The Department of Health is considering adding up to a minute to the ambulance response time target for life-threatening calls in an attempt to use resources more efficiently.
Ambulance services want to see the category A target – which requires such calls to be attended within eight minutes – altered to give call handlers more time to triage the call and identify the most appropriate response.
Currently two or more vehicles are dispatched as soon as a call is received. The clock starts before it has been established whether a blue light response is necessary. Earlier this year a report by the National Audit Office found more than two million ambulances had been dispatched unnecessarily in 2009-10.
In a speech to the Ambulance Service Network’s annual conference, health minister Simon Burns told delegates the government was committed to removing clinically unnecessary targets and was looking at how the eight-minute target could be modified.
He said: “I can understand the reasoning that you balance the best use of resources with the safety of the most critically ill patients. The department is looking at this and will make a decision in due course.”
Association of Ambulance Service Chief Executives director Steve West said the situation was wasting cash resources and affecting staff morale, with crews sometimes spending a whole shift being repeatedly called out and sent back again.
The association argues only cardiac arrests, which account for about 1 per cent of calls, are truly time critical in the sense that arriving seconds earlier could make a significant difference to patients. It would like the clock to start once the chief complaint has been identified, up to a maximum of one minute after the call is received.
Since April, ambulance services have been measured on their survival rates for cardiac arrest patients in an attempt to incentivise them to improve patient outcomes and pathways.
Mr Burns also addressed concerns that leaving the commissioning of ambulance services to clinical commissioning groups could lead to fragmentation.
He said: “[I’m sure] CCGs will make the right decisions for their communities. That includes adopting a lead commissioner model to commission things like ambulance services.”
Ambulance Service Network director Jo Webber told HSJ the minister’s comments were supportive of the drive for 999 services to be commissioned at a more regional level but stressed there would be a place for individual CCGs to commission urgent care services.