Dear Mr Charles,

I am writing to you in response to the concerns that you highlighted to the Trust following the inquest hearing into the sad death of Liliane Andree Bowden that concluded on 24th October
2025. Thank you for providing us with the opportunity to respond to your concerns.

At the outset I would like to offer my personal condolences to Mrs Bowden’s family and friends.

To confirm, your Regulation 28 report relates to concerns regarding delays that the ambulance service experience when ambulance crews are handing over patients at local hospital Trusts and the impact this has on our ability to respond to patients waiting in the community. Your officer confirmed that you did not issue a report to the local hospital Trust because you wanted to receive a full appraisal of the difficulties SCAS and more importantly, patients face upon arrival at Queen Alexandra Hospital.

It is regretful that a Regulation 28 report was issued to this Trust when the source of the concern relates to a different organisation, and it is they who ultimately have the power to take action to resolve the concerns. Moving forward, we would be grateful if HM Coroner could write to the appropriate organisation in line with paragraph 9 of Chapter 16 of the Chief Coroner’s Bench Book.

Response to concerns

HM Coroner will be aware that the issue of ambulance response times being affected by hospital handover delays is not a matter that is isolated to Hampshire. In response to the problem, in January 2023 NHS England asked London hospitals to support the timely handover of patient care and the release of ambulance crews from London Ambulance Service within a maximum of 45 minutes where it is safe and appropriate to do so.

South Central Ambulance Service is commissioned by 2 Integrated Care Boards (ICB); Buckinghamshire, Oxfordshire and Berkshire ICB and Hampshire and Isle of Wight ICB. In September 2024 both ICB’s agreed that they would also implement the now nationally recognised process of “Release to Respond” in their respective geographical areas. This process was fully implemented in all hospitals in Hampshire by the end of 2024 and resulted in significant improvements in our response times to patients waiting in the community.

2 To demonstrate the impact of the “Release to Respond” process, in September 2024 our ambulance crews spent over 4,072 hours waiting longer than the 15 minute national target to handover patients at Queen Alexandra Hospital alone and over 8,224 hours at all hospitals within the geographical area we cover. By September 2025 the figure for Queen Alexandra Hospital had fallen significantly to just under 319 hours and the total for all hospitals was just over 2,538 hours. To evidence the effect the reduced wait times at hospitals, among other initiatives, has had on our ability to attend to patients in the community, despite nearly 1,000 extra incidents taking place in the month of September 2025 compared to September 2024, we reduced our Category 2 response times by over 8 minutes. HM Coroner has asked for details of difficulties the Trust experiences when arriving at Queen Alexandra Hospital. Like all the acute hospital Trusts in our area, we maintain effective working operational relationships with senior teams at Queen Alexandra Hospital and good professional relationships at all levels between our organisations, including the Chief Executives who have worked together with system partners to reduce the amount of time ambulances are delayed handing over their patients. This includes operational leaders working closely together face to face at the Emergency Department and participating in regular operational tactical calls during times of increased demand. The Trust is extremely grateful to our Acute Trust Partners for their continued willingness to work together for the benefit of our mutual patients. The SCAS and PHT CEO’s jointly presented the work our teams had carried out to the Association of Ambulance Chief Executives to showcase the excellent achievements in reducing handover delays. Each year we are required to submit an annual plan to NHS England on how we will deliver our services. For 2025/26, our plan included average handover times at hospitals across our geography. Each hospital was asked to sign up to the improvement and for the year to date we have delivered on or below plan across our region. There is a requirement within the next 3 years for all hospitals to reach the 15 minute handover target and have not delay over 45 minutes. We will continue to work with all hospitals to deliver these targets and we will submit our plan to NSHE in February for 26/27. Commissioning HM Coroner may find it useful to understand the response targets we have been commissioned to provide. I have enclosed a table providing details for this financial year with this letter. I hope that this letter has adequately addressed the concerns that you have raised. Should you wish to discuss these matters further, please contact Jennifer Saunders, Head of Legal Services at SCAS who will be able to facilitate this.