28 May 2026
More than half of Emergency Department Clinical Leads in Northern Ireland believe a new ambulance handover policy is increasing overcrowding in A&Es – a situation RCEM says is ‘extremely dangerous’.
It comes as RCEM’s Vice President in Northern Ireland, Dr Michael Perry, appeared in the Northern Ireland Assembly today (28 May 2026), in front of the Committee for Health, to talk about the state of Emergency Medicine in the country.
During his evidence, he referred to a snap survey RCEM conducted between 21- 26 May, asking department clinical leads – who are doctors responsible for patient safety in A&Es – a series of questions aimed at capturing the impact of the government’s new ambulance handover directive.
It mandates that patients are offloaded within two hours of arrival at an Emergency Department, regardless of capacity on site.
In total, representatives from all nine EDs across Northern Ireland responded.
The results revealed:
- Over half of the Clinical Leads (5 of the 9 EDs) stated that the handover policy has improved handover times but has increased overcrowding within the department.
- The feeling among some clinical leads was that this policy has been created and implemented without the consideration of ED staff.
- 8 Clinical Leads said safe and effective handovers of patients are being followed.
Dr Michael Perry, RCEM Vice President for Northern Ireland said: “Our ambulance colleagues are working extremely hard, as we all are, to ensure a patient’s arrival into A&E happens in a timely and safe manner.
“The Government’s ‘release to rescue’ policy aimed to speed up ambulance handovers at Emergency Departments, and our survey of clinical leads suggests that, by and large, the policy is working – patients are arriving at EDs safely via ambulance.
“However, the departments they enter are overcrowded and far beyond capacity.
“When this policy was announced, we warned that it might make ED overcrowding worse, and it is now clear this has proven to be the case
“Overcrowding in EDs is dangerous, inefficient and leads to compromises in patient care. When departments are overcrowded, the sickest patients are more likely to deteriorate, or even lose their lives.
“Ultimately, this policy has, as we feared, put patients at risk – the opposite of what it was intended for.”
The survey also found that most clinical leads felt more focus should be on patient flow through the hospital system, particularly ‘exit block’. This is when inpatient beds are occupied by patients medically fit to leave but who cannot be discharged, often due to a lack of social care.
Clinical leads also mentioned a lack of existing capacity throughout the system, and the potential of ‘release to rescue’ to make this worse.
Dr Perry said: “Once again, policymakers have put their focus in the wrong place. The ‘back door’ of our hospitals is what needs the attention.
“If exit block is tackled, patient flow would be substantially improved and the dangerous overcrowding – that this policy is making worse – would be addressed.”