Ambulance handover delays, the critical period between a patient's arrival by ambulance and their formal transfer to A&E staff, are worsening at 21 hospital trusts across England. This deterioration is occurring despite specific national targets from NHS England and broader efforts aimed at improvement, marking a key systemic pressure point in urgent and emergency care in early 2026.
NHS guidance stipulates that patient handovers should be completed within 15 minutes of arrival. However, this target is routinely missed when A&E departments are overwhelmed. In a major effort for 2025/26 winter planning, a maximum handover time of 45 minutes was set, alongside goals to improve four-hour A&E performance—yet many trusts are consistently failing to meet even this longer limit.
Amid record demand, which saw nearly 1.27 million ambulance arrivals in 2024/25, these delays have severe knock-on effects. Handover waits exceeding 15 minutes contributed to a loss of over thousands hours of ambulance crew time last winter. When crews are held up outside hospitals, they cannot respond to new 999 calls, leading to slower response times and reduced overall capacity. Independent analysis has previously linked prolonged handovers to thousands of patients potentially experiencing harm due to delayed definitive care.
The issue is highly visible on the ground. For instance, ambulance workers have described "soul-destroying" waits, such as the more than 13,000 hours crews were held up in March at Nottingham’s Queen’s Medical Centre, often forcing patients to be treated on corridors. These delays reflect deeper, systemic failures, including high bed occupancy rates, a lack of timely patient discharges, and generally poor flow through hospitals. When beds are blocked by patients medically ready for discharge, A&E space becomes restricted, directly inhibiting the ability to accept ambulance handovers. Professional bodies, like the Royal College of Emergency Medicine, have connected these pressures to a rise in "corridor care", treating patients in hallways, a practice described as "normalised" in parts of the NHS despite the risks to patient safety and dignity.
Trust and system leaders are currently pursuing a range of solutions for 2026, including targeted investment in urgent and emergency care, developing community care pathways to prevent avoidable admissions, and operational plans to boost discharge rates. The Government and NHS England’s 2025 reforms included a £450 million package aimed at improving A&E waits and handovers, though the impact remains mixed at the local trust level.
As NHS leaders work to meet winter performance targets, resolving handover delays remains crucial for both improving urgent care performance and achieving the broader goals of a safer and more responsive emergency service in England. Continued monitoring and targeted support for the most affected trusts are essential to break this cycle and ensure patients in crisis receive timely care.
