To ask the Minister of Health to detail (i) the number of ambulance staff vacancies; and (ii) the number of ambulance operational hours that were lost due to hospital handover delays, in the last 12 months;, and (iii) any plans in place to reduce this figure.

I acknowledge the outstanding dedication of staff in the Northern Ireland Ambulance Service (NIAS). These professionals deliver a high-quality service under extremely challenging circumstances, often supporting people at the most critical moments of their lives.

My Department is working with NIAS to ensure sufficient ambulance and staffing capacity to meet Category 1 and Category 2 response time standards. An independent review of the NIAS Clinical Capacity and Demand has just been completed, and this will inform the service model in the future. NIAS are finalising an implementation plan, and some of the key strands - including the development of the advanced paramedic role - have already commenced, with the first 15 staff having started their training in Autumn 2025. As part of this commitment, my Department has increased the number of paramedics on the Degree Programme from 50 to 65.

The number of current NIAS staff vacancies, as at 23 January 2025, is shown below.

Table 1

The number of lost operational hours, due to handover delays, for the period 1 January 2025 – 31 December 2025 (12 months) is shown in the table below.

Table 2

Reducing ambulance handover delays at emergency departments (EDs) is a key priority due to the impact on NIAS’ ability to respond to calls in the community. The importance of timely ambulance responses was highlighted in the Getting It Right First Time (GIRFT) Review of Emergency Medicine.

Average and longest ambulance handover waits were lower in 2025/26. It should be acknowledged that there was an early and significant flu season with cases starting to increase in November 2025 and peaking in the first week of December. Flu cases remained high throughout December with episodes higher than 2024/25. Seasonal peaks in respiratory illness will inevitably place additional pressure on hospitals.

Vaccination rates, especially for those over the age of 65 (72.4%) and in care homes (79.3%) were good. Additional support has also been provided to care homes by Trusts in the administration of antivirals to residents where flu outbreaks occurred. This intervention is aimed at reducing admissions from care homes.

Ambulance handover delays are influenced by system-wide pressures, particularly during periods of high demand. The recent flu surge contributed to increased hospital admissions and reduced bed availability, which in turn affected the ability to offload patients promptly at EDs.

Reducing ambulance handover delays is a key priority for my Department, as prolonged delays impact NIAS’ capacity to respond to calls in the community. To address this, my Department and the Trusts have implemented a range of measures, including:

New ambulance handover guidance is being developed with Trusts and NIAS, aiming to eliminate delays exceeding two hours and progressively reduce shorter thresholds;

Targeted investment to improve patient flow, including additional short-stay and intermediate care beds, expansion of Same Day Emergency Care pathways, and enhanced discharge coordination;

Hospital at Home services and community-based care initiatives to reduce admissions and free up capacity in acute hospitals; and,

An integrated clinical hub within NIAS to provide clinical triage and alternative care pathways, reducing unnecessary conveyances to EDs.

These actions are part of a wider Unscheduled Care Improvement Plan designed to improve system flow and ensure timely access to emergency care.