Patient handover delays at Peterborough and Cambridgeshire hospitals took equivalent of 1,286 ambulances off the road

Delays handing over patients at hospitals took the equivalent of 1,286 ambulances off the road in Cambridgeshire and Peterborough between April and October this year.

The national standard says patients should be handed over from an ambulance to a hospital within 15 minutes, but the East of England Ambulance Service (EEAST) said it was a “significant way off that”.

Terry Hicks, the head of operations for Cambridgeshire and Peterborough at EEAST, said a plan was being worked on to automatically hand over patients after 45 minutes, to enable the ambulance crews to respond to more emergency calls in the region.

A report presented to Cambridgeshire County Council’s adults and health committee this week (December 12) said 15,435 hours of patient-facing time had been lost between April and October this year due to delays handing over patients at hospitals, compared to 8,448 hours lost over the same period last year.

It said this was the equivalent of 1,286 ambulances being taken off the road.

The report also said the average response times had also increased compared to last year.

The average time it took for ambulances to respond to Category 1 cases, the most serious incidents, increased from nine minutes in 2023 to nine minutes and 19 seconds.

Average response times for Category 2 incidents, which include serious medical emergencies such as chest pains and strokes, increases from 35 minutes and eight seconds in 2023, to 40 minutes and 56 seconds in 2024.

Mr Hicks explained some of the reasons behind the delays and some of the work taking place to try and improve the situation.

He said some patients do not need to go to hospital and said there was an “awful lot of work” that went into preventing them from needing to go to hospital in the first place.

However, for those who did need to go to hospital Mr Hicks said they needed to make sure they got into the emergency department and be seen “as quickly as possible”.

He said: “The emergency department teams are working really hard to make sure they get their flow, but we do know as well that there are many patients that are in our hospitals that don’t necessarily need to be there.

“They are fit for discharge, but the social care is not necessarily as reactive and responsive to allow that patient flow to happen as quickly as possible.

“There are many bottlenecks in the patient journey that will end up meaning that a patient can’t be offloaded from an ambulance in a timely manner.”

Mr Hicks said the ambulance service was “some significant way off” the national handover standard of 15 minutes, but said they were working to address this.

He said: “We are working very hard with the collective teams with the emergency department, the wider hospital teams, and the community care teams, to implement a transitional period where at 45 minutes we will automatically hand a patient over into the hospital to release a crew to respond back into the community.

“That is no easy feat and I don’t underestimate the impact that is going to have for the hospital teams, but we have to make a significant shift change in trying to make sure we get to our patients as quickly as is reasonably possible, recognising that there is a lot of work that has got to go in behind that.

“That is one key element that we are working on at the moment.

“Regionally, we have implemented that across a number of our other [integrated care system] colleagues, but we haven’t yet done that across Cambridgeshire and Peterborough, we are looking to do that over the next few weeks, but to do it safely I think it is really important that we manage to do that.”

Councillor Richard Howitt said the 45 minute handover proposed “has its own risks associated with it”.

Councillor Simone Taylor said she had “massive concerns” if the change to automatically handing over a patient at 45 minutes led to them waiting in hospital corridors.

She said: “How would it work, the department is not ready for the patient, ambulances are waiting outside, ‘by the way we are dropping a patient off for you to deal with’, is that patient sitting in the corridor on a bed or in a wheelchair? That is a massive concern.”

Mr Hicks said he recognised the plans were “not ideal”, but said the ambulance service had to make sure it was responding to patients in the community.

He said people who have called 999 and have not had a face-to-face assessment were at the “greatest risk” and needed to be seen.

Mr Hicks also said corridor care was already happening and was not a “new phenomenon”, but stressed it was done safely.

He added that the ambulances would not “just drop patients” at the hospital after 45 minutes, but would work with the emergency department to make sure patients can be handed over safely.