East Midlands Ambulance service had delays at hospitals of more than 18,000 hours in February

---

East Midlands Ambulance Service, serving Nottinghamshire, Derbyshire, Leicestershire, Rutland, Lincolnshire, and Northamptonshire, says it faced “significant operational hurdles” last month, with delays averaging 628 hours per day across the region, reports ITV

During a board meeting on Tuesday 5 March, Ben Holdaway, EMAS’s Director of Operations, voiced concern over the impact of these delays on both staff morale and the ambulance service’s efficiency.

He identified the Queen’s Medical Centre, operated by Nottingham University Hospitals (NUH), as a key contributor to the problem, responsible for 28% of the lost hours.They say the crux of the issue lies in the lack of available hospital beds, forcing ambulances to wait longer to hand over patients.

This is largely attributed to the fact that patients who are medically fit for discharge cannot leave the hospital due to a lack of social care placements, exacerbating the backlog.NUH say they have attempted to mitigate these challenges by allowing paramedics to ‘cohort’ patients, a process in which some ambulance staff can depart to respond to other calls while their colleagues remain at the hospital to oversee grouped patients. .

Richard Henderson, EMAS’s Chief Executive labelled the situation a “deep-rooted” problem

Mr Holdaway said: “What compounds the 18,000 lost hours is that 28% of those were lost at NUH, our busiest hospital, and 18 per cent at Leicester Royal Infirmary, our second busiest.

“46% of our hours were lost in those hospitals which adds pressure elsewhere as we have to move resources around.

“We have been working to highlight the risk we are facing through NUH, not just through lost hours but also the moral injuries through staff having to cohort patients and waiting with patients for a long period of time.

“We’ve been raising these concerns with the Integrated Care Board (ICB) and hospital. Lots of escalation meetings are taking place until we are more assured we will see improvement.”

Mr Henderson told the meeting: “I am confident we will see further change and improvement but it would be wrong to say the improvements have been sustained.

“It would be unfair to say the meetings aren’t having any impact. This is not just a hospital issue.

“It is clear to say, we would deliver all the trajectories if the handover delays weren’t present.

“That’s not to say we haven’t got our own internal inefficiencies but there is a clear correlation between handover delays and our inability to respond.

“That scrutiny of handover is well and truly understood, addressing it is a different challenge as it is deep-rooted.

“Almost 50 per cent of our lost hours are being experienced by our biggest acutes [hospitals] in the region. That has a profound impact.

“This is not just a Nottingham or a Leicester issue, it is something which impacts the whole region.”

In February 2024, EMAS board papers show there were 317 breaches in Minimum Care Standards during the transition from ambulance to hospital.

Of these, 33 patients were taken for a scan or X-ray before being returned to the hospital to wait for handover.

Board Chair Karen Tomlinson said it was “unacceptable”.

She said: “If somebody is that ill, they should not be returned to the ambulance. From a patient perspective it is abysmal.

“For the paramedics, it is not part of what they came into the job to do.

“That worries me more than a lot of other stuff. It’s not acceptable and we need to keep a tight focus on it.”

Dr Keith Girling, Medical Director at Nottingham University Hospitals NHS Trust, said: “We apologise to those patients who have experienced long waits. We are working closely with East Midlands Ambulance Service and other system partners to improve flow through the hospital and transfer patients into the care of our emergency department as quickly as possible.

“We continue to ask the public to help by using NHS services wisely. If it is not a life-threatening emergency, please use alternative services where possible, including NHS 111 online, pharmacies or urgent treatment centres.”