The Association of Ambulance Chief Executives (AACE) has played a pivotal role in the development of new national ambulance response standards which were announced by NHS England today – 13 July 2017 – and are designed to ensure that the most suitable high-quality response is delivered to every patient in an appropriate clinical timeframe.
The introduction of these new standards, which have been rigorously tested on some ten million 999 calls, recognises that many of the patients the ambulance service currently tries to reach in eight minutes do not actually derive a clinical benefit from a response in that timeframe. The new system allows the ambulance service to concentrate on providing an even faster response to those patients who are truly life-threatened whilst also reducing the transport delays for all other categories of patients.
The new system also gives the ambulance control room call handler vital extra minutes to assess the level of clinical response a patient (who is not immediately life-threatened) may need more accurately before deciding on the most appropriate resources to send to that patient, meaning that ambulance resources are then more likely to be available for people with very serious conditions – such as those in cardiac arrest.
The new system introduces a new pre-triage set of questions designed to identify those patients in need of the fastest response even earlier than occurs at present. In calls which are not deemed immediately life threatening it also gives 999 call handlers up to 180 seconds longer to get all the information they need from a person making a 999 call before deciding on the right type of response. This is called Dispatch on Disposition. At the same time, a new evidence-based set of clinical codes has been introduced into ambulance control systems that better match the patient’s presenting condition with the most suitable ambulance response requirement.
For the most serious calls, where every second counts, ambulances continue to be dispatched immediately. This group of patients will now be designated ‘Category 1’ and contains almost double the number of patients who were in the original top ‘Red 1’ category, thereby ensuring that all those patients with a life-threatening emergency continue to receive the fastest possible response.
AACE Managing Director Martin Flaherty OBE says:
“The introduction of the new ambulance response standards is positive for patients and ambulance services alike. Our control room staff and paramedics out on the road have welcomed the new system which has been developed with significant input from senior ambulance clinicians. We know it is safe because it has been rigorously tested using over ten million 999 calls, with no safety concerns.
We can also see clearly how the quality of care will improve for all patients because the new standards will mean greater availability of our limited resources, especially for those with life threatening conditions who need us there fastest. It is a common-sense approach that is long overdue and AACE is pleased to have played a significant role in its introduction.”
The demand for ambulance services is at an unprecedented high and is increasing at a rate of more than six per cent each year, which is placing considerable strain on ambulance services and their staff, leading to some long delays for patients – particularly those who have less serious conditions. The new system enables ambulance services to be much more stable and efficient and therefore able to provide a better service for all patients whatever their clinical condition. Ambulance services will also be better placed to manage unexpected events and peaks in demand, such as major incidents or adverse weather.
The new response standards were extensively piloted in ambulance services during an initiative known as the Ambulance Response Programme (ARP) which was independently evaluated by Sheffield University in what has been the largest study of its kind ever completed anywhere in the world. They concluded that ARP was safe and works more effectively than the old system, delivering benefits for all patient groups.
Adds Martin Flaherty:
“We are delighted that the new system will now be implemented nationally and we are sure that it will deliver benefits for our patients and our staff going forward. We will work closely with NHS England to ensure its smooth introduction across all English ambulance services in the coming months.”