the vehicles.

Any decline suffered in patient condition while waiting in the vehicles may, in turn, increase the urgency of treatment required once the patient is transferred to the emergency department.

The increased pressure prompted NHS England to send a letter to all healthcare leaders in July advising that ambulances should not be held outside of hospitals for longer than 30 minutes due to the increased risk as a result of the heatwave.


We're of course all concerned about this issue. The letter from NHS England is welcome evidence of an attempt to address this and put guidelines in place which seek to protect patients. 

It can be hoped that any reduction in ambulance handover times following NHS England’s letter will also result in a reduction in ambulance response times, which will have a positive impact overall by reducing the pressure on NHS ambulance services and emergency departments and therefore improve patient safety and outcomes.

Find out more about Irwin Mitchell’s expertise in supporting patients and families affected by care  delays at our dedicated medical negligence section.