That this House has considered ambulance service response times.
It is a pleasure to serve with you in the Chair, Ms Jardine. I thank the Backbench Business Committee for scheduling this important debate.
Unacceptable ambulance response times have become endemic in the UK, leaving people in pain and distress and costing lives. An estimated 50,000 people died last year after long A&E waits, according to Office for National Statistics data. One of those was Jim’s wife in Street. She was suffering from aggressive liver and bowel cancer and had to wait seven hours in agony for an ambulance in February last year. When the ambulance arrived, Jim and his wife were told that the crew were not trained to take her downstairs, so they were left to wait for another crew. When they arrived, several hours later, Jim’s wife was too ill to be moved and was told that the journey would kill her. She died shortly after.
Jim told me again today how that experience still makes him angry, yet he recognises the perilous state that the NHS is in, caused largely by the last Conservative Government. Like Jim, many people have lost faith in health services after the NHS was stretched and left grossly underfunded as a result of the last Conservative Government’s neglect.
We know that this is having a devastating impact on patients, but it is also impacting the incredibly hard-working medical staff. The 2023 NHS staff survey showed that 39% of ambulance staff respondents often or always felt burnt out. The number is higher for control room staff, at 44%, and higher still for ambulance technicians and paramedics, at 45%. I am sure that Members across the House will join me in thanking and paying tribute to everyone working in the ambulance service whose hard work, dedication and commitment to patient safety is second to none.
Most people in Somerset will sadly know of someone who has faced a heartbreakingly long wait for an ambulance. The family of an 89-year-old Somerton resident told me how they faced a 10-hour wait, stuck in agony on the floor, as no ambulances could come to help them. Another resident told me about their ordeal of having to prop their mother up on the toilet after she had had a fall. They then had to spend 13 long hours waiting for an ambulance to arrive. I am sure other Members will have similar heartbreaking examples.
It is important to understand the context of these examples, so I will briefly outline the NHS targets: seven minutes for category 1 calls, for which 90% of ambulances should arrive within 15 minutes; 18 minutes for category 2 calls, for which 90% of ambulances should arrive within 40 minutes; while 90% of ambulances for category 3 and 4 calls should arrive within two and three hours respectively.
Those targets remain unmet in the south-west, where we have the worst-performing ambulance service in the country. In January 2025, South Western Ambulance Service failed to meet the targets for category 1 and 2 calls. The average time it took to respond to a category 2 call was 51 minutes and 45 seconds—nearly three times slower than the NHS target. This has serious repercussions for people’s health. In every minute that a stroke is left untreated, nearly 2 million brain cells die, and lifesaving treatments such as clot-busting drugs need to be delivered quickly, often within four and a half hours.
I was in my local hospital, Queen’s medical centre in Nottingham, where they are currently trialling 45-minute handovers, to make sure that paramedics get back on the road as quickly as possible, while also making sure that patients are safely handed over into the target speciality care they need. Does the hon. Member welcome that sort of trial, given the challenges she describes?
I thank the hon. Gentleman for his intervention. I will come to that point a little later.
With the stark realities facing people in an emergency and the distressing sight of ambulances backed up at hospitals now commonplace, leaving my constituents in Glastonbury and Somerton in despair, it is time to properly address these failures. The NHS standard contract states that handovers between ambulance and emergency departments should be 100% within 60 minutes, 95% within 30 minutes and 65% within 15 minutes, but these targets are left unmet. Between October 2023 and June 2024, 3.7 million handovers took an average of 35 minutes and one second, resulting in over 900,000 hours lost. It is even worse in the south-west. In January 2025, over half the handovers took over 30 minutes, which is nearly 30% higher than the England average.
We in the south-west face specific issues due to our rurality. Analysis by the Liberal Democrats revealed that waits for life-threatening calls were 45% longer in rural areas than in urban areas. The South Western Ambulance Service has responsibility for the provision of ambulance services across 10,000 square miles, covering an incredible 20% of mainland England. Rural regions have a lower capacity to divert ambulances to other hospitals during periods of significant pressure, largely due to the vast distances between emergency departments.
