West Midlands Ambulance Service is now facing the worst level of hospital handover delays in the country "by some margin", bosses have revealed.

In October alone, ambulance crews lost 41,000 hours waiting outside hospitals across the region to transfer patients, Staffordshire county councillors have been told, and the number of lost hours has more than doubled in recent months.

In November 2023 the service called for an independent review of resources in a bid to improve its performance.

Members of Staffordshire County Council's Health and Care Overview and Scrutiny Committee backed this call at the time – and a fresh review plea was made by senior members of the service at Monday's committee meeting (November 10).

Two years ago the committee heard that the service covering Staffordshire and Stoke-on-Trent was failing to meet response time targets.

Since then improvements have been seen, but hospital handover delays are having an impact, councillors were told on Monday.

Vivek Khashu, strategy and engagement director at West Midlands Ambulance Service (WMAS), said: "The main target we are responsible for achieving is category 2 response times. That represents about two thirds of our workload and category two calls are things like strokes and heart attacks. 

"Last year we just got under the 30 minute threshold and we delivered 29 minutes and some seconds. I'm pleased to say to the committee we've managed to sustain that this year and improve it since – the target we've been given by NHS England is for us to deliver 28 minutes.

"At the minute we are at 23 minutes year to date. However that's under some pressure as the time we have been gaining is now beginning to erode as we get into winter.

"Three months ago it was 21 minutes and we've been losing a minute on our year to date performance every month. The amount of times ambulances are spending at hospitals is rising."

WMAS has been experiencing a "steep curve" in the number of hours lost to handover delays at hospitals in the past three months, Mr Khashu told councillors. He said: "In October it was 41,000, the month before that was 31 and the month before that 20. 

"It's quite a difficult period – not just in terms of performance but what that means to patients and to our staff.

"Whilst we may still be getting to patients in a reasonable timeframe most of the time, that doesn't help the patient stuck in an ambulance for five, 10 or 15 hours outside a hospital, maybe being moved around four times between ambulances outside the hospital – it's not a good experience at all for them.

"We have what is the worst handover delays in the country by some margin if our handover delays equal that of North East Ambulance Service, South Central Ambulance Service, South East Coast Ambulance Service, North West and London Ambulance Service added together. There's only 10 ambulance services in the country so it's pretty bad

"How have we mitigated that? We've put in a huge amount of additional resources.

"We've put in over the last 18 months what amounts to £30m additional frontline resource to offset the time that ambulances are spent at hospitals. It's the only thing that we can realistically do that's in our control."

The Staffordshire and Stoke-on-Trent system was described as one of the most pressurised systems for the service.

Of the 41,000 lost hours in October, 8,500 of those were in Staffordshire and Stoke-on-Trent and primarily at Royal Stoke University Hospital, the committee was told.

Mr Khashu said: "The NHS in its planning guidance earlier this year mandated hospitals to deliver a maximum handover wait of 45 minutes. That is not occurring here or anywhere in the West Midlands, perhaps with the exception of South Warwickshire who manage to maintain that standard most of the time.

"Perhaps 2,200 patients didn't meet that standard in October alone. Every month we have thousands of patients not being handed over within the time the NHS requires us to do."

Stafford councillor Ann Edgeller said: "We all care about the health of our constituents. Is there anything you feel we could do to help you in your situation?

"If you haven't got your health, you've got nothing."

Mr Khashu responded: "We appreciate the support because that is what we are all here for. One thing we have previously asked for, which the committee did support but between the six integrated care boards it wasn't, was an independent capacity review.

"We want an independent capacity review so we can establish what resources are required where, independently of the NHS. We could come up with it, but we would always be accused of trying to feather our own nests by enriching ourselves with resources – we don't want to do that.

"The other thing is a very basic ask, and is for the committee to scrutinise performance and delivery against NHS operating standards and frameworks.

"If we were all performing against it and delivering it, we would all be serving each other really well – performance and patient safety are inextricably linked.

"There's 10 ambulance services and what's going on in the West Midlands equals five others added together. If you added East Midlands Ambulance Service to West Midlands Ambulance Service, we are half the country's delays.

"It doesn't have to be this bad because it's not this bad everywhere else. Everywhere else has the same issues of frailty, resource constraints and everything else and the West Midlands is not different to other parts of the country.

"Whilst variation at one level is painful, it does show us that other parts can do it, so we can conceivably here as well."