AQW 38378/22-27

Ms Claire Sugden
Independent
East Londonderry

Tabled Date: 16/01/2026
Answered On Date: 02/02/2026
Priority Written: No

Question:
To ask the Minister of Health to detail (i) whether measures such as (a) Hospital Ambulance Liaison Officers; (b) rapid handover protocols; and (c) cohorting areas, are being used consistently in Emergency Departments; and (ii) any plans in place to ensure their effective implementation.

Answer:

Hospital Ambulance Liaison Officers (HALOs) have a key interface role between the Northern Ireland Ambulance Service (NIAS) and Trusts ensuring good communication and helping to expedite patient handover. In the largest emergency departments (EDs) - the Royal Victoria Hospital (RVH), Ulster, Antrim, Craigavon and Altnagelvin Hospitals - NIAS provide HALO cover on Monday to Friday from 7.00am to 11.00pm (16 hours), and either 7.00am to 7.00pm or 9.00am to 9.00pm (12 hours) Saturdays and Sundays. HALOs located at these sites also provide oversight of smaller sites in each of the respective Trusts. There will be periods where, from an operational perspective, NIAS are not always able to provide a HALO presence on the hospital sites. When this happens, NIAS will work to provide other cover through station managers and the NIAS control room. NIAS and the Trusts also join daily calls seven days a week, and the Regional Control Centre (RCC) manages any interface issues, dealing with them in a timely manner.

Regional Ambulance Handover Protocols aim to ensure a standardised, safe and efficient transfer of patient care from ambulance crews to ED clinical staff, minimising delays and associated risks to patient outcomes and ambulance service capacity.

The national standard for ambulance handover states that patients arriving by ambulance should be handed over to ED staff within 15 minutes, with the ambulance cleared and ready to respond within a further 15 minutes. Any handover that exceeds 15 minutes is considered a delay.

Reducing handover delays is a critical priority, given the direct impact on the NIAS’ ability to respond to emergency calls in the community.

In August 2025, my Department held a regional workshop with senior management and clinicians from Trusts and NIAS, focusing on improving ambulance handover times. Input was provided from the London Ambulance Service and King George Hospital in London, where they have been successful in reducing ambulance handover delays.

My Department is working with NIAS and the Trusts to finalise the ambulance handover guidance/protocol for Northern Ireland, based on the experience of other ambulance services including the London Ambulance Service.

In order to support improved ambulance offload and response times, my Department has repurposed £10 million to fund targeted initiatives across Trusts. These measures include:

The expansion of Hospital at Home services in Belfast, South Eastern, and Northern Trusts, increasing community-based capacity;

Additional short stay inpatient beds (for example, eight in Altnagelvin) and intermediate care beds (for example, 12 in the Western Trust) to facilitate timely discharge;

Frailty assessment and multidisciplinary team reviews at the front door of acute hospitals;

Expansion of Same Day Emergency Care and ambulatory pathways across acute medicine, respiratory, cardiology, and surgical specialties; and,

Enhanced capacity for Early Review Teams and Discharge Coordination.

Ultimately, all of these measures are aimed at improving flow throughout the hospital, reducing ambulance handover times and congestion in our EDs and improving waiting times. These efforts are part of a broader system-wide approach to ensure patients receive timely, safe, and effective care, both within EDs and across the wider health and social care system.

The cohorting of patients in ED should not be seen as normal business in response to ambulance delays outside EDs and should only be considered as an exceptional escalation measure, in line with Trusts’ escalation plans when discharge opportunities have been exhausted. Ambulance handover zones are in place in each of the major EDs (RVH, Antrim, Ulster, Craigavon, Altnagelvin) and are operational 24/7.

In addition to the operational calls every day between the RCC, NIAS and the provider Trusts, there are discussions every two weeks providing oversight of the measures which have been put in place to ensure their effective implementation.

Performance against the ambulance handover standards is also overseen by my Department as part of the HSC Support and Intervention Framework. Whilst the improvement trajectories for ambulance handover have not yet been met across all hospital sites, in December 2025, several hospitals demonstrated strong performance against the 2hour threshold, with less than 20% of ambulance arrivals delayed over two hours. This included the Mater (8%), South West Acute Hospital (10%), Altnagelvin (13%), Daisy Hill (15%), and the Royal Victoria Hospital (16%), reflecting focused efforts to improve patient flow and reduce prolonged waits. Work will continue with Trusts and NIAS to deliver improved handover times.