To ask the Minister of Health to detail (i) the average ambulance turnaround time at Emergency Departments in December 2025; and (ii) the performance of the Emergency Departments against the two-hour ambulance turnaround target in the Overarching Winter Preparedness Plan 2025-26.

Table 1 shows both the average and the longest ambulance handover time for December 2025 at each emergency department (ED) and the percentage of ambulance arrivals with a handover delay over the 2-hour maximum threshold set out in the 2025/26 Overarching Winter Preparedness Plan.

Table 1

Dec-25Average ambulance handover time

(hh:mm:ss)Longest ambulance handover time

(hh:mm:ss)% arrivals with delays over 2 hours

Altnagelvin01:06:5107:54:5212%

Antrim Area01:44:0615:26:5129%

Causeway01:39:1916:31:5326%

Craigavon01:46:4715:40:4425%

Daisyhill01:06:0005:21:4515%

Mater00:54:4110:39:138%

RBSC00:25:0101:36:370%

RVH01:11:1810:08:4417%

South West01:01:1607:12:089%

Ulster02:28:0219:04:0640%

My Department recognises the significant pressures faced by EDs and the impact these have on ambulance handover times and overall system flow. Through the Overarching Winter Preparedness Plan 2025–26, a comprehensive set of actions has been developed to address these challenges.

With regard to improving ambulance handover times, in August 2025 a regional workshop involving Trusts and the Northern Ireland Ambulance Service (NIAS) was convened, drawing on best practice from the London Ambulance Service and King George Hospital. Based on this, new ambulance handover guidance is being finalised. Phase 1 thresholds, agreed with Trusts, aimed to eliminate ambulance handover delays exceeding two hours by 1 December 2025. Trusts are also working to prevent deterioration in shorter delay thresholds (15, 30, and 60 minutes), with a longer-term objective of achieving the 15-minute standard.

In addition to the focus on eliminating delays exceeding two hours, Trusts have been asked to reduce delays in excess of 12 hours in EDs by a minimum of 10% when compared to the same period last year. Belfast Trust has made significant progress in this regard, having achieved a 12.5% reduction in the first 9 months of the year. Whilst progress has not been as significant in other Trusts, Northern Trust achieved a 7.5% reduction in Quarter 3, Western Trust achieved a 5% reduction and South Eastern Trust achieved a 2.5% reduction. Whilst the Southern Trust did not see a reduction, they have seen a significant improvement in Quarter 3 compared to the first six months. This is the first year where the trend has been reversed.

Trusts and NIAS are implementing a range of measures aimed at reducing these extended delays, including additional short stay and intermediate care beds, enhanced front door frailty and multidisciplinary assessments, the expansion of Same Day Emergency Care pathways, and strengthened discharge co-ordination. These actions are intended not only to improve performance against the two hour threshold but also to minimise the occurrence of the longest delays.

With regard to NIAS’ capacity and system flow, 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.

These measures are embedded within each Trust’s Unscheduled Care Improvement Plan, developed in collaboration with the Regional Co-ordination Centre (RCC) and informed by the ‘Big Discussion’ workshops. Trusts are on course to have these initiatives in place ahead of winter.

With regard to how these compare with measures included in the Winter Preparedness Plan 2024-25, the 2025–26 plan builds on the foundations of the previous year, which focused on expanding urgent care alternatives such as Phone First, minor injury units, and urgent care centres. The current plan introduces:

•Defined performance targets for ambulance handovers;

•Expanded consultant capacity (18 emergency medicine consultants appointed, 10 more by early 2026);

•System-wide collaboration through winter planning workshops; and

•Significant investment in fracture care services (£12 million), with additional operating lists and beds already in place.

Trust-level delivery highlights include the following:

•Belfast Trust: The full implementation of the Regional Emergency and Acute Team (REACTT) model; expansion of Hospital at Home; and new roles in physiotherapy, social work, and discharge coordination;

•Northern Trust: The establishment of the Hospital at Home service; enhanced senior nursing in EDs; frailty in-reach service; expansion of early intervention teams; and anticipatory care planning;

•South Eastern Trust: Hospital at Home capacity increased to 40 patients; extended Early Review Team coverage; Frailty at Front Door service expanded;

•Southern Trust: The expansion of ambulatory cardiology and respiratory care; Control Room Site Co-ordinator in place; and digitisation of domiciliary care brokerage; and

•Western Trust: 24/7 ambulance offload cover at Altnagelvin Hospital; additional short stay inpatient and community beds; strengthened discharge co-ordination and allied health professionals navigation.

The RCC maintains operational oversight of hospital services and works closely with NIAS and Trusts to manage pressures. All hospitals retain the capability to open additional beds during surges, with up to 258 beds available across the system to respond to increased demand.

These measures reflect a coordinated and outcome-driven approach to winter preparedness, aimed at ensuring timely, safe, and effective care across Northern Ireland’s health and social care system.