First reported 20 Apr 2016•Latest report 6 Jan 2026
Definition
What this concern includes
Includes protocols and operational arrangements for clinical escalation, expedited response, alternative emergency-service assistance and maintenance of safe emergency coverage when ordinary ambulance allocation is inadequate.
Not included
Ordinary ambulance response delays or capacity shortages where escalation and contingency controls are reliable
Hospital handover and treatment after an effective response
Other agencies' internal failures after a clear and appropriate assistance request
Reports
5
Distinct published reports
Individual concerns
7
A report can raise multiple concerns
Date range
2016–2026
First to latest report issue date
Stated actions
8
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Department of Health and Social Care2
Welsh Ambulance Services NHS Trust2
Welsh Government2
Cheshire Constabulary1
Cheshire Fire and Rescue Service1
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust1
Daughter of the deceased1
East Midlands Ambulance Service NHS Trust1
Healthcare Inspectorate Wales1
Lincolnshire Police1
NHS England1
North East Ambulance Service NHS Foundation Trust1
Northumbria Police1
North West Ambulance Service NHS Trust1
Office of the Chief Coroner1
NHS trust5
Police force3
Devolved government2
Ministerial department2
Coronial office1
Executive non-departmental public body1
Fire and rescue service1
Health and care inspectorate1
Type not available1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Greater Lincolnshire
Concerns raised1
Lack of an ABD protocol between police forces and the local ambulance service
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
Action
Work with EMAS and the Clinical Governance Forum to implement an ABD joint-working policy.
Stated by Lincolnshire PoliceStated in progressThe respondent said that this action was in progress when they made their response on 8 January 2026.
Action
Share learning from the coronial process with EMAS to support ABD guidance development and implementation.
Stated by Lincolnshire PoliceStated completedThe respondent said that this action was complete when they made their response on 8 January 2026.
Action
Work with EMAS and Forum partners to develop and align ABD practices and training, including response times and restraint practices.
Stated by Lincolnshire PoliceStated in progressThe respondent said that this action was in progress when they made their response on 8 January 2026.
Action
Continue participating in the Police Regional Clinical Governance Forum to align ABD training and response protocols.
Stated by East Midlands Ambulance Service NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 8 January 2026.
Action
Continue working with regional police forces and health partners to explore a single joint operational framework for ABD management.
Stated by East Midlands Ambulance Service NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 8 January 2026.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
East Midlands Ambulance Service is responsible for responding directly to the concerns and revising relevant clinical presentation protocols with system partners.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
EMAS is responsible for leading the joint ABD policy because the medical response is a crucial element and EMAS is best placed to lead.
Stated by Lincolnshire PoliceRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Gwent
Concerns raised1
Ad hoc clinician intervention to expedite ambulance responses without local policy or guidelines
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Action
Conduct secondary triage of waiting patients, including Amber 1 calls, through the Clinical Support Desk to reassess or confirm priority.
Stated by Welsh Ambulance Services NHS TrustStated completedThe respondent said that this action was complete when they made their response on 24 January 2023.
Action
Use welfare calls and Clinical Support Desk procedures to reassess waiting patients and upgrade calls when clinical conditions or prolonged waits warrant it.
Stated by Welsh Ambulance Services NHS TrustStated completedThe respondent said that this action was complete when they made their response on 24 January 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Operational concerns about ambulance service delivery are best addressed by the Welsh Ambulance Services Trust.
Stated by Eluned MorganRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Gateshead and South Tyneside
Concerns raised1
Lack of a protocol enabling personnel to initiate responses beyond ambulance allocation
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Cheshire
Concerns raised2
Lack of provision to provide updates to other emergency services during significant ambulance delays
Lack of provision to utilise other emergency services during significant ambulance delays
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
South Wales Central
Concerns raised2
Lack of clear planning and direction for maintaining and delivering ambulance services
Failure to maintain ambulance service delivery during significant call volumes
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Develop an action plan addressing the Regulation 28 improvement requirements.
Stated by Welsh Ambulance Services NHS TrustStated completedThe respondent said that this action was complete when they made their response on 20 April 2016.
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Includes protocols and operational arrangements for clinical escalation, expedited response, alternative emergency-service assistance and maintenance of safe emergency coverage when ordinary ambulance allocation is inadequate.
