Ambulance Delays

We regularly receive complaints that patients have had to wait an unacceptable length of time for an ambulance to arrive after calling 999.  The NHS is under significant pressure and as a result it is unfortunately inevitable that some patients will have to wait longer than they would like for an ambulance.  This factsheet sets out our approach to complaints about ambulance delays and the factors we will take into account when deciding whether to investigate a complaint, and if we do investigate it, the circumstances where a complaint may be upheld.

It is important to bear in mind that the causes of ambulance delays are not always fully within the control of the Welsh Ambulance Services NHS Trust (“WAST”) which provides the ambulance service in Wales.  Sometimes, there are no ambulances available for WAST to send to new calls because they are waiting outside hospitals as there is no capacity within the hospital to admit the patients who are currently in those ambulances.  Where this situation applies, we will take it into account in reaching a decision.

While each case is determined on the individual facts, we are more likely to investigate and uphold your complaint in the following circumstances:

• There is evidence to suggest that there were ambulances available to send to the call, but this was delayed due to the call being wrongly categorised by WAST, and this delay caused clinical harm to the patient.
• There is evidence to suggest that the call was correctly categorised, there was an ambulance available to send to the call, but WAST wrongly failed to allocate the ambulance to the call, and this delay caused clinical harm to the patient.
• Where there is evidence to suggest that there were no failings on the part of WAST, but there were no ambulances available to send to the call due to them being held outside hospitals, and there is evidence the delay caused clinical harm to the patient, we are unlikely to uphold a complaint against WAST as the reasons for the delay were outside its control. However, we may need to consider instead the actions of the relevant Health Board and whether it took appropriate actions to manage the pressures in its hospital(s) to release ambulances to attend calls.

While each case is determined on the individual facts, we are unlikely to investigate and uphold your complaint in the following circumstances:

• There is no evidence that any delay caused clinical harm to the patient, notwithstanding that the delay may well have been distressing for the patient and/or their family.
• The evidence suggests that the relevant health board and WAST applied all relevant policies/procedures to address capacity issues in the relevant hospital(s), however, demand was such that even with all the measures being taken, there were still no ambulances available to send to the call.

The resources allocated to WAST and the wider NHS are political matters for the government to decide.  We are unable to recommend that more resources are allocated to WAST or the health boards.

We will need to judge whether the treatment/care provided was of an appropriate standard and bearing in mind the setting in which it was being provided. For example, care provided in a general hospital would not be judged against the standards that would apply in a specialist unit. More information can be found on the Clinical Standards page, under the ‘For Service Providers’ tab.

Under Putting Things Right (“PTR”), WAST must consider if the person making the complaint (or the person they represent) has suffered harm due to it failing in its duty of care.  If WAST considers that this is the case, it may offer you redress. This might include remedial treatment or financial compensation. Please note that we cannot refer a complaint back to the PTR process once we have started an investigation. If you want your complaint to be considered under PTR, you must do this before asking us to investigate your complaint.

Llais can provide free help and support with making your complaint. You can contact them via their helpline on 02920 235 558. 

Examples of cases that we have looked at can be found on our website, under the ‘Publications’ tab on the Our Findings page.

If you are unsure whether we would be able to look into your complaint, please contact us on 0300 790 0203 or ask@ombudsman.wales

Also available in Welsh.