We may now see ambulance teams in Somerset adopt a “drop and go” policy, which involves leaving patients in certain areas in a hospital without an official handover to A&E staff. The nationally defined target for hospitals included in the NHS standard contract states that after 15 minutes of waiting, the patient in the ambulance becomes the responsibility of the hospital. If no formal handover to A&E happens within 45 minutes, the ambulance crews can just leave the patient within the department and get back on the road.
It is a pleasure to serve under your chairmanship, Ms Jardine. I thank the hon. Member for Glastonbury and Somerton (Sarah Dyke) for securing this much-needed debate.
It is incumbent on us to get the waiting times down to the level that we all expect because in a medical emergency every second counts. Every minute without the right care could mean the difference between life or death, independence or disability, full recovery or a lifetime of complications. Yet, across nearly all categories, ambulances are failing to meet their target response times. They are often stuck waiting instead of saving lives, held up by staff shortages or gridlocked outside hospitals with no beds to offload patients. I know this from personal experience because my health trust suffers from it more than most in London. We all have a stake in improving our NHS. We all want to see more beds, more timely treatment and a healthcare system that keeps our friends, neighbours and families healthier for longer.
Last year, Labour’s Budget unlocked £22.6 billion in funding for the NHS over the next two years to pay our doctors fairly, to provide critical hospital beds, and to end the backlog, but for emergency services there remains a critical issue that pumping money into the NHS alone will not fix: staff shortages. Paramedics have one of the highest turnover rates of any profession. Although the number of paramedics has increased since March 2018, absence caused by poor mental health has also increased and so has the number of staff leaving the field all together. Between 2022 and 2023, nearly 7,000 paramedics left their jobs—a 51% increase in leavers from 2019-2020. Without enough staff, ambulances cannot operate at full capacity and response times suffer.
In the current state of the NHS, paramedics are overworked, stretched to the limit and living with the consequences of underfunding and lack of support. Burnout is not just a risk; it is their reality. Who can blame paramedics for wanting to leave? Let us be clear: we have reached this point not because paramedics are not working hard enough, because they are, but because the emergency services have become a safety net. Without preventive measures such as screening, GP appointments or adequate social care, patients get treated only when their condition has escalated to a true emergency, putting undue stress on services. When patients can be treated only once their condition has become an emergency, it is a failure of the system and it increases pressure on our emergency services. It is a bad deal for patients and for those working tirelessly in our emergency services—a deal made possible by 14 years of Tory mismanagement, underfunding and neglect.
Thank you, Ms Jardine, for calling me to speak and also for giving me my full name, Nicholas—I think the last time that was done was when I was six years old and in trouble with my mother.
I applaud the hon. Member for Glastonbury and Somerton (Sarah Dyke) for securing this very important debate. I think we can all agree that this is an important issue not only for our constituents, but for every community across the country. As we have just heard, the time it takes for an ambulance to reach people in need of urgent medical care can make all the difference in saving lives. We have a responsibility to engage constructively across party lines to find solutions that work.
Since the pandemic hit, we have all seen the challenges faced by our local health services, and ambulances are no exception. In January, average response times for the two highest priority incidents missed NHS targets. Official data shows average response times for category 1 incidents of eight minutes and 16 seconds, instead of the seven-minute target, and average response times for category 2 incidents of 35 minutes and 40 seconds, instead of the 18-minute target.
Even those statistics obscure dramatic variation across the country. This is particularly concerning in my constituency of West Suffolk. Haverhill, our biggest town, has a population of 30,000 people, but the response times for the highest priority incidents in Haverhill are twice as long as they are in Cambridge. Figures from the NHS England weekly ambulance scorecard show that in the 12-month period to the end of September, Cambridge’s average response time for category 1 incidents was 7.3 minutes, just missing the national target, but Haverhill’s was 14.7 minutes. Ambulances starting their shifts in Haverhill are often dispatched towards Cambridge, which is 15 miles away at its nearest point. This is an inequality that needs to be addressed as soon as possible.
