Northern Ireland

More than 500 patients a month at Ulster Hospital wait longer than two hours for ambulance handover

The figure is well above the recommended 15-minute target

Archive files revealed official concerns about ambulance service capacity if Northern Ireland was to experience a major attack following 9/11
(Rebecca Black/PA)

More than 500 patients a month are waiting longer than two hours in an ambulance to be seen at Ulster Hospital’s emergency department.

Well above the recommended 15-minute target, the Northern Ireland Ambulance Service (NIAS) said the patients “waited significantly more than would be acceptable.”

The new figures from between October and January were disclosed by the Health Minister Robin Swann in a written answer to North Down MLA Alex Easton.

In January, 578 patients (the equivalent of 18 a day) waited more than two hours to be handed over to emergency staff with similar numbers reported each month since October.

Close to 200 patients also waited between one to two hours each month and around 500 waited less than one hour.

NIAS figures detailed the handover times at the Ulster Hospital.

“Safe ambulance handover standards indicate that a patient should be handed over to waiting clinicians within 15 minutes of arrival at the receiving ED,” Mr Swann’s answer read.

“NIAS advise that the patients waited significantly more than would be acceptable.”

The ambulance service added that patient handover delays from ambulance staff to emergency departments and the resulting poor ambulance response times remained “a significant cause of concern for the Trust”.

“Reports show that significant risk to urgent and emergency care patients was that of delayed ambulance handovers. NIAS continues to work with all Trusts and the Department of Health, to develop solutions to improve handover times.”

In December 2023, NIAS reported a total of 12,202 lost hours because of delayed handovers – the equivalent of 33 shifts per day where crews are waiting with patients outside emergency departments.

This equates to a third (29%) of NIAS planned capacity.

The lost hours covered 9,218 incidents where crews waited longer than 15 minutes to handover patients, with 3,887 handovers taking longer than an hour in December.

A South Eastern Trust spokesperson said that long waiting times were “regrettably” experienced across every Trust in the region.

“This is not the service we want to be provide. Unfortunately demand for care continues to outstrip current capacity,” they said.

With emergency staff “working very hard” with NIAS colleagues, they said every effort was being made to see patients as quickly as possible according to clinical need.

“Our ED team will always treat the most acutely unwell patients first. Patient safety remains our top priority,” they said.

“Teams across the hospital and in the community are working together to ensure that every effort is being made to discharge patients who no longer need an acute hospital bed, creating space in our wards so patients can be transferred out of ED. This facilitates the admission of patients into the Emergency Department as soon as possible,” the spokesperson said.

“To help alleviate pressures within our Emergency Department and on NIAS, we would appeal to patients to leave hospital when they are deemed medically fit.”

Michael Bloomfield, Chief Executive of the NIAS, said: "Working alongside colleagues from all emergency services, North and South, our staff brought their vast experience to a situation requiring the highest levels of clinical skills and decision making in the most difficult pre-hospital environment that one could imagine".

In February, NIAS chief executive Michael Bloomfield told Stormont’s Health Committee the service was “operating under extreme pressure most of the time”.

Over one year, he said 108,000 hours were lost by paramedics waiting to hand over patients to crowded emergency departments.

With average handover times across Northern Ireland peaking at 90 minutes in December, he said the number taking longer than two hours had increased from 8.8% in the first quarter of 2023 to 19.2% in quarter three.

“That level and pace of deterioration is very concerning,” he said, stating it created “a risk and poor experience for patients”.