NHS England has today announced a new set of performance standards for English ambulance services.
Dr Bob Winter, East Midlands Ambulance Service (EMAS) Medical Director and a clinician who responds to 999 emergency calls said: “We welcome the announcement made today. It is clear that patient safety and patient care is at the heart of this change.
“In most 999 calls we know the best clinical outcome for patients is not about the fastest response by the nearest vehicle but the most appropriate one.
“The changes announced today have been called for by paramedics and ambulance crews, the people that care for and treat the most seriously ill in our communities, and the evidence from a trial involving over 14 million calls handled shows that the change gives the opportunity to save more lives.”
EMAS’ neighbouring service West Midlands Ambulance Service took part in the ambulance response programme trials. Its Chief Executive Anthony Marsh said: “Since introducing these changes, our ambulances are now reaching stroke patients a minute quicker than before, helping them get to hospital and receive vital treatment as rapidly as possible. Response times fell across all of our response categories during our involvement in the trial, and we have no doubt that implementing these changes has significantly improved the service we can offer our patients.”
The changes focus on making sure the best, most appropriate response is provided for each patient first time. They are designed to change the rules on performance standards so that they are met by doing the right thing for the patient rather than trying to ‘stop the clock’.
Under current standards life-threatening and emergency calls should be responded to in eight minutes.
Dr Winter added: “The current standards mean that we and other ambulance services often send more than one vehicle to get to the patient quickly and have the best chance of meeting the eight minute standard. This is inefficient, it is not good for patients and it is not good for staff morale and wellbeing.
“Changing the performance standards, which were set back in 1974, will free up more vehicles and staff to respond to emergencies. For stroke patients this will mean that instead of sending any vehicle that can get to them within eight minutes, eg a fast response car, we will send an ambulance which can take them to hospital to get the treatment they need.
“As we develop our Operations Model (which involves our staff skill mix and the number of ambulances and cars available) to match the new Ambulance Response Programme Model, more stroke patients will get to hospital or a specialist stroke unit quicker because the most appropriate vehicle will be sent first time.
“In addition, under the new system early recognition of life-threatening conditions, particularly cardiac arrest where the current national survival rate out of hospital is around 7%, would also increase because our call handlers are able to identify those patients in need of the fastest response.”
Following the announcement today, there will be four categories of call:
- Category one is for calls about people with life-threatening injuries and illnesses. These will be responded to in an average time of seven minutes.
- Category two is for emergency calls. These will be responded to in an average time of 18 minutes.
- Category three is for urgent calls. In some instances you may be treated by ambulance staff in your own home. These types of calls will be responded to at least nine out of 10 times within 120 minutes.
- Category four is for less urgent calls. In some instances you may be given advice over the telephone or referred to another service such as a GP or pharmacist. These less urgent calls will be responded to at least 9 out of 10 times within 180 minutes.
This redesigned system for ambulance services in England focuses on ensuring patients get rapid life saving, life-changing treatment, and is strongly endorsed by expert organisations such as the Royal College of Emergency Medicine, the Stroke Association, Association of Ambulance Chief Executives and the College of Paramedics.