It is a pleasure to serve under your chairmanship, Ms Jardine. I congratulate the hon. Member for Glastonbury and Somerton (Sarah Dyke) on securing today’s important debate.
I welcome the news that ambulance waiting times are slowly improving in my area of the west midlands, but I would like to raise an issue that has been brought to me by several of my constituents in very distressing circumstances: how long those ambulances are having to wait outside A&E departments.
An ambulance service needs hospital services that can support it, and my constituents deserve to know that if they need urgent healthcare, an ambulance will turn up quickly and be able to deliver them to the appropriate care as soon as possible. At the moment, that is simply not happening: 66.6% of ambulances at Worcestershire Royal hospital, which serves many of my constituents, were left waiting longer than 30 minutes in the first week of January 2025. Prior to that, in October, only 50% of people attending any of the trust’s A&E departments, including mine in Redditch, were treated, admitted, or discharged within four hours. That same month, 1,300 ambulance patients waited more than an hour outside. I would like to share what that means in reality for some of my constituents.
My constituent Connie’s mother was sat in the back of an ambulance for hours outside the Royal, waiting for space to go in. Once she was finally admitted, she was left in a chair in a corridor for even longer. Not only is that a distressing situation for the patient, but while she was unable to be admitted, that ambulance was forced to stay outside and not be redeployed to help others. I heard from another constituent, Elaine, who had to call an ambulance for her 80-year-old mother-in-law due to a serious hypoglycaemic event, and although the ambulance crew were prompt in their arrival, she spent seven hours in the back of an ambulance as the A&E was not in a position to take her. She then spent 48 hours in A&E and a further three weeks in hospital before she was discharged, having received excellent care, but it is those seven hours that still stay with her now.
It is a pleasure to serve under your chairmanship, Ms Jardine. I congratulate my hon. Friend the Member for Glastonbury and Somerton (Sarah Dyke) on securing this important debate.
From the January 2024 figures, we can see that the South Western Ambulance Service consistently ranked near the bottom across all categories of ambulance response times. The mean response times were nearly all below NHS targets, and the longest category 4 response was over nine hours against a target of three. The geography of rural Devon, and particularly of my constituency of South Devon, is not conducive to speedy ambulance response times—I would challenge anyone to drive along our hedge-lined rural lanes at speed, even with a blue light flashing—so it is no wonder that figures might be lower than national NHS targets dictate, but while ambulances spend hours waiting at clogged A&E departments, they are not out on the road responding to patients.
I will focus particularly on two areas. The first is the very worrying issue of the proposed relocation of out-of-hours emergency cardiac services from Torbay Hospital to Exeter, which is being proposed by Getting It Right First Time—a programme that claims to present
“a data-driven evidence base to support change.”
Patients in Torbay and South Devon currently face significant delays with ambulances already struggling to meet response time targets, but with the relocation of cardiology services, ambulances will have to travel an extra 20 miles to Exeter after collecting and stabilising a patient, and for those who live in the furthest southern part of my constituency—Dartmouth, for example—this is a significant extra travel time to add to what is already quite a long and slow journey. That extra travel time will delay critical interventions for heart attack patients. For every 30-minute delay to treatment, there is a 7.5% increase in mortality. In other words, that is 15 people out of every 200 who could lose their life because of an extra half-hour delay.
It is a pleasure to serve under your chairship, Ms Jardine.
NHS England has set ambulance response time targets since 2018. As the hon. Member for Glastonbury and Somerton (Sarah Dyke) indicated, there are four categories of severity for ambulance calls, each with a different response-time standard. In my Wolverhampton West constituency, ambulance response times are managed by the West Midlands Ambulance Service. The Care Quality Commission’s 2023 inspection of the West Midlands Ambulance Service resulted in a regulation 12 notice for response times.
I pay tribute to ambulance workers, who work very hard. When the ambulance was called for my parents, before they passed away, the ambulance workers were very diligent. They worked very hard and did their best for my parents.
