Ambulance Watch: Hospital warned over ambulances waiting in the car park

Norfolk's biggest hospital will be fined if ambulances are kept waiting outside its accident and emergency department.

The new agreement means the Norfolk and Norwich University Hospital will be fined �70 per hour for ambulance handover delays, which are aimed to be completed within 15 minutes.

The financial penalties have been introduced in an attempt to put pressure on the hospital to improve its times, with commissioners saying the N&N's poor performance in this area is severely hampering the East of England Ambulance Service NHS Trust's ability to meet its response time targets.

A recent report showed that in the four weeks to September 16, the N&N was accountable for 144 out of 378 of the instances when there were excessive handover delays.

This represented 7pc of patients arriving by ambulance at the N&N during those four weeks.

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At the Queen Elizabeth Hospital King's Lynn there were 12 excessive delays, representing 1.4pc of the patients brought in by ambulance, and at the James Paget University Hospital in Gorleston there were 20 excessive delays, which was 1.7pc of recorded patients.

Anna Dugdale, chief executive of the Norfolk and Norwich University Hospital, (pictured) said: 'We are pleased to have reached agreement on the contract.

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'This agreement recognises the interdependent nature of the health and social care system and we are working hard with our health partners to ensure patients receive the best possible care and outstanding issues in the system are resolved.'

The ambulance service says handover delays in Norfolk and Suffolk have cost it more than �400,000 in lost resources, nearly double the costs incurred elsewhere in the region.

The new contract says that as a minimum, 80pc of patients in any given month should be 'handed over' from an ambulance to the N&N within 15 minutes.

If the hospital meets or exceeds the 80pc standard then there are no penalties.

If performance does not meet 80pc then the 'additional' time it took to hand over all of the patients in that month (the time over 15 minutes per patient) will be added up and a penalty can be imposed at the rate of �70 per 60 minutes.

The penalties can be waived in special circumstances.

A spokesman for NHS Norfolk and Waveney said: 'We have agreed a target that at least 80pc of patients should be handed over from ambulance to hospital within 15 minutes of arrival and that penalties will be issued for breaches.

'These penalties are �70 per hour for delays over 15 minutes. This agreement is part of a whole health and social care system working together to ensure prompt discharge for hospitals and the avoidance of admission to hospital where more appropriate alternative care can be provided.'

Health minister Norman Lamb, who is also MP for North Norfolk, met with health chiefs including the N&N's chief executive earlier this year to discuss the issue of ambulance turnaround times.

He said: 'We need extra levers like this to make sure that this is addressed.

'The truth is this has dragged on for years now, this problem of handover times.

'We have got a very, very busy hospital.

'It's the busiest hospital in the East of England, but some better co-ordination between the ambulance trust and the hospital is needed.'

A spokeswoman for the ambulance service said: 'Obviously any handover delays at A&E mean time off the road for our crews but we are continuing to work with hospitals, the Strategic Health Authority and our commissioners to proactively tackle the issue so that we can hand over in good time and respond more quickly to calls.'

Another reason it took so long for the contract between the hospital and the PCT to be agreed was due to targets on referral to treatment times.

It has now been agreed that the N&N will meet the national standard to treat 90pc of patients within 18 weeks of referral from October onwards.

In orthopaedics, where there is a longer waiting list, it has been agreed the hospital will aim to meet 90pc from December onwards and by March at the latest.

The EDP launched Ambulance Watch in response to increasing concerns over rural response times, back-up ambulance delays, poor turnaround times at hospitals for ambulances and a controversial staff and vehicle rota redesign.

We want to hear from you about your experiences and views of the region's ambulance service. You can fill in our survey online at, or email

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