Why are ambulances queuing outside hospitals? Waiting times and causes of delays explained

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None of England’s ambulance services are close to the target, with Wales, Scotland and Northern Ireland also all missing their targets

More than 10,000 ambulances a week are caught in queues of at least an hour outside accident-and-emergency units in England, new analysis has found. But what does this mean for patients and what’s causing the queues? Here’s what you need to know.

What did analysis find?

A BBC News analysis found that more than 10,000 ambulances a week are caught in queues of at least an hour outside accident-and-emergency units in England, The total - the highest since records began, in 2010 - means one in eight crews faced delays on this scale by mid-November, research found.

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Both ambulance response times and A&E waits have hit their worst levels on record in all parts of the UK in recent months. In Cornwall, patients facing emergencies such as heart attacks and strokes are now waiting more than two hours on average for an ambulance when the target is 18 minutes. Cornwall is thought to be among the worst delays in the country as well as parts of Gloucestershire, Lincolnshire, Somerset and Bristol, Freedom of Information requests by the Liberal Democrats have revealed.

None of England’s ambulance services are close to the target. Wales, Scotland and Northern Ireland are also all missing their targets.

More than 10,000 ambulances a week are caught in queues of at least an hour outside accident-and-emergency units in England (Photo: Leon Neal/Getty Images)More than 10,000 ambulances a week are caught in queues of at least an hour outside accident-and-emergency units in England (Photo: Leon Neal/Getty Images)
More than 10,000 ambulances a week are caught in queues of at least an hour outside accident-and-emergency units in England (Photo: Leon Neal/Getty Images) | Leon Neal/Getty Images

Why are there queues?

A key problem is the delays ambulances face handing over patients to A&E staff. This is meant to happen within 15 minutes of arrival, but the BBC News analysis shows that this regularly takes longer. Patients may then face long waits for a bed on a ward after being admitted into A&E, with hospital bosses blaming a shortage of beds and problems discharging patients back into the community.

The College of Paramedics said crews were facing a "perfect storm", with the queues outside A&E preventing them reaching patients who need a 999 response. College chief executive Tracy Nicholls said: "We all know patients are coming to harm and in some cases severe harm."

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The government said the NHS will publish its emergency care recovery plan in the new year, which will set out proposals to improve ambulance response times and A&E performance in England.

A spokesman for the Department of Health said an extra £500m was being made available to speed up hospital discharges and free up space in A&E, creating the equivalent of at least 7,000 more beds this winter. He added: "This will be supported by an additional £6.6bn in the NHS over the next two years to enable rapid action to improve urgent and emergency care performance towards pre-pandemic levels.”

Are ambulance workers striking?

Ambulance workers who are part of the GMB union and the Unison union have voted to take part in strike action.

More than 80,000 health workers across England who are part of the union Unison have voted to go on strike over pay and staffing issues. The union said thousands of 999 call handlers, ambulance technicians, paramedics and their colleagues working for ambulance services in the North East, North West, London, Yorkshire and the South West ​are to be called out on strike. The union’s health committee is analysing the results of the ballot and will decide what happens next.

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More than 10,000 ambulance workers have also voted to strike across nine trusts in England and Wales, the GMB union has announced. Further details are yet to be announced.

Paramedics, emergency care assistants, call handlers and other staff who are members of the GMB union are also now set to walk out in the following trusts:

  • South West Ambulance Service
  • South East Coast Ambulance Service
  • North West Ambulance Service
  • South Central Ambulance Service
  • North East Ambulance Service
  • East Midlands Ambulance Service
  • West Midlands Ambulance Service
  • Welsh Ambulance Service
  • Yorkshire Ambulance Service

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