Debate contribution: Ambulance Handovers

Debate contribution by Mr Danny Donnelly on 24 March 2025.

MLA

Mr Danny Donnelly

Party at the time

Alliance Party

Date

24 March 2025

Type

Debate contribution

Business

Opposition Business

Heading

Ambulance Handovers

Assembly identifier

Official Report component 4864648

Read the official Assembly record

Text

I thank the SDLP for tabling the motion. It is timely, following the publication of the recent Audit Office report on ambulance handover times, and the issue affects everyone in the Chamber. We will support both amendments. In January, the Alliance Party brought a motion on the issue to the Chamber for debate. It called on the Minister to:

"bring forward proposals to improve the availability and capacity of ambulance services, including the development of an Ambulance Service workforce plan". — [Official Report (Hansard), 13 January 2025, page 53, col 1].

I have personal experience of working in busy A&E departments and wards. I know the impact that wards that are completely full of patients, corridor beds put wherever they can be and A&E departments in which every square inch of floor space is being used can have on ambulance handovers. The staff cannot safely accept a patient until there is room for them to do so. Sometimes, there can be up to two wards' worth of patients being cared for in our A&E departments. That incurs a risk of harm to the patient, who is sick enough to have needed an ambulance to take them to hospital for treatment, and it impacts on Ambulance Service staff, who can sometimes spend their whole shift outside a hospital with a patient in the back of the ambulance, and on hospital staff, who work under extreme pressure for extended periods. That is incredibly stressful and can leave staff with the impression that, despite working hard, they cannot give their patients the care that they deserve. That moral injury is hard to accept. The report is stark and confirms what we have been hearing for a long time. It states that, from 2023 to 2024, there were 36,000 incidents in which patients experienced some harm as a result of handover delays, and that, in about 3,800 cases, patients were potentially exposed to severe harm. Ambulance response times are suffering, and a concerning 25% of ambulance capacity is lost due to those delays. We have all heard from our constituents of cases of overlong stays and ambulances waiting outside hospitals, sometimes with the engine on to keep patients warm. I have heard of many such cases, including a 29-hour wait that included a shift change for the paramedic team outside the hospital. Paramedics and ambulance staff want to be on the road answering calls, not outside full hospitals. We know that long waits and overcrowding in A&E departments are unsafe and can lengthen the time that patients need to be in hospital. They are even associated with increased mortality. Emergency medical consultant and chair of the Royal College of Emergency Medicine (RCEM), Dr Russell McLaughlin, reviewed the situation of pressures in A&E in 2022 and concluded:

"there is strong evidence that indicates that in 2022, 1,434 people died as a result of delays in Northern Ireland’s emergency departments".

Overcrowding causes excess deaths. The most recent winter was the worst yet for A&E waits, and I can only imagine what the number is now. While there are many contributing factors, including workflow, waiting lists and the impact that funding of GP services has, the root cause lies in the hospital system, as Linda outlined. It is about patient flow. Patients who are medically fit for discharge cannot be discharged because of a lack of the social care packages required to meet their needs in the community. That is a bottleneck in the system. We recognise the incredible work being done by our Health and Social Care (HSC) staff — in this case, particularly by the Northern Ireland Ambulance Service (NIAS) staff — who continue to work tirelessly under extreme pressures. We must recognise, however, that the situation is not sustainable. We all know that the budget is tight and that the Minister has a difficult job, but it is unacceptable that patients are suffering harm. We need to improve flow, and that means providing alternative care pathways such as minor injuries units; see-and-treat protocols for Northern Ireland Ambulance Service staff whereby patients are assessed by paramedics as not requiring attendance at emergency departments and can instead be referred to specialist clinical teams or to their GPs; and paramedics making informed decisions about patients who are nearing the end of their life and wish to remain at home. Another example, visited by the Committee last year, is the joint mental health pilot scheme, in which mental health practitioners work with the Northern Ireland Ambulance Service in the control room. That scheme de-escalated 40% of mental health calls over the phone, to the point where those calls did not require an ambulance response. I am keen to hear from the Minister about the long-term plans for that successful service. Another scheme that reduces inappropriate admissions is the Hospital at Home service in the Southern Trust, through which unscheduled care is delivered to an increasing number of older residents who live with more and more complex needs directly in their homes, avoiding unnecessary admissions, promoting quality of life and freeing up space in our A&E departments. There is an urgent need to progress health service reform in line with the principles outlined in the 2016 Bengoa report. We could have been nine years into a 10-year reform programme had we not had two Assembly shutdowns since that report. That alone is more than enough reason to reform our political institutions to prevent one party from having a veto and collapsing the institutions.

No problem. We cannot address problems, if we are not here.

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

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Assessed 21 October 2026 at 12:11 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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