Department publishes full letter on ambulance handover issue

Date published: 15 November 2020

The Department of Health is today publishing in full a letter issued to HSC Trusts on 12 November 2020 in relation to delayed ambulance handover times at hospital Emergency Departments.

Covid-19 news update
Covid-19 news update

Partial, simplistic and sensationalist reporting of this letter has the potential to cause concern among hospital colleagues. That is why we are publishing it in full.

Contrary to what was reported in the Belfast Telegraph, this letter is not “an attack” on anyone. Nor is it an attempt to blame any colleague for the unprecedented pressures and challenges being faced in our health service during this pandemic.

We all have to rally round our health service at this time – by using emergency departments appropriately and, most crucially, doing everything we can to prevent the spread of Covid-19.

An already near impossible situation is not helped by sensationalist reporting by a newspaper that previously and offensively branded many of our health service colleagues as “penpushers”.

The Department wants to again place on record its deep appreciation and gratitude to all staff across the health and social care system – including in highly pressurised Emergency Departments and ambulance crews.

Our letter of 12 November 2020 explicitly acknowledges the scale of the current pressures, stating that “all our hospitals are working at or above capacity and that this creates complex problems that require extremely difficult decisions”.

The letter was prompted by a particularly disturbing case of a patient waiting 12 hours in the back of an ambulance. It also follows a marked increase in the number of ambulances delayed longer than 3 hours at hospitals.

Had the Department not proactively elevated this issue to ensure it is addressed, the Belfast Telegraph would presumably have participated in a chorus of criticism about inaction.

Ambulances are not an extension of the hospital and should not be used in this way. When an ambulance is kept at a hospital by a delayed handover, it is not available to attend emergency calls in the community.

Under existing Departmental policy, once an ambulance arrives at the Emergency Department, the patient’s care is the responsibility of the hospital. Reiterating this policy in a letter does not constitute an attack on anyone.

The Department of Health letter also emphasises that an escalation framework is in place in our health service to ensure that any ambulance handover delays are appropriately and consistently actioned. This framework is an important initiative – but was strangely not mentioned in the newspaper coverage.

The issue of ambulance handover delays is a symptom of wider and complex challenges facing our health service. That does not mean that efforts should not continue to tackle and alleviate the problem. That would be deeply unfair on patients in ambulances – and on ambulance crews who would much rather be answering calls.

Work will continue to make this situation better and the Department will play its part. Unlike the Belfast Telegraph, we do not have the luxury of sniping from the sidelines.


Notes to editors: 

  1. Permanent Secretary Richard Pengelly's letter to Chief Executives, Medical Directors and Directors of Nursing is available on the Department's website.
  2. For media enquiries please contact DoH Press Office by email:
  3. Follow us on twitter @healthdpt.             
  4. The Executive Information Service operates an out of hours service for media enquiries between 1800hrs and 0800hrs Monday to Friday and at weekends and public holidays. The duty press officer can be contacted on 028 9037 8110.

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