Debate contribution: Ambulance Handovers

Debate contribution by Mr Alan Robinson on 24 March 2025.

MLA

Mr Alan Robinson

Party at the time

Democratic Unionist Party

Date

24 March 2025

Type

Debate contribution

Business

Opposition Business

Heading

Ambulance Handovers

Assembly identifier

Official Report component 4864629

Read the official Assembly record

Text

Thank you, Madam Principal Deputy Speaker. I thank the mover of the motion. I begin by saying something that none of us in the House should ever tire of hearing, and it is that, day after day and week after week, dedicated paramedics, ambulance crews and all other front-line healthcare workers go well over and above their role in order to save lives and to provide comfort in people's moments of crisis. Let us be honest, however: their ability to do so is being increasingly and dangerously compromised. The Northern Ireland Audit Office's report, which was published this month, made clear the interconnection between ambulance handovers and pressures in the health service over hospital bed space and over delays in discharging patients. Ambulance waiting times are one symptom of the challenges that the health service faces. Without good patient flow through the hospital system, more patients cannot be admitted to EDs, while sick patients in ambulances cannot get into hospitals because well patients cannot leave. Unless the issue of delayed discharge is resolved, the Ambulance Service will only ever be operating at a fraction of its real capacity. I am on record saying in the Chamber that, when you begin to fix the wider social care system, you begin to fix the health system in the Province. The number-one reason for delayed complex discharges is that no domiciliary care packages are available. That is why my party added that to our amendment. The report laid bare the state of the health service for that sector. At a time when it is being reported that money will be the cure for some of our ills, it is also being reported that £50 million has been lost through Ambulance Service inefficiency since 2019. It gets worse with the high reliance on private ambulances. Just 20 private ambulances were required in 2019, rising to 1,100 in 2023-24 at a cost of £3·6 million, yet handover delays continue to increase. Significant costs are also cited for ambulance staff overtime, which has been running up to £37·8 million since 2019. Those are just some of the negatives. How can that be fixed? The report recommends fixing patient flow. It also recommends implementing the 46 recommendations in the 'Getting It Right First Time' (GIRFT) report and to use the best practice that is in place in other parts of the UK. The report also makes 11 individual recommendations, calling for trusts to work together, better regulation of the private ambulance sector and well-functioning handover zones at each of the major EDs. The report painted a bleak picture of all nine hospitals having seen their handover performance fall between 2019 and 2024. It points to a Province that is in a crisis of patient safety and resource management. The backlog at our hospitals means that ambulance crews are stuck waiting and unable to respond to new emergencies. At the end of January, the Minister advised us that there is active recruitment for over 1,000 nursing vacancies. We must also ensure that there is staff retention and recruitment in the Ambulance Service so that vital skills there are not lost. From January to August last year, there were no Saturday nights when the Province had a full rota of emergency ambulance crews. The Northern Ireland Ambulance Service aims to have 52 crews out on a typical Saturday. On three occasions, just 36 were in place. The impact is cascading and far-reaching. Emergency response times are compromised, hospital capacity is choked and healthcare staff are overwhelmed. Waiting on an ambulance is a horrible experience. I have been there twice in as many years, waiting on one for my father, who had suddenly become ill. On both occasions, his wait was relatively short in the grand scheme of things, but how stressful must it be to have to wait hours on an ambulance for a loved one when time is of the essence? Bundling very ill people into taxis and the back seats of cars should never be the norm. How can we ever forget the story from December 2024 of a popular County Antrim man who died when his wife was forced to transport him to hospital in their car due to there being no ambulance available? Our hearts go out to that family and the many others who are in the same position. My party is happy to explore the introduction of the W45 policy, which the London Ambulance Service has implemented to reduce delays and enhance patient care. The evidence points to the W45 policy being a targeted, efficient approach that aims to significantly reduce ambulance handover delays, in that it requires that no ambulance crew be kept waiting at a hospital for more than 45 minutes. If that threshold is breached, the patient's care is formally transferred to the hospital and the ambulance crew is released to respond to new emergencies. That policy is supposed to prioritise patient flow, which is something that we have all been calling for, and to ensure that ambulance crews are not held hostage due to bottlenecks in hospitals. It also creates accountability in the healthcare system by making it clear that patients must be accepted into hospital in a timely manner. Hospitals can no longer be car parks for ambulances. Implementing the W45 policy here in the Province would send the message that we want to see true efficiency, we value our front-line staff and, above all, we value the safety of our patients. However, we have to recognise that the policy alone is not enough. To do it right, it needs to be paired with an increase in medical capacity, improved patient flow systems, an increase in the number of available beds, standardisation of guidance across all health and social care trusts and implementation of the recommendations of the Audit Office report. The health service can no longer afford fragmented practices that vary from one trust to another. Consistency and acting like one trust are essential.

997 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 12:10 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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