East Midlands Ambulance Service (EMAS) has revealed its latest performance figures, shedding light on the significant challenges faced during one of its busiest periods in history.
The Integrated Board Report, which will be presented to the Trust Board on 14 January 2025, highlights critical pressures, including soaring demand, prolonged response times, and the strain on workforce capacity.
December 2024
December marked the second busiest month ever recorded by EMAS, with over 93,000 incidents reported. The month also saw the second-worst hospital handover delays, with over 25,400 hours lost — equivalent to 68 twelve-hour ambulance shifts every day. The average pre-handover time reached 55 minutes, more than three times the national target of 15 minutes, with Northamptonshire reporting delays of up to 1 hour 25 minutes.
Performance
Despite deploying additional resources, including private ambulance services and overtime shifts, performance targets were missed across all key categories:
Category 1 (Life-threatening emergencies): Average response time was 9 minutes and 39 seconds, exceeding the 7-minute target.
Category 2 (Emergency conditions): Mean response time rose to over 66 minutes in December, well above the 30-minute national target. Year-to-date performance also increased to 44 minutes.
Categories 3 and 4: Severe delays persisted, with some patients waiting over 11 hours in
Category 3 and over 15 hours in Category 4 emergencies.
The Impact on Patient Safety
The pressures have also affected patient safety:
Incidents: In November, 866 incidents were reported, with 310 classified as Patient Safety Incidents (PSIs). Breaches of Minimum Care Safety Standards (MCSS) rose to 426 cases in December.
Clinical Outcomes: Resuscitation Bundle performance outperformed the national average, but other metrics, such as Return of Spontaneous Circulation and Survival to 30 Days, remained stable amid operational challenges.
Staffing
The workforce remains under strain as sickness absence reached 8.1% in December, rising steadily since August. Appraisal compliance fell short of targets, with only 86.9% of frontline staff and 64.4% of non-frontline staff completing statutory training. Efforts to support staff include targeted wellbeing initiatives and increased recruitment drives.

EMAS has outlined a three-pillar strategy to address performance challenges:
Increasing Capacity: Additional recruitment, extended shifts, and enhanced fleet availability.
Managing Demand: Improved triage processes and reducing unnecessary hospital conveyances.
Supporting Staff: Enhanced health and wellbeing programmes to mitigate sickness rates and improve morale.
Environmental Progress
EMAS exceeded its year-to-date emissions reduction targets. Increased use of electric vehicles contributed to a reduced carbon footprint, aligning with the Trust’s goal of achieving net-zero emissions by 2040.
The challenges faced by EMAS mirror those across the NHS as the healthcare system navigates post-pandemic recovery and increasing winter pressures. The national Urgent and Emergency Care Recovery Plan, launched in 2024, aims to reduce response times and improve outcomes, but achieving these targets remains a work in progress.
The Trust has reaffirmed its commitment to continuous improvement and collaboration with healthcare partners to better serve the East Midlands community.