Ambulance trust lost more than 19,000 handover hours due to ‘ongoing pressures’

EMAS ambulances waiting outside QMC A&E department (Credit: Lauren Monaghan - LDRS)

By Lauren Monaghan – Local Democracy Reporting Service

East Midlands Ambulance Service lost more than 19,000 hours in handover delays where patients were waiting to be admitted to A&E in January – the worst month for the trust since April 2025.

The figure was presented to East Midlands Ambulance Service (EMAS) board officials in a meeting on Tuesday (March 3rd).

In January 2026, EMAS lost more than 19,500 hours in its pre-handover window – this refers to the period when an ambulance arrives outside A&E to when they hand the patient over to A&E staff.

The national target is for this to be done within 15 minutes of a patient arriving at hospital – anything over that target counts as time lost.

This was the ambulance trust’s highest month for these lost hours this financial year since April 2025, compared to nearly 14,500 being lost in December 2025 and more than 16,200 lost in November 2025.

This same month, the average pre-handover time increased to 41 minutes and 22 seconds, around seven minutes more than in December 2025.

Of the major hospital trusts in the East Midlands, Royal Derby Hospital’s pre-handover averaged at 49 minutes and 16 seconds, followed by Leicester Royal Infirmary at just under 40 minutes and Nottingham’s Queen’s Medical Centre (QMC) at 36 minutes and 48 seconds.

But timings appear to be improving, where Ben Holdaway, director of operations at the trust, told officials these average handovers took around nine minutes less in February trust-wide.

Mr Holdaway also told the board nearly one fifth – 19.3 percent – of all calls into EMAS in February did not get an ambulance response.

Speaking to the local democracy reporting service following the meeting, he said: “This was slightly below our plan, but it’s still a positive because we’re dealing with nearly 20 percent of patients in a better way and then saving ambulances for patients that really need them.”

The ambulance service has been battling with heightened system-wide pressure – particularly over the winter period – where its performance has been impacted by capacity issues at hospital trusts.

Both of Nottinghamshire’s hospital trusts, Nottingham University Hospitals and Sherwood Forest Hospitals both declared critical incidents in January due to ‘severe’ and ‘sustained’ capacity and demand pressures.

This has led to more patients having to wait in ambulances outside emergency departments for longer and increased levels patient care being given on A&E corridors.

Board papers say ‘ongoing pressures’ across the health system has led to ‘several’ hospital sites pausing the 45-minute ‘Release to-Respond’ initiative at times.

NHS England has instructed all hospitals to implement this, where it aims to have no pre-handovers longer than 45 minutes to allow ambulances to get back out into the community.

Andrew Hall, chief operating officer at Nottingham University Hospitals Trust, said: “We do not underestimate the importance of getting ambulances back out to those who need them most.

“We have been working closely with colleagues in EMAS on 45-minute handovers this winter and it is reassuring to see that, despite pressures on our hospitals in January, that our average handover time was 36 minutes.

“During such times of pressure, like a critical incident where we are seeing more than 500 in our A&E a day and having to care for patients on our corridors, we may need to pause our approach to 45 minute handovers.

“This allows us a short amount of time to take actions such as moving patients between areas or out of the department to create the space for the new patients to come in. Usually there is a pause of just 15 minutes before we accept the next patient.”