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13.07.17

Major change to ambulance response targets revealed

New performance targets for ambulance services have today been announced as for the first-time national response targets will apply to every single 999 patient.

NHS England say that the new system could save the lives of 250 people per year, and put an end to the “hidden waits” that some patients, including the frail and elderly, are put through.

Now, call handlers will change the way they assess cases and have slightly more time to decide the most appropriate clinical response, meaning that cardiac arrest patients can be identified quicker.

The changes were hinted at back in March by NHS England as it was revealed that the current system was causing major inefficiencies to crop up.  

Under the new system, patients who are suffering serious life-changing conditions like a stroke will be given the care they need at the first point of call.

Previously, patients with severe issues could face a “hidden wait” as the vehicle sent to them, such as a bike or a car, was unable to transport them to A&E.

Ambulances will also now be expected to reach the most seriously ill people in an average time of seven minutes compared to the previous target of eight minutes, and the ‘clock’ will only stop when the appropriate response arrives on scene, rather than the first.

It is hoped this will free up vehicles, as at the moment three or four vehicles may be sent to the same 999 call to be sure of meeting their target – leading to one of four having to stand down before they reached their destination.

In addition, response time targets will now apply to all 999 patients, to change the fact that at present, half the calls received classed as “green” were not covered by a national target, and so these patients who were often old or frail were forced to wait for up to six hours for care.

Sir Bruce Keogh, NHS England’s outgoing national medical director, who commissioned the Ambulance Response Programme in 2015, said: “Patients across the country deserve to benefit from the significant improvements seen in the trial areas, from ambulances reaching cardiac arrests in London 30 seconds faster to the one minute improvement on stroke responses in the West Midlands.

“These changes, together with ambitious new clinical standards for heart attack and stroke patients, will end the culture of ‘hitting the target but missing the point.’ They will refocus the service on what actually counts: outcomes for patients.”

And Professor Keith Willett, NHS England’s medical director for acute care, said: “Our core priority will always be patient safety, but paramedics are rightly frustrated that under the current ‘stop the clock’ system they are frequently dispatched to simply hit targets. This has led to the inefficient use of ambulances, with the knock-on effect of ‘hidden waits’.

“These are changes which have been called for by paramedics, and the evidence shows that they will save lives.”

Chair of NHSCC’s National Ambulance Commissioners Network (NACN) Yvonne Rispin said that the shift from focus on time-based targets to an emphasis on a patient’s clinical need was the right way forward.

“This change is an important step in enabling the ambulance service to provide patients with the best care possible, within an appropriate timeframe, while also making the most effective use of its resources in the face of rising demand,” she stated.

The Royal College of Emergency Medicine (RCEM) added that extending the time call handlers took to assess the patient was sure to allow for a better diagnosis of the problem without reducing the speed of response to those in need of urgent medical attention.

The organisation’s president Taj Hassan said: “Response times will be more appropriate according to the patient’s need, and trials have suggested that ambulances could arrive up to three minutes quicker to the most serious incidents – time which can make the difference between life and death. 

“By using the new system nationally, NHS England have calculated that there will be up to 14,500 occasions each week in England where an additional ambulance is freed for response to the most serious of cases, which will ensure that those in most need get to an emergency department quicker.”

Top Image:  Peter Byrne PA Wire

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