Hospital Handovers - A 90 Day Improvement Collaborative

  • There were 423,556 ambulance attendances to hospital in England in December 2017 and 14% resulted in handovers longer than 30 minutes.
  • There were more than 700,000 ambulance attendances to hospital in the North West in 2018, with average weekly handover turnaround time of 33 minutes.
  • In 2018 95,126 hours were lost in the North West due to handovers that took longer than 30 minutes.

Collaborative solution

Six hospitals and local NWAS partners agreed to work together for 90 days to improve the hospital handover process, reducing handover times and lost hours. The collaborative aim was to reduce daily average hospital handover time across the six teams to 20 minutes by March 2019.

90 days of improving

Using quality improvement (QI) methodology and supported by organisational and QI leaders, the six sites developed local project teams of key NWAS and hospital staff (consultants, nursing staff, HCAs, hospital managers, porters, ambulance paramedics, ambulance consultants, senior leaders, improvement professionals etc) to create a firm understanding of the local hospital handover process, develop change ideas to improve the process and test and re-test improved and new ways of working. These teams met together for four separate one-day events to share the work they had undertaken locally and to collaboratively develop ideas and tests of change driven by data (see Fig. 1). This was complemented by regular collaborative data packs and an executive site visit to each of the participating hospitals involving hospital and NWAS senior leaders.

You can read about improvements achieved in ‘Tackling the challenge of safe and efficient handover – A 90 Day Improvement Collaborative’ booklet - available to download in the box on the right.


Delivered in partnership with:

  • Aintree University Hospital NHS Foundation Trust
  • Wrightington, Wigan and Leigh NHS Foundation Trust
  • Wirral University Teaching Hospital NHS Foundation Trust
  • Lancashire Teaching Hospitals NHS Foundation Trust
  • East Lancashire Hospitals NHS Trust
  • Blackpool Teaching Hospitals NHS Foundation Trust
  • NHS Blackpool Clinical Commissioning Group
  • NHS Improvement
  • NHS England