Ambulance handover delays harming patients, says UNISON

Long ambulance handover delays at UK A&E departments are leading to patients deteriorating and even dying while waiting for admission, according to new research by the UNISON union. The union's findings, based on surveys of hundreds of frontline emergency staff, highlight severe overcrowding and bed shortages within NHS hospitals, forcing paramedics to provide care in ambulances and hospital corridors.

In England, based on over 600 frontline emergency staff, 59% of ambulance workers reported that patients' conditions worsened while in their care. Alarmingly, 3% reported that people had died because they could not be handed over to A&E departments quickly enough. The national target for ambulance crews to hand over patients to A&E departments is 15 minutes, with none meant to take longer than 45 minutes. However, 7% of staff reported caring for someone for 12 hours or more, and 13% reported doing so for six hours.

Across the UK, UNISON's research from nearly 600 ambulance staff paints a similar grim picture. More than two-thirds (68%) of ambulance workers reported patients' health deteriorating during long waits, and 5% said people had died in their care due to long delays. The UK-wide target for handover is 15 minutes, with none meant to exceed half an hour. However, 16% of respondents experienced delays of 12 hours or more, and over half (53%) experienced delays of six hours or longer.

UNISON states that ambulances are effectively becoming makeshift wards due to a lack of hospital space. In England, 26% of staff said vehicles are used as extra space for hospital staff to assess or care for patients during almost every shift. Half transferred patients for tests only to return them to the ambulance as they still could not be admitted. More than four-fifths (83%) believe handover delays compromise patient care and safety, while 69% report dignity and privacy being put at risk.

These delays also significantly impact ambulance workers' wellbeing. In England, 92% reported shift overruns, 77% missed breaks, and 57% said their mental health had been affected, with some taking time off, seeking counselling, or being prescribed medication. Across the UK, 60% reported a significant impact on their mental health, with 39% considering leaving the profession due to the pressures.