Health Foundation calls for more hospital beds following harrowing decline in ambulance response times

Greater investment in hospital capacity and flow through hospital with more beds and more staff is needed, as recent analysis from the Health Foundation reveals a worrying and significant decline in ambulance response times in England.

It warns that an increase in handover delays – the time an ambulance spends waiting outside a hospital before transferring a patient – is a major cause of the decline in ambulance response times.

Long ambulance handover times signal system-wide challenges and have “devastating” consequences for patients and their families, according to the organisation. Rising times suggest different parts of the system – from social care to hospitals – are under severe strain, putting patients’ lives at risk.

Charles Tallack, Director of Data Analytics at the Health Foundation, said: “The sharp increase in handover delays is a major cause of the increase in ambulance waiting times.

“The cumulative effect of demand returning to pre-pandemic levels, the need to catch up with backlogs, and the ongoing impact of COVID-19 has resulted in the pressures we are now seeing right across the system – putting patients’ lives at risk.”

Health Foundation analysis shows that the percentage of handover times exceeding 60 minutes was seven times higher in July 2022 than in 2019.

In July 2022, over 10 percent of ambulances waited over an hour with patients outside hospitals – up from one in 50 in July 2019.

Patients with the most critical calls are waiting 18 percent longer than in 2018/19 – a record-breaking waiting time. For less urgent cases, waits have doubled to an average of three hours.

As ambulance services are stretched, the increases in handover times are magnified, leading to far greater increases in average response times.

Now, the Health Foundation is crying out for an urgent “whole system” focus ahead of a challenging winter for the NHS.

The increase in ambulance handover delays is largely being driven by the lack of hospital bed capacity and delays in discharging patients, the foundation highlights. To ease this pressure there needs to be greater investment in social care and community services.

To address increasing ambulance waiting times, the Health Foundation is calling for a whole system approach with greater investment in hospital capacity and flow through hospital with more beds and more staff; out of hospital care, including social care; and community services, which can prevent health conditions becoming crises.

Charles added: “Delays at the front door of the hospital are a consequence of wider challenges hospitals are facing in discharging patients. Getting a handle on this must be a priority for the new Secretary of State for Health and Social Care. Tackling ambulance performance will require further investment in NHS and social care capacity and a comprehensive, funded workforce plan to ensure services have the staff they need.”

Responding the new analysis from the Health Foundation on increasing handover delays contributing to growing ambulance waiting times, Matthew Taylor, Chief Executive of the NHS Confederation, commented: “Health leaders will be very concerned but sadly not surprised by this analysis of ambulance waiting times and handover delays.

“With the government still to clarify how and when the vital £500 million Adult Social Care Discharge Fund will be allocated to help alleviate some of the worst of these bottlenecks, and with the social care sector under such intense strain that the NHS has no choice but to delay the discharge of medically fit patients from hospital because they lack the help they need when they leave, the weeks and months ahead are looking very bleak.

“We would urge the government to immediately release additional funding, to free up hospital beds, reduce A&E overcrowding and ensure as many ambulances as possible are able to get back on the roads to attend as many emergencies as they can as quickly as they can, without this we are headed for a winter crisis the likes of we have not seen for several decades.”

The Care Quality Commission’s (CQC’s) recent ‘state of care’ report also reveals system-wide pressures.

It found that a lack of available adult social care is continuing to keep patients in hospital for longer than necessary, with only two in five people able to leave hospital when they are ready. This has led to record-breaking waits in emergency departments, patients being stuck in hospital because there is no social care to support them in the community, and a lack of available ambulances as they are waiting to transfer patients.