Hospital chiefs have rolled out a raft of measures to tackle ambulance handover delays and long A&E waits.

University Hospitals of North Midlands carried out a 'change week' at the end of March with staff shifting to new ways of working aimed at speeding up the flow of patients.

Bosses said the evidence shows that creating capacity by moving on patients quickly is the best way of tackling UHNM's long-standing problems with A&E delays.

Ambulance handovers took one hour 15 minutes on average in February, the best performance since last September but still well above target – the NHS says handovers should take no longer than 45 minutes as a maximum.

Chief operating officer Katy Thorpe told a UHNM board meeting that while there had been 'teething problems' during change week, the new ways of working had now been embedded.

Actions have included improving frailty assessments and making better use of the discharge lounge – measures that managers know will have an impact.

Ms Thorpe said the challenge had been to apply all these actions on a consistent basis. She said: "The data shows that flow is the most important factor in terms of ambulance handovers, as well as the time patients spend in the emergency department.

"The focus has been on all different points on a patient pathway, all the way from the front door and our pathways through the emergency department itself, to try and speed up the flow of patients.

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"Frailty assessment have been amended. We're moving vulnerable adults with high priority score from the emergency department to be treated by vulnerable adults team earlier in their pathway

"It's fair to say there were some teething problems during that first week. If you ask the whole system to work differently you'll have to work through some issues. But we've seen some real change after that, and going into the strike action we've been able to maintain that way of working."

Ms Thorpe said the results of the new ways of working would be reported to the board at its next meeting in June. There will also be more data on the trust's use of 'escalation spaces' such as corridors, which is now being collected nationally by the NHS.

Chief executive Simon Constable said urgent and emergency care continued to be the trust's 'Achilles heel', and that consistently applying the new ways of working would be key.

He said: "It's less to do with the number of people presenting at our front door, and more to do with the subsequent flow through the organisation, which then becomes a massive team effort. Our strongest efforts have been when we've had high attendance and everyone has pulled together.

"There have been improvements. Ten of the last thirteen weeks have been better than this time last year. From where I'm sitting it certainly feels better. At this point last year we'd declared seven critical incidents – we declared two this winter. That's a very crude marker but it is positive.

"Clearly we're not satisfied with where we're at, we've still got a long way to go. But what it does show is what we're capable of doing when we do all of the right things consistently."