I wish to address an issue raised by my hon. Friend the Member for Ilford South (Jas Athwal): mental health among ambulance workers. Sadly, it has come to my attention as the MP in Wolverhampton West that there have been cases of bullying and harassment among ambulance workers, with whistleblowers then being targeted by management. Although I appreciate that this is probably a discussion for another time, I want to emphasise that we need to protect whistleblowers in our health service. The wellbeing of ambulance workers will have an impact on ambulance response times.
The Black Country integrated care system covers my constituency of Wolverhampton West. On the four categories for ambulance response times, although the ICS’s response time for category 1 was found to be within target, the response times for categories 2, 3 and 4 were under target.
In January this year, the Secretary of State for Health and Social Care acknowledged that patients have been let down by ambulances that do not arrive on time, and that there is variation in performance across different parts of the country. He also mentioned the urgent and emergency care improvement plan, which is currently in production and will be published before spring 2025. I look forward to seeing the results.
I have heard from many constituents across Glastonbury and Somerton who are deeply concerned by the delays in stroke treatment due to ambulance waiting times. These fears are compounded by the planned closure of Yeovil district hospital’s hyper-acute services. The reconfiguration of services will mean that all patients who have suffered a serious life-threatening stroke will be taken to hyper-acute stroke units in Dorchester or Taunton to receive care.
As much as these new cutting-edge services and facilities are welcome in the south-west, the fact remains that if stroke patients or any patient needing emergency treatment gets to hospital too late, the results will be catastrophic without improvements to the ambulance service, and all the best equipment, drugs and treatment by clinicians will have minimal impact on patient outcomes. I have spoken about the impact of these changes on stroke care in this place before. I do not feel it necessary to go into detail again today, suffice to say that ambulance delays only increase the pressure on stroke services. The Liberal Democrats have demanded that localised data on ambulance delays is published, so rural areas like Somerset that are underperforming can receive focused and appropriate support. I would welcome the Minister’s comments on that.
Lengthy delays are made all the worse when we consider the impact of drawn-out handover times, meaning ambulance crews are unable to head back out on to the road to pick up more patients. The Darzi review laid bare just how dire the situation has become. In 2024, around 800 working days each day were lost due to handover delays. Incredibly, that is the full-time equivalent of nearly 14,000 paramedics over a year. In addition, ambulances across England collectively spent 112 years waiting outside hospitals to hand over patients in 2023-24.
The South West Ambulance Service is moving towards this approach with hospitals from Swindon and Bristol to Cornwall and Plymouth. Although this policy might alleviate some of the pressure on ambulance crews, it would fail to ease the struggles that underfunded and overstretched A&E departments in Somerset are facing. Somerset has an ageing population: within the next decade, one in three people in Glastonbury and Somerton will be 65 or older. That may make it harder to quickly discharge patients, as some may also require onward social care provision. It is inevitable, therefore, that delayed discharge due to internal processes such as waiting for pharmacy diagnostics and therapy assessments, and a lack of capacity in adult social care, will lead to poorer ambulance service performance. The social care crisis has a devastating effect on the healthcare system.
Last year, Care England said that
“over 45% of hospital discharge delays are linked to social care”.
One in seven hospital beds are taken up by people who are medically fit to be discharged. For patients, delayed discharge can lead to an increased risk of hospital infections and the loss of mobility or cognitive function, and can make it harder for them to regain their independence. The problems in the healthcare system will never be fixed unless we urgently address the social care crisis. Only last week, social care providers felt the need to protest against Government inaction for the first time ever.
The Liberal Democrats have been campaigning to fix social care by introducing free personal care based on the model introduced in Scotland, so that provision is based on need, not ability to pay. We also welcome the cross-party commission to forge a long-term agreement on social care, but we believe it can be completed within a year, not three. We cannot afford to kick this can any further down the road, and I urge the Government to listen to the Liberal Democrats’ calls.
