AQW 39293/22-27

Mr Justin McNulty
Social Democratic and Labour Party
Newry and Armagh

Tabled Date: 28/01/2026
Answered On Date: 04/03/2026
Priority Written: No

Question:
To ask the Minister of Health for his assessment of the figures in an Irish News article on 28 January 2026 which states that less than one in five suspected heart attack and stroke patients in Northern Ireland get an ambulance in target time, compared to almost half across the border.

Answer:

While I acknowledge the concerns raised by the figures in the Irish News article of 28 January 2026, direct comparison between the Northern Ireland Ambulance Service (NIAS) and the National Ambulance Service is not straightforward. Both services operate within fundamentally different healthcare systems, with distinct emergency department (ED) structures, patient pathways and access arrangements. These systemic differences have a significant bearing on measured response times and limit the validity of a likeforlike comparison.

In Northern Ireland, suspected heart attack calls are categorised as Category 2, for which the anticipated response time is 18 minutes. NIAS has been open and transparent about its continued challenges in meeting this target. The single greatest factor affecting performance remains delayed hospital handovers at EDs. Although the expected handover time is 15 minutes, EDs are regularly unable to accept ambulance patients within that timeframe due to pressures across the acute hospital system. As a result, ambulances can be tied up outside hospitals for prolonged periods.

These delays reduce NIAS’ operational capacity by an estimated 26% over the past year alone. This represents a substantial loss of frontline availability and directly impacts the ability to respond promptly to subsequent emergency calls. Tackling these handover delays is therefore critical to improving response times.

The root of this issue lies in wider patientflow challenges within the health and social care system. Difficulties in discharging medically fit patients into community and social care settings reduce bed availability, which in turn slows movement out of EDs, leading to congestion throughout the system. All Trusts committed in late 2025 to accelerating improvements in handovers, and while early gains were achieved, maintaining those improvements has proved difficult. Evidence from elsewhere in the UK clearly demonstrates that improved hospital flow leads to improved ambulance response performance across all categories.

NIAS continues to prioritise emergency calls to ensure that the most clinically urgent cases such as suspected heart attack, acute stroke, major trauma and timecritical interhospital transfers receive the fastest possible response. Senior paramedics within the Emergency Operations Centre also review Category 2 calls in real time to identify those requiring immediate intervention.

My Department fully recognises the serious and sustained pressures placed on EDs, hospitals and community care services. Through the Winter Preparedness Plan 2025–26, we have taken a series of targeted actions to improve patient flow and reduce the pressures that contribute to ambulance delays. These actions include:

Strengthening sevenday discharge services: Trusts have increased early senior clinical review, discharge co-ordination teams and allied health professional capacity to ensure timely decisionmaking and reduce avoidable delays;

Expanding capacity outside acute hospitals: additional shortstay beds, intermediate care beds and expanded Same Day Emergency Care pathways in specialties such as acute medicine, respiratory, cardiology and surgery are helping to avoid unnecessary admissions;

Increasing social care capacity and efficiency: Early Review Teams have reviewed over 4,100 individuals, releasing more than 12,000 weekly care hours. Regional consistency in protecting home care packages during hospital admission is improving discharge speed. Digital tools such as Careline Live now provide realtime oversight of homecare capacity across all Trusts;

Supporting timely discharge to care homes: the Trusted Assessor model is now in place across all Trusts, improving co-ordination between hospitals and care homes. Work is underway with the independent sector to strengthen this model further and to explore enhanced dementia care home tariffs to increase capacity where it is most needed; and,

Strengthening wholesystem oversight: The Regional Co-ordination Centre provides daily operational oversight, focusing on ambulance handover delays, interTrust repatriation and discharge barriers. Each Trust also has an Unscheduled Care Improvement Plan to support this work.

Improving ambulance response times is dependent on the performance of the entire health and social care system. The measures underway reflect a co-ordinated, systemwide effort to improve patient flow, alleviate ED pressures and support NIAS in responding more quickly to patients with lifethreatening and timecritical conditions.