HSE warned ambulance handover delays putting patients safety at risk
Ken Foxe
A senior HSE official warned ambulance handover delays at emergency departments were a “significant patient safety risk” with systemic problems at several hospital sites.
Internal records detail how HSE deputy chief executive Damien McCallion said an ambulance stuck at an emergency department meant another patient waiting for help was at risk.
The documents also show plans for a Hospital Ambulance Liaison Supervisor service – designed to reduce handover delays – had repeatedly failed to receive permanent funding or staffing despite requests over four winters.
It said where it had been introduced on an ad hoc basis, significant improvements in getting ambulances back on the road were evident.
A briefing note said: “Out of the 34 hospitals listed, 19 hospitals showed an average improvement of 7%. The best was a 20% improvement in Cork University Hospital.”
However, repeated efforts to fully fund and resource a handover service failed, according to records released under FOI.
Last winter, the National Ambulance Service (NAS) experimented with using staff who were deemed unfit for their core role by occupational health.
An email said the CEO of the HSE had asked for three acute sites to be supported every day during the busy winter period.
It said the NAS was also supplementing alternative-duty staff with overtime when they could secure volunteers.
The message said: “Feedback from most acute colleagues highlights the benefits of the role which is now well established in many ambulance services across the UK.
“This is the fourth winter where there has been continued requests for NAS to place [handover staff] on site, however, the role remains unfunded (WTE [whole-time staff] or funding).”
The email also warned the current informal system was “unsustainable in the longer term.”
It said: “Given the specific skill set required, we need to select the right people for the role, and with the input of acute colleagues.”
In another email, a senior HSE official said hospitals were a “long way off” targets for hospital handovers of less than 20 minutes.
It said the health service needed to monitor “any outliers” with one hour plus transfers and facilities with consistent delays.
The message said there appeared to be “systemic issues” at specific hospitals in Leinster, Munster, and the West North-West region.
However, follow-up correspondence warned some figures might not be fully reliable as they were based only on ambulance vehicle movements.
An email from the HSE National Director Grace Rothwell added: “It seems that in the absence of the Acute Ops function there is little focus on ambulance delays at regional level as I hear the unacceptable delays reported daily.”
Asked about the records, a spokesperson said the NAS was undergoing a significant transformation to enhance service delivery, optimise resources and expand its role.
They said its base budget had risen to €285 million with a 28% increase in staffing and a €126 million investment in fleet replacement and expansion.
The spokesperson said plans for 2026 included around €20 million in new revenue funding, 263 additional staff, and four dedicated Hospital Ambulance Liaison Supervisors for the HSE West and North West region.
They said: “Where required, NAS can deploy Hospital Ambulance Liaison Supervisors (HALS) to individual hospitals to support crews with patient handovers and help resolve operational delays.”
