Ambulance delays now the worst of the year

Ambulances lost nearly 2,000 hours waiting to offload patients at the Royal Stoke University Hospital last week.
The ambulance handover delays at the Royal Stoke were the worst seen in 2025 so far, with the emergency department coming under increasing pressure.
University Hospitals of North Midlands, which runs the Royal Stoke, declared a critical incident on Monday due to the “extremely high demand” facing the trust.
Trust chief executive Simon Constable gave an update on urgent and emergency care to board members at their meeting on Tuesday, describing the current situation as “unacceptable”, (ITALICS writes local democracy reporter Phil Corrigan).
Some of the pressure has been due to a surge in flu cases, with 73 in-patients with flu currently at the trust, including two in critical care.
But Dr Constable told the board that flu was only part of the picture, with the trust having the more general problem of too many patients ending up at A&E due to a lack of alternative provision.
The situation could get even worse last week, with resident doctors due start five days of industrial action.
Dr Constable said: “We lost nearly 2,000 ambulance service hours last week, which is the worst this calendar year. It surpassed the worst we had in February. On Monday it just got to the point where we had no choice but to declare a critical incident.
“I’m pleased to report that we are in a much better position 48 hours later – I don’t think we’re holding any crews at the moment.”
Dr Constable said that the response from system partners such as local councils and other NHS providers had improved since last year and had helped “enormously”.
He added: “Urgent and emergency care and ambulance handovers are a real problem for us. We’ve acknowledged that we are not nearly responsive enough for a variety of reasons.
“We continue to see a high number of conveyances to hospital by 999 ambulances which are inappropriate due to a lack of alternative provision. I did a quick audit myself of the ambulances sitting outside yesterday, and at one point I think around 50% of the patients could have been seen at an alternative venue. That is for us as a system to resolve.”
Chief operating officer Katy Thorpe told the board that the trust was currently failing to hit its targets for ambulance handovers and four-hour waits in A&E, although there has been a “slight improvement” in the number of patients staying in the department for 12 hours.
She explained the various “tactical actions” being taken to reduce the A&E waiting times. These have included the increased use of assessment areas, getting consultants to review waiting ambulances, and the use of the discharge facilitation team to support complex discharges, including at weekends.
Ms Thorpe said: “There are some real improvements here, particularly the reduction of 12-hour stays in the department and the reduced length of stay. All of those are positive things, but set in the context of high attendances, high acuity and winter pressures, they aren’t going far enough or fast enough to touch the sides of the position we’re in.
“The challenge for us is how do we do those things on a wider scale, and do more of the things we now know are working. Some of the things we’ve only been doing for two or three weeks.”
The trust has also adopted a continuous flow model, where staff move patients to “temporary escalation spaces”, such as corridors, in order to make room in the emergency department.
Chief nurse Ann-Marie Riley said that while this was far from ideal, it allowed risk to be spread across the organisation, instead of it being concentrated in A&E.
She said: “While we don’t want to have extra patients in these spaces, it is safer than a person being at home with no help at all. We monitor temporary escalation spaces each day to make sure the care is of a standard we would want. We recognise that the impact on patients and staff experience might be negatively affected, but we haven’t seen any harm.”
(Photo: Credit: Ian Syme).