The West Midlands Ambulance Service (WMAS) is currently experiencing the most severe hospital handover delays in the UK, surpassing all other regions “by some margin,” senior officials have revealed.
In October alone, ambulance crews were held outside hospitals for an alarming total of 41,000 hours as they waited to transfer patients. This figure has more than doubled in recent months, causing deep concern among healthcare leaders.
Previously, in November 2023, WMAS called for an independent review of its resources to improve its performance. This request was supported by Staffordshire County Council’s Health and Care Overview and Scrutiny Committee, which reiterated the need for a review during its meeting on November 10.
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Despite some improvements in response times over the last two years, hospital handover delays remain a considerable challenge, particularly as the NHS enters its annual winter pressures period.
Vivek Khashu, WMAS Strategy and Engagement Director, explained the importance of meeting category 2 response time targets, which cover critical emergencies such as strokes and heart attacks. “Last year, we barely met the 30-minute target, delivering an average response time of just under 29 minutes,” he said. “This year, we have improved to an average of 23 minutes year to date, but that progress is now under threat as winter pressures intensify.”
According to Khashu, the ambulance service has recently seen a “steep curve” in lost hours due to hospital handover delays: 20,000 hours in August, increasing to 31,000 in September, and soaring to 41,000 in October.
For patients, these delays mean long waits inside ambulances—sometimes up to 15 hours—and multiple transfers between vehicles outside emergency departments, an experience far from ideal.
WMAS currently holds the worst handover delay record nationally, with combined delays exceeding those of five other large ambulance services combined. To combat this, the service has invested approximately £30 million in additional frontline resources over the past 18 months, the only feasible measure within their control.
The Staffordshire and Stoke-on-Trent area is particularly affected, with 8,500 hours of delay recorded in October alone, much of it centered around Royal Stoke University Hospital.
The NHS requires hospitals to hand over patients to ambulance crews within 45 minutes—a standard rarely met in the West Midlands, apart from South Warwickshire. It is estimated that in October, around 2,200 patients waited longer than this mandated time.
Khashu emphasized the need for an independent capacity review, separate from NHS governance, to objectively assess resource demands and allocation. He also called for stronger scrutiny of performance against NHS operating standards, noting, “If we all met these standards, patient care would be vastly improved.”
Highlighting the scale of the issue, Khashu noted that delays in the West Midlands match the combined delays of five other ambulance services. Adding the nearby East Midlands Ambulance Service doubles this figure, meaning half of the country’s ambulance delays stem from these regions.
The underlying problems—frailty, resource constraints, and systemic pressures—are common nationwide, but some areas maintain better performance, indicating that the West Midlands can achieve similar improvements with the right strategies and investment.