We also need to solve the hospital bed shortage in the UK. The lack of available beds negatively impacts hospital flow. As a comparison, the OECD EU nations have about five beds per 1,000 people, whereas the UK has only 2.4. The Royal College of Physicians revealed that four out of five doctors were forced to provide corridor care in the past month due to a lack of hospital beds. According to the Royal College of Emergency Medicine, bed occupancy is at a staggering 93%. The Liberal Democrats want to bring that down to a safe 85% by increasing the number of staffed hospital beds.
We are waiting for the Government to publish the urgent and emergency care improvement plan soon, along with the 10-year health plan. It is vital that we urgently wrestle with the problems that the Conservatives left behind to ensure the safety of patients. Over the past seven years, the previous Conservative Government were forced to find an average of £376 million of emergency funding each year to tackle the NHS winter crises. Under the Liberal Democrat proposals, a new winter taskforce would instead manage a ringfenced fund of £1.5 billion over the next four years to build resilience in hospital wards, accident and emergency departments, ambulance services and patient discharging. That would allow integrated care boards and NHS trusts to plan their budgets more effectively to prevent winter crises, instead of just receiving emergency funding from the Government at the last minute.
We urgently need to give our healthcare services the ability to forward plan. They must not be forced to deal with crises on the fly as situations unfold. Somerset’s ambulance services, like all services across the country, desperately need and deserve support. Localised data must be published to help pinpoint specific improvements that can be made in rural areas. The Government have outlined their desire to improve urgent and emergency care—they accept that ambulance waiting times are unacceptable—but now is the time to act to achieve those objectives; otherwise, more people will suffer and sadly some lives will be lost. That must be part of a serious rethink about the way we fund social care; otherwise, we will never move towards a solution that works.
If we want better health outcomes and to meet our response time targets, we must make bold structural changes. We need to ensure that paramedics are not carrying the burden of overstretched services in every corner of the NHS. We must ensure that all parts of the NHS function well, from community screenings to adequate support for paramedics, who should be able to continue in their roles and not be driven out because the system has made it unbearable to stay. Every minute counts for overworked paramedics at breaking point and the patients who desperately need their care. I look to the Minister to do the heavy lifting and fix the broken system, which will be the difference between life and death.
The problem arises in part from the fact that Haverhill ambulance station is located right on the county boundary, at the edge of south Cambridgeshire. The ambulance station is used for maintenance, but it does not have its own ambulances on standby. This appears to have a negative effect on how ambulances are assigned for the local area, with resources sucked into Cambridgeshire and staying there. Addenbrooke’s hospital has become a hotspot for this problem: ambulances with patients waiting to be treated wait outside for long periods, instead of responding to more incidents in and around Haverhill.
I have spoken to the East of England Ambulance Service several times over the past few months to learn more about the situation. It believes that the system status plan, which decides where to send ambulances, should be changed so that Haverhill becomes a priority and more ambulances can be sent there.
Since my election, I have also been making the case for a co-located and purpose-built blue light facility in the town. This would allow the local police, fire and rescue service, and ambulance service to better serve local residents and save taxpayers’ money. The plan has the support of local councillors and several interested parties, and the Government have also made positive comments about adopting this approach nationally. I look forward to the publication of the Government’s urgent and emergency care improvement plan, as well as the 10-year health plan.
I remind the Minister of the Health Secretary’s commitment, which he made on the Floor of the House, to follow up with me regarding this proposal. Since the Health Secretary made that commitment, I have not received a response to my letter. I hope that a Minister or appropriate official from the Department will come to visit us in West Suffolk. It would be an excellent opportunity for them to meet representatives of the East of England Ambulance Service NHS Trust, officers from Suffolk police, the Suffolk police and crime commissioner, and the fire and rescue service to discuss the next steps.
I hope that today’s debate will provide us all with an opportunity to work together to improve ambulance services. I know that the problems that I have described in West Suffolk exist in other parts of the country, and we have much to learn from one another. There are solutions that can be implemented to deliver faster response times and improve outcomes for our constituents. I look forward to supporting any practical measures to help achieve exactly that.
