An ambulance trust is “not assured” the 45-minute limit on hospital handovers can be consistently delivered this winter, after repeated requests from hospitals to “pause” it.
East Midlands Ambulance Service Trust’s winter plan, presented to its board last month, says support is needed for “a zero tolerance to pausing the process”, given “current requests for pauses”.
Under the “release to respond” protocol, crews hand over their patient and leave after 45 minutes at hospital. NHS England’s urgent and emergency care plan for 2025/26 said the maximum, which 17 trusts were missing last summer, should “now be delivered without exception, including in the winter months”.
Anna Parry, managing director of the Association of Ambulance Chief Executives, said: “There may be exceptional circumstances in which the protocol needs to be temporarily paused or suspended, for example where there are specific clinical safety concerns, during a declared incident or where there is exceptional system failure. However, these should be strictly governed, escalation-based exceptions, agreed between ambulance and acute trusts, rather than becoming a routine response to operational pressure.”
She said any suspension should only be considered after actions to reduce pressure within the hospital had been exhausted.
Sarah Noonan, chief operating officer of University Hospitals of Northamptonshire, the group formed by Kettering General and Northampton General, said: “Only when our emergency departments and inpatient services are at full capacity may we need to temporarily hold ambulance crews, while recognising the impact this can have on patients waiting for an ambulance in the community.”
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Source: HSJ, 8 October 2026
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