By Dr Ioannis Laliotis
There is an assumed link between health outcomes and emergency medical services response times.
But in the words of Iron Maiden, is it a case of "Be Quick Or Be Dead"?
Recent technological advances, e.g. automated dispatch services, geographic information systems and mobile intensive-care units, have allowed ambulances to reach and treat patients more quickly. At the same time providers are pushed to meet the nationally set response targets. For example, 75% and 95% of patients must be reached within 8 and 19 minutes, respectively. This applies both to patients with life-threatening conditions (Red 1 calls) and to serious but not the most life-threatening incidents (Red 2 calls). Local agreements apply to less critical conditions and to incidents that can be assessed without an ambulance response, i.e. via telephone (Hear & Treat).
However, nearly nothing is known regarding the relationship between health outcomes and ambulance response times. Primarily, this is due to the scarcity of good quality data. NHS England publishes some Ambulance Quality indicators for each one of the eleven Ambulance Services operating in the country. These are available at a monthly frequency from April 2011 onwards. They can be classified into two main categories: Systems Indicators and Clinical Outcomes. The former contain information regarding the total volume of emergency calls and the number which resulted in an emergency response arriving at the scene of the incident within 8 minutes. Other information such as the number of emergency calls closed with telephone advice, the number of patients treated and discharged on scene, re-contact rates within 24 hours and the total number of transported incidents is also available. The Clinical Outcomes monthly reports contain information about the proportion of resuscitated patients who had return of spontaneous circulation on arrival at hospital following an out-of-hospital cardiac arrest, STEMI or stroke. Also, the proportion of resuscitated patients who were discharged from hospital alive after an out-of-hospital cardiac arrest is also available.
These published data can provide a first insight regarding the trends of the efficiency of ambulance services.
But in the words of Iron Maiden, is it a case of "Be Quick Or Be Dead"?
Recent technological advances, e.g. automated dispatch services, geographic information systems and mobile intensive-care units, have allowed ambulances to reach and treat patients more quickly. At the same time providers are pushed to meet the nationally set response targets. For example, 75% and 95% of patients must be reached within 8 and 19 minutes, respectively. This applies both to patients with life-threatening conditions (Red 1 calls) and to serious but not the most life-threatening incidents (Red 2 calls). Local agreements apply to less critical conditions and to incidents that can be assessed without an ambulance response, i.e. via telephone (Hear & Treat).
However, nearly nothing is known regarding the relationship between health outcomes and ambulance response times. Primarily, this is due to the scarcity of good quality data. NHS England publishes some Ambulance Quality indicators for each one of the eleven Ambulance Services operating in the country. These are available at a monthly frequency from April 2011 onwards. They can be classified into two main categories: Systems Indicators and Clinical Outcomes. The former contain information regarding the total volume of emergency calls and the number which resulted in an emergency response arriving at the scene of the incident within 8 minutes. Other information such as the number of emergency calls closed with telephone advice, the number of patients treated and discharged on scene, re-contact rates within 24 hours and the total number of transported incidents is also available. The Clinical Outcomes monthly reports contain information about the proportion of resuscitated patients who had return of spontaneous circulation on arrival at hospital following an out-of-hospital cardiac arrest, STEMI or stroke. Also, the proportion of resuscitated patients who were discharged from hospital alive after an out-of-hospital cardiac arrest is also available.
These published data can provide a first insight regarding the trends of the efficiency of ambulance services.
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