A data request from the BBC to the Association of Ambulance Chief Executives (AACE) has revealed that between September 2023 and September 2024, NHS ambulance services in England managed to improve the speed at which they responded to patients across all four categories of the national ambulance performance standards, despite a significant increase in the number of calls and incidents responded to as well as some of the highest levels of handover delays seen to date.
The data shows that:
- NHS ambulance services responded to 8% more incidents taking the total in the 12 months to September 2024 to 8.8 million, from just under 8.2 million in September 2023.
- NHS ambulance services lost 1.6 million hours (of their total annual capacity to respond to patients) to handover delays at hospital emergency departments in excess of 15 mins – of which 654k went on to breach one hour. This is the equivalent of 183 years. In simple terms, aside from the potential additional harm being caused to the patient being cared for in the back of these ambulances, crews are stuck at hospital unable to hand their patients over to the care of the hospital meaning they are unable to respond to other people elsewhere who may be in urgent need of an ambulance.
- Early sight of October 2024’s handover data worryingly shows that these continuing handover delays increased to some of their highest levels seen to date. Volume of delays of over 15 minutes and over 30 minutes were at their highest levels since recording began (at 262k and 127k respectively), while delays of over 60 minutes were at their second highest volume (at 54k, with the highest being December 2022 at 66k).
Despite these significant challenges NHS ambulance services managed to achieve the following during September 2023 – September 2024: - Responded to Category 1 incidents 29 seconds faster than in 2023; Category 2 incidents over six minutes faster; Category 3 incidents nearly ten minutes faster and Category 4 incidents in excess of sixteen minutes faster.
- A 27% growth in the number of incidents handled through the ‘hear and treat’ process (with clinical advice and help provided over the telephone) avoiding the need for ambulance crews to respond to scene in 1.3m cases.
- A significant reduction in the need to take patients to emergency departments – from 51.7% to 50.7% of incidents resulting in ‘conveyance’. So, despite attending to 624k more incidents at a time when the system was under sustained pressure, NHS ambulance services were more effective at finding suitable alternatives to taking patients to hospital emergency departments, relieving pressure on the system and improving experiences for patients.
Anna Parry, Managing Director of AACE said:
“When we consider the sustained pressure that our ambulance workforce has been under in recent years, we are pleased and proud to report that the commitment, dedication and hard work of employees has continued to improve the experiences of NHS care for many patients. This has been achieved by reaching those who need us most, faster, and ensuring that those who do not need to be treated at hospital are provided with more appropriate pathways of care such as urgent care centres or same day emergency care.
“However, these figures show a significant increase in the workload for ambulance services against a backdrop of major challenges exacerbated by the onset of winter, when pressures traditionally increase across the whole system. Most concerning for us is the continued increase in handover delays at some hospital emergency departments which we know is just one example of delays in transfer of care across urgent and emergency care, and more broadly, the wider health and social care system.”
Jason Killens, Chair of AACE said:
“As we have been consistently warning for a number of years, hospital handover delays continue to cause serious problems that directly impact ambulance service performance and waiting times for patients and cause untold, inexcusable additional harm.
This problem is not intractable and AACE regularly publishes examples of positive system working and initiatives that have helped reduce handover delays in some hospitals, demonstrating 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.”
AACE publishes monthly national ambulance data here: https://aace.org.uk/uk-ambulance-service/national-ambulance-data/.
