Transforming NHS ambulance services
Department of Health
Description:... The Department of Health has until recently been focusing on speed of response as a measure of performance of the ambulance service, rather than on clinical outcomes for patients. The ambulance service achieves high levels of public satisfaction but there are wide variations in ambulance trusts' efficiency and the NAO concludes that the system has not delivered the best value for money to date. The 8-minute response target, intended for the most seriously ill patients, is one of the most demanding in the world. However, its application has skewed ambulance trusts' approach to performance measurement and management. The target is also applied to a much wider group of patients than intended. The report identifies various inefficiencies in the system, with cost per incident varying between £176 and £251. There is scope across the urgent and emergency care system to make more of different ways of responding to patients, such as clinical advice to callers over the phone and taking patients to minor injuries units rather than A&E departments. If all 11 trusts adopted the best practice currently being used in at least one trust, the NHS could save £165 million a year. The elements of the emergency care system are not yet fully integrated and this leads to delays in turnaround times at hospital A&Es. Over one-fifth of patient handovers take longer than the recommended 15 minutes. The new clinical quality indicators introduced from April offer the potential for a fuller measurement of performance based on outcomes.
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