March 23, 2023 | Terry Smith

What’s causing NHS ambulance handover delays? Current ambulance handover times explained

Delays in NHS ambulance handovers are a hot topic currently, and in this short article, we will be breaking down what an ambulance handover is, and how the introduction of ambulance handover units is helping to reduce ambulance handover delays and improve ambulance response times.

“Ambulance handover delays are risky because they delay assessment and treatment for those waiting in an ambulance queue at hospitals. Such delays also compromise safety in our community by reducing the availability of ambulances to respond to emergencies.”

NHS England

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What is an ambulance handover?

An ambulance handover is quite simply the process of moving a patient from an ambulance to the emergency department of a hospital upon arrival. Delays in ambulance handovers indicate a hospital is under pressure and that the hospital/A&E department doesn’t have the capacity to cope with the number of patients arriving.

The national guidance states that patients arriving at an emergency department by ambulance must be handed over to the care of A&E staff within 15 minutes¹. The handover time starts when the ambulance arrives at the hospital, and stops once the patient has been handed over to A&E staff.

Current NHS ambulance handover times

The below chart from Nuffield Trust shows the number of ambulance handovers that took over 30 minutes to complete, during the winter weeks, with a separate line for each year from 2017-2022.

As evident from the graph, the winter of 2021-2022 is the worst on record for ambulance handover times, with the number of handovers over 30 minutes nearly reaching 20,000 per week.

What’s causing NHS ambulance handover delays?

So, what’s causing the NHS ambulance handover delays? The primary reason is overcrowded emergency departments and delays in transferring patients from A&E, either to be admitted, discharged, or transferred to another department.

The delays in admitting patients from A&E are largely caused by high levels of bed occupancy; quite simply there are not enough free beds to cope with the number of new patients.

Delays in discharging patients from hospital cause high levels of bed occupancy and subsequent capacity issues.

As you can see, exactly what is causing ambulance handover delays can’t be put down to a single cause; rather there is a cycle of events that are causing high levels of pressure and a lack of capacity to cope with the demand.

What is an ambulance handover unit? How are they helping?

Ambulance handover units, also known as ambulance receiving centres, are small units that are separate from the main A&E department, designed to give ambulances an area to safely and quickly hand over patients when capacity in A&E is maxed.

Allowing ambulance queues to build up is not an appropriate way of managing an increase in demand, and ambulance handover units aim to prevent queues from forming, helping to reduce handover delays and helping reduce ambulance response times.

Below is an image of an ambulance handover unit recently installed at Southend Hospital, which has space for up to 12 patients.