Ambulance Crisis: Thousands of West Midlands Patients Face Dangerous Delays

Thousands of patients in the West Midlands endured waits of more than six hours in ambulances outside hospitals this winter, according to an exclusive FactCheck investigation that reveals the shocking extent of healthcare delays in the region.

While the NHS in England stipulates that all ambulance “handovers” – the formal transfer of patients from paramedics to hospital staff – should be completed within 15 minutes, the reality for patients in the West Midlands has been starkly different. January saw an average handover time of 80 minutes in the region, the longest in England.

The investigation uncovered disturbing statistics from October 2025 to January 2026. More than 50,000 patients waited over an hour in ambulances before hospital admission, with over 5,500 enduring waits exceeding six hours. Most alarmingly, more than 100 people were left waiting 12 hours or longer.

The most extreme case identified occurred in December 2025, when a patient waited outside Royal Stoke hospital for 17 hours. This comes against the backdrop of a 2021 report by the Association of Ambulance Chief Executives that found 80 percent of patients waiting more than an hour outside hospitals “potentially experienced some level of harm,” with 9 percent at risk of “severe harm.”

The crisis takes on added urgency considering the conditions of many affected patients. Approximately 1,000 people who waited over six hours were suffering from breathing problems, suspected strokes, or were considered at risk of cardiac arrest. While emergency call handlers make initial assessments that may change upon hospital examination, and patients in cardiac arrest would be prioritized for immediate treatment, the prolonged waits for seriously ill patients raise significant concerns.

The burden of these excessive delays has not been evenly distributed across the region’s hospitals. Nearly half of all six-hour waits occurred at just two of the region’s 20 facilities – Royal Stoke and Heartlands hospitals. In October 2025, one in seven patients arriving by ambulance at Heartlands waited at least six hours before being admitted, the highest proportion for any hospital during the analyzed period.

Healthcare professionals attribute these delays to overwhelmed A&E departments without capacity to admit additional patients. While some care can be administered in ambulances, including oxygen and certain medications, and some hospitals send staff to assess patients in ambulance bays, the implications extend beyond individual patient care.

Every ambulance delayed outside a hospital is unavailable to respond to other emergencies in the community, creating a domino effect that reduces overall emergency response capacity. This compounds the healthcare crisis across the region.

West Midlands ambulance service acknowledged the correlation between hospital handover delays and response times, stating they will “continue to work with our partners in hospitals to find new ways of reducing the handover delays” to improve community response times.

The NHS Trust responsible for Royal Stoke hospital recognized “the pressure that ambulance handover delays place on patients, crews and our Emergency Department” and reported they are “working intensively with our partners to reduce them,” noting recent improvements in patient flow and handover times.

Similarly, the NHS Trust overseeing Heartlands hospital claimed significant improvements throughout February and March, emphasizing that patients are “assessed on arrival and prioritised according to clinical need, with the sickest seen first.”

The investigation analyzed raw data covering 1.3 million ambulance journeys in the West Midlands between October 2023 and January 2026, with particular focus on the 188,000 journeys from October 2025 to January 2026. The analysis included all ambulance transports to hospitals, including non-emergency departments, as many involve seriously ill patients.

After accounting for missing data, the investigation identified 50,948 handover waits exceeding one hour, with 5,663 longer than six hours. The data revealed that patients arriving at Heartlands hospital had an 8.5 percent chance of waiting six hours in an ambulance this winter, while at Royal Stoke the figure was 7.5 percent – significantly higher than the next highest hospitals, Royal Shrewsbury and Good Hope, both at 5 percent.