Ambulances being left to queue outside hospitals is one of the top issues to address, says the UK's new health secretary Therese Coffey. EPA
Ambulances being left to queue outside hospitals is one of the top issues to address, says the UK's new health secretary Therese Coffey. EPA
Ambulances being left to queue outside hospitals is one of the top issues to address, says the UK's new health secretary Therese Coffey. EPA
Ambulances being left to queue outside hospitals is one of the top issues to address, says the UK's new health secretary Therese Coffey. EPA

Why are ambulance waiting times so long in the UK?


Gillian Duncan
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Ken Shadbolt, 94, was in good health for his age and was often seen cycling around the Cotswolds on his electric trike.

However, in March, he fell after getting out of bed and could not stand.

Logs showed he made three phone calls in the hours he waited for the South Western Ambulance Service to arrive, each of them increasingly desperate.

During the final call he told the handler he felt “terrible sick” and was struggling to breathe. He pleaded: "Can you please tell them to hurry up or I shall be dead."

Kenneth Shadbolt waited hours for an ambulance. He tragically died from a bleed on the brain. Photo: Shadbolt family
Kenneth Shadbolt waited hours for an ambulance. He tragically died from a bleed on the brain. Photo: Shadbolt family

By the time the ambulance finally reached him at 8.10am, four hours after his last call, he was unconscious. He died later that day from a large bleed on the brain.

Figures show ambulance waiting times have become significantly worse in England over the past year.

But why are they so bad? And what does the government plan to do about it?

The National explains.

How bad is the problem?

According to the latest data from the NHS, ambulances took 59 minutes and seven seconds on average to respond to category two calls, which are classed as emergencies, in England in July.

"People should not have to wait as long as they are for ambulances and my new health secretary is immediately tackling this issue, she's already laid out her priorities and sorting out the ambulance service is one of them."
Liz Truss

That figure was up from 51 minutes and 38 seconds in June.

Ambulances responding to life-threatening incidents — classed as category one — took an average of nine minutes and 35 seconds.

That is well above the target of seven minutes and the joint-longest average response time since records began in 2017.

How long should ambulances take to respond?

Ambulance response times represent the time a 999 call is received to when the vehicle arrives at the patient’s location.

Since 2017, waiting times have been governed by performance targets.

Responses to emergency calls, which are classed as category two and includes strokes or severe burns, should be made within 18 minutes. That means people are currently waiting more than three times longer for an ambulance.

For urgent calls, referred to as category three, which includes the late stages of labour and non-severe burns, 90 per cent of calls should be responded to within 120 minutes.

And 90 per cent of category four calls, classed as non-urgent, which could include the likes of diarrhoea or vomiting, should be responded to within 180 minutes, according to the targets.

How long has the problem been building?

Since the pandemic.

According to the government, from 2017 and 2019, average response times actually declined and remained stable at around the target of seven minutes.

At the start of the Covid outbreak in March 2020, response times to category one incidents climbed to more than eight minutes. Between April and July of that year, response times improved.

However, they have deteriorated since summer last year, with increases in the average response time for the most urgent calls and the 90th percentile targets being missed.

“Response times for the same period for categories two to four show a similar trend to the category one data,” said a paper published on the House of Lords Library.

Doctors and paramedics say ambulance waiting times are putting patients in danger across the UK. EPA
Doctors and paramedics say ambulance waiting times are putting patients in danger across the UK. EPA

Why is it taking longer for ambulances to reach people?

The health service, the NHS, has come under increasing strain, with waiting lists at an all-time high.

In a recent survey by the Royal College of Nursing, 63 per cent of staff said emergency care was taking place elsewhere, such as in corridors, instead of on wards.

At the end of May, waiting lists for routine treatments had reached 6.6 million. That was one million more than the previous month.

More than 100,000 staff vacancies across the NHS and a lack of social care capacity means it is taking longer to discharge patients than it should. That has left ambulances queueing outside hospitals, slowing down response times to new calls.

What will be done about it?

Former health secretary Steve Barclay recently called ambulance handover times the health service’s “number one priority” this winter.

He has since been replaced by Therese Coffey, who was appointed health secretary in Liz Truss’s Tuesday reshuffle.

On Wednesday, Ms Coffey reiterated how important the issue was to the government.

Speaking to Sky News, she set out her top four priorities: "A, B, C, D — ambulances, backlogs, care, doctors and dentists".

She also pledged to do more on delayed discharges of patients, which prevents others from accessing hospital beds.

"There are actually thousands of people currently in hospital today who don't need clinically to be in hospital, that need that care for once they leave hospital," she told the BBC.

She said it was "critical" to focus on both social care and healthcare.

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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

Updated: September 07, 2022, 1:35 PM