Patients to benefit from changes to 999 system and new quality of care measures

More than one million people across London who dial 999 will from now on see the care they receive judged on its quality, not just how quickly ambulance staff arrive to treat them.

New clinical quality indicators, which are intended to help better assess how ambulance services perform, came into effect today (1 April). They include the survival rate of people who collapse and stop breathing and the recovery rate of patients suffering heart attacks or strokes (a type of brain attack). Another measure will be patients’ overall experience of using their local ambulance service.

As part of the changes introduced by the Government, the time-based target to reach people in a non life-threatening condition (Category B calls) has been removed.

In London, from 19 April these and other less serious calls will be put into one of four new categories so that they can be responded to in the most appropriate way, with the time of the response to still be monitored.  

The target concerning the response to patients in a potentially life-threatening condition will remain in place – and the latest figures show that in the capital more of these incidents are being reached more quickly than ever before.

The Service achieved the Government’s target of attending 75 per cent of these Category A calls within eight minutes for the eighth year in a row in 2010/11.

Director of Operations Richard Webber said: “We know that the speed with which we reach patients is important, and people who are critically ill or injured will still receive the same fast response. We will also continue to quickly respond to anyone in a less serious condition who needs our staff to attend them.”

“The changes that are being introduced are building on some of the systems we already have in place, enabling us to better respond to those who might not even need an ambulance or to go to hospital, and focus more on the quality of care being provided to them. This could include giving them advice over the phone or referring them to their GP or a walk-in centre. The most important thing is that patients are cared for in the right place, at the right time and by the right person or people.”

Key changes coming into effect this month:

  • As of today (1 April), eleven new clinical quality indicators are being introduced to help patients and the public better assess how ambulance services are performing:
  1. Outcome from acute ST-elevation myocardial infarction (STEMI – a type of heart attack)
  2. Outcome from cardiac arrest – return of spontaneous circulation (having a pulse/heartbeat)
  3. Outcome from cardiac arrest – survival to discharge
  4. Outcome following stroke for ambulance patients
  5. Proportion of calls closed with telephone advice or managed without transport to A&E (where clinically appropriate)
  6. Re-contact rate following discharge of care (i.e. closure with telephone advice or following treatment at the scene)
  7. Call abandonment rate
  8. Time to answer calls
  9. Service Experience
  10. Category A 8 minute response time
  11. Time to treatment by an ambulance-dispatched health professional
  • Also as of today, the time-based target to reach people in a serious but not immediately life-threatening condition (Category B calls) within 19 minutes has been removed.
  • From 19 April, all non life-threatening calls to the Service will be put into one of four categories, and patients in the first two of these will still be attended by ambulance staff in either 20 or 30 minutes, depending on their condition.
    Those patients in the other two least serious categories could in the first instance be offered advice over the phone by trained ambulance staff or NHS Direct, as happens for some callers now. They could then be referred to their GP or a walk-in centre, or sent an ambulance if it is decided they need one.

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Notes to editors:

  • For more information, please contact the Communications Department on 020 7783 2286
  • During 2010/11, more than 1,500,000 emergency calls were received and more than 1,057,000 incidents responded to.  These included over 260,700 Category A patients  (assessed from information received as being serious or immediately life-threatening) reached within eight minutes, up five per cent on last year.