At the Alexandra hospital in my constituency, there are no in-patient children’s beds, so very sick children have to be taken to Worcestershire by ambulance if they need to be admitted. The Minister knows all too well that I have raised this issue with her before. If these services were provided more locally, over more than one site, ambulances would be freed up to deal with truly urgent cases across Worcestershire. Our ambulance and hospital staff work tirelessly to help us stay safe and well, but they are being let down by a system that has been neglected for too long.
I will not make a party political point, but—let’s be honest—we pay for the service we get. As the son of someone who worked in the NHS for 40 years, I would say that for too long we have not been investing in our health and social care systems in this country. We must take action now to ensure that our hospitals are given the resources they need so that handovers from ambulances can take place quickly and safely, and patients can truly receive the care that they deserve.
Last week, a dozen cardiologists at Torbay hospital met me and other local MPs. They told us that they have been calling on the local ICB for a year not to go through with the change and that, crucially, no evidence has been presented in a case that would justify the move. They said that even 10 to 15 minutes can literally save a life. We know that quicker response times also mean a better chance of full recovery for patients who get to hospital in time to survive. Most worryingly, South Western Ambulance Service did not know anything about the proposed move. It feels appropriate, while we are discussing ambulance services, to say that that strikes me as wholly unacceptable for a body that wants to “get it right”.
There is growing support for treating strokes as category 1 emergencies, on a par with conditions such as cardiac arrest, due to their time-sensitive nature, which my hon. Friend the Member for Glastonbury and Somerton described. Quicker responses could significantly improve long-term outcomes, reducing the risk of permanent disability or death. The first three hours are critical for intervention as brain tissue continues to deteriorate after that. Faster treatment helps to prevent that damage. Although strokes are in category 2, evidence shows that response times often exceed the ideal timeframe. The average time it takes for an ambulance to arrive and provide care for category 2 calls is often well beyond the optimal window for effective stroke treatment.
In the south-west, the mean time for an ambulance to respond to a cat 2 call was nearly 52 minutes, against an NHS target of just 18 minutes. The longest time was one hour and 53 minutes. Changing the categorisation of stroke could ensure that ambulances prioritise stroke victims as they would a cardiac arrest or a trauma case, which could improve response times and overall care. That would put yet more pressure on ambulance services but, after all the public education campaigns about recognising stroke symptoms—which are very welcome—ambulances are simply not arriving in time to provide the necessary treatment.
Our paramedics and ambulance services have so much to offer, from providing lifesaving urgent medical care to delivering care in the community and driving welcome innovation for the NHS. Yet according to official NHS figures, in the winter of 2023-24 ambulances across England collectively spent a staggering total of 112 years waiting outside hospitals to hand patients over. It is an astonishing and dangerous waste of resources for ambulances to be stuck for hours waiting outside crammed A&Es. As my hon. Friend the Member for Glastonbury and Somerton said, the crisis in our social care system goes a long way to exacerbating bed blocking in hospitals, which is having a direct impact on ambulance services.
The Liberal Democrats are calling on the Government to publish accessible, localised reports of ambulance response times and create an emergency fund to reverse closures of community ambulance stations—which are particularly vital in rural areas—and cancel planned closures where needed. We need a proper plan to fund this crucial part of our NHS, rather than last-minute emergency funding each year during repeated winter crises, which does not enable local trusts and ICBs to plan effectively and efficiently.
The Government’s mandate to NHS England this year includes an objective to reform and improve urgent and emergency care. The mandate describes ambulance response times and A&E waiting times as unacceptable. NHS England’s priorities and operational planning guidance includes a national priority to improve A&E waiting and ambulance response times.
As a Government we have made excellent strides in reducing hospital waiting lists and making more hospital appointments available, and we have improved accessibility to GP appointments. In the same way as we have made strides in reducing hospital waiting lists and increasing hospital appointments, we must now make similar strides in improving ambulance response times.