NHS set new 999 performance targets for ambulance service

Inappropriate calls received by EMAS in April included a woman who had lost her credit card.

Ambulance services have been given a new set of four performance targets for responding to calls.

NHS England has today (Thursday, 13 July) announced a new set of performance targets for the ambulance service which will apply to all 999 calls for the first time. It now means that are four categories of call, designed to ensure the best and most appropriate response gets to each patient first time.

The changes have been welcomed by East Midlands Ambulance service chiefs who say they have patient safety and care at the heart of them.

Category 1 is for calls about people with life-threatening injuries and illnesses. These will be responded to in an average time of seven minutes.

Category 2 is for emergency calls.

These will be responded to in an average time of 18 minutes.

Stroke patients will get to hospital or a specialist stroke unit quicker because the most appropriate vehicle can be sent out first time.

Category 3 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 9 out of 10 times before 120 minutes.

Category 4 is for less urgent calls.

In some instances patients 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 before 180 minutes.

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’.

Uder 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 seven per cent, would also increase because our call handlers are able to identify those patients in need of the fastest response.”

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