Waiting times for ambulances and emergency department care

For the latest statistics on ambulance response times and Accident and Emergency (A&E) activity and waiting times, please see our briefing paper: NHS Key Statistics: England, June 2022 – House of Commons Library (parliament.uk)

Background on ambulance and A&E waiting time targets

As health is a devolved matter this information relates to ambulance and A&E services in England.

There are four categories of severity for ambulance calls, as follows. Each has a different response time standard:

• Category 1: An immediate response to a life-threatening condition, such as cardiac or respiratory arrest. The average response time should be under 7 minutes and 90% of ambulances should arrive within 15 minutes.
• Category 2: A serious condition, such as stroke or chest pain, which may require rapid assessment and/or urgent transport. The average response time should be under 18 minutes and 90% of ambulances should arrive within 40 minutes.
• Category 3: An urgent problem, such as an uncomplicated diabetic issue, which requires treatment and transport to an acute setting. 90% of ambulances should arrive within 2 hours.
• Category 4: A non-urgent problem, such as stable clinical cases, which requires transportation to a hospital ward or clinic. 90% of ambulances should arrive within 3 hours.

The current categories and standards have been in place nationally since 2018, after NHS England introduced a new set of ambulance performance targets.

The most common measure of A&E waiting times is the “four-hour wait” – the percentage of patients whose total time in A&E is four hours or more (measured from arrival to departure, admission or transfer). The current target is that 95% of attendances should last less than four hours.

The four-hour wait measure is planned to be abolished soon and replaced with a new ‘package of measures’ for different parts of the emergency care system. You can read about the planned new standards in this Nuffield Trust article: A new era for A&E targets: what will be the impact of the new basket of measures? (August 2020). Some NHS trusts are currently field testing the new standards.

A&E waiting time targets and ambulance response time targets are set out in the Handbook to the NHS Constitution for England.

In September 2021 NHS England published an implementation guide for their Urgent and Emergency Care (UEC) Recovery 10 Point Action Plan. This includes a focus on ambulance and A&E waiting times.

Parliamentary material

Parliamentary questions

Ambulance Services: Standards

UIN 15333 | 20 June 2022

Asked by: Stephanie Peacock

To ask the Secretary of State for Health and Social Care, what steps he is taking to improve ambulance response times.

Answering member: Edward Argar

Ambulance trusts receive continuous central monitoring and support from the NHS England and NHS Improvement’s National Ambulance Coordination Centre. An additional £150 million has been allocated in 2022/23 to improve response times through additional call handler recruitment, retention and relieving other funding pressures.

Information on the average response time in England is not collected in the format requested. Ambulance response times are measured by category at regional ambulance trust level since the introduction of the current national response time standards in 2017/18. Average ambulance response times were not collected under the previous ‘Category A’ national response time standards. The following table shows the mean average ambulance waiting times in hours, minutes and seconds for Category 1, 2, 3 and 4 incidents in England in each year from 2017/18 to May 2022.

Source: NHS Ambulance Quality Indicators.

Ambulance Services: Standards

UIN 1331822 | 7 March 2022

Asked by: Jim Shannon

To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the adequacy of ambulance waiting times in England.

Answering member: Edward Argar

Performance data for January 2022 shows an improvement in response times in England against all ambulance waiting time categories. NHS England and NHS Improvement are providing an extra £55 million to ambulance trusts to increase staff numbers this winter, providing over 700 additional staff in control rooms and on the frontline to reduce response times.

Early Day Motions

Ambulance waiting times

EDM 222 | 29 June 2022

That this House recognises the crisis in our ambulance services, particularly in rural and coastal communities; welcomes the Government’s commitment to fund specialised mental health ambulances across the country; urges the Government to improve the contributing factors to ambulance delays, including staff shortages, throughout the health and care service; calls on the Government to require ambulance service providers to report response times by postcode in order to target resource where it is most urgently needed; and repeats its call for the Government to commission the Care Quality Commission to review the ongoing ambulance crisis.

Further reading:

• Ambulance wait times endangering patients, doctors say – BBC News, 12 May 2022
• Ambulance response times – The Nuffield Trust, 4 May 2022
• Ambulance handover delays – The Nuffield Trust, 4 May 2022
• A&E waiting times – The Nuffield Trust, 4 May 2022
• The state of Urgent and Emergency Care and the question of the Clinical Review of Standards – Royal College of Emergency Medicine, 1 February 2022
• About urgent and emergency care – NHS England