Ambulances told to leave patients on a trolley if A&E wait is too long

Dec 13, 2023

Leaked letter revealing instructions to crews in London comes as paramedic says pressure on NHS is 'worst he has seen'

Paramedics will only wait with patients for 45 minutes before leaving them on a trolley in A&E, one ambulance trust has said.

One in five ambulances are waiting at least an hour outside accident and emergency departments to hand over patients, the latest data show, despite NHS standards stating it should only be 15 minutes.

Now, London Ambulance Service (LAS) leaders have told hospitals their staff will only remain with patients for a maximum of 45 minutes for handover due to "the significant amount of time being lost" waiting in A&E departments.

A leaked letter, seen by ITV News, from the LAS said: "From January 3 we are asking that any patients waiting for 45 minutes for handover... are handed over immediately to ED (emergency department) staff allowing the ambulance clinicians to leave and respond to the next patient waiting in the community.

"If the patient is clinically stable the ambulance clinicians will ensure the patient is on a hospital trolley or wheelchair/chair and approach the nurse in charge of the emergency department to notify them that the patient is being left in the care of the hospital and handover the patient."

The email added that if the patient was not clinically stable, ambulance crews would stay with the patient until handover is achieved but added that the clinical responsibility for the patient lied with the hospital.

It added that the current "operational challenges" in the NHS were "very significant" and stated "this is a difficult time for everyone".

NHS figures show that almost two fifths of handovers in the week to Christmas Day were delayed by at least 30 minutes, down from 41 per cent the previous week but much higher than the 13 per cent recorded at that point in 2021 and 11 per cent figure from 2020.

Handover delays in London meant that 3,269 hours were lost to ambulances waiting outside hospitals, in the week up to Dec 18.

Richard Webber, a spokesman for the College of Paramedics, said pressure on the NHS was the worst he had "ever seen", with elderly patients left waiting up to 10 hours for treatment.

Mr Webber, a paramedic in London, also spoke of waiting five and a half hours in the back of an ambulance with a man in his nineties who had an internal bleed and needed care last week.

On at least two occasions, while he was with other patients, calls came over the radio to respond to cardiac arrests, he said."I know at that point in time there were probably all of the ambulances in my local area queued outside the hospital," he told BBC Radio 4's Today programme.