A report published today reveals a "dramatic deterioration" in ambulance handover times in Northern Ireland. The number of handovers taking longer than three hours has surged from approximately 400 (less than one per cent) in 2019-20 to just over 11,000 (nine per cent) in 2023-24.
The number of handovers taking more than three hours rose from around 400 (less than 1%) in 2019/20 to just over 11,000 (9%) in 2023/24.
A new report by Northern Ireland’s Comptroller and Auditor General Dorinnia Carville found that these delays led to tens of thousands of instances of potential harm to patients.
It comes as hospital emergency departments (EDs) across the region continue to be under pressure with high volumes of patients.
In 2019-20, around 27 per cent of handovers were completed within this timeframe – a stark contrast to just seven per cent in 2023-24. Overall, performance throughout Northern Ireland is significantly worse than in England and Wales.
The report outlines the impact of this decline in ambulance handovers on both operational efficiency and patient outcomes. This includes potentially over 36,000 instances in 2023-24 when patients may have experienced some harm due to ambulance handover delays, and around 3,800 occasions when patients were potentially subject to severe harm.
The report estimates a loss of £50 million in operational capacity for the NIAS between 2019-20 and 2023-24, with a quarter of operational capacity expected to be lost in 2023-34 due to delays. It also highlights a decline in NIAS performance in responding to 999 calls as ambulances are increasingly held up outside Emergency Departments.
It also raises specific concerns about performance in relation to emergencies and potentially serious incidents.
Furthermore, the report reveals an increased reliance on the unregulated private sector to fill service provision gaps. In 2019-20, NIAS commissioned private-sector ambulances to provide ED relief just over 20 times. However, by 2023-24, this number had escalated to over 1,000 instances.
The report acknowledges that delays in completing ambulance handovers are intertwined with other well-documented challenges and pressures on the health service, such as limited hospital bed space and delays in discharging patients who are fit to leave hospitals. It refers to other Department-commissioned research which identified ambulance handover delays as the single biggest risk to patients in the local emergency care system.
Dorinnia Carville, Northern Ireland's Comptroller and Auditor General, has voiced her concerns: "Having ambulances waiting outside hospitals for lengthy periods of time is bothunacceptable for patient wellbeing and a waste of public resources. Addressingthis issue will no doubt be challenging. However, this report includesrecommendations, and good practice from other regions, highlighting key areasfor improvement.
"In particular, we have stressed the need for strong leadership to help breakdown siloed working and instil a culture that sees patients as the responsibility of hospitals and trusts when an ambulance arrives at a hospital, and not just once the handover process is complete."
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