Since April 2011, all ambulance trusts in England have been measured and reporting against 11 ambulance quality indicators (AQIs), which allow our performance to be compared with that of other services across the country. The indicators are split into ambulance systems and clinical outcomes.
Ambulance system indicators consider the way in which we answer and manage responses to all emergency calls coming into the Trust, whilst clinical outcome indicators consider the care that we deliver to some of the most seriously unwell patients that we attend. Further details on each indicator can be found below and on the NHS England website.
Whilst response times are still an important part of the AQIs and the current target of responding to at least Cat 1 emergencies within a mean average time of seven minutes and at least nine out of 10 times before 15 minutes, the Trust welcomes the greater focus of clinical outcomes for our patients
NHS England collates performance information against the AQIs for each ambulance trust on a monthly basis. This is published on a national dashboard. (Please note that due to the complexity of drawling the clinical data together, it will be three months in arrears from the non-clinical data)
Clinical Outcome Indicators
Outcome from acute ST-elevation myocardial infarction (STEMI – a type of heart attack) This indicator requires ambulance services to ensure delivery of rapid assessment, treatment and transport for patients experiencing this type of heart attack, as this is crucial to the cardiac care pathway which aims to restore coronary blood flow, thereby improving patient outcome
Outcome from cardiac arrest – return of spontaneous circulation There are three indicators that measure how many patients who are in cardiac arrest but following resuscitation have a pulse (heartbeat) on arrival at hospital, and the care they receive.
Outcome from cardiac arrest – survival to 30 days There are two indicators that measure the proportion of those who survive to 30 days following their cardiac arrest.
Outcome following stroke for ambulance patients This indicator requires ambulance services to measure the time it takes from the 999 call to the time it takes those F.A.S.T-positive stroke patients to arrive at a specialist stroke centre, so that they can be rapidly assessed for treatment known as thrombolysis.
Falls Care This indicator requires ambulance services to measure the care they provide patients aged 65 years and over who have had a fall and are not conveyed to hospital. The standards of care are set nationally and can be found here.
Non-recurring national audits The above audits run on a monthly or quarterly rolling basis. However, there are also one-off audits commissioned nationally. Examples include a Recontact Audit and an End-of-Life Care audit. Each ambulance service submits just one dataset against agreed standards of care.
Ambulance System Indicators
Re-contact rate following discharge of care (i.e. closure with telephone advice or following treatment at the scene) If patients have to go back and call 999 a second time, it is usually because they are anxious about receiving an ambulance response or have not got better as expected. Occasionally it may be due to an unexpected or a new problem. To ensure that ambulance trusts are providing safe and effective care the first time, every time, this indicator will measure how many callers or patients call us back within 24 hours of the initial call being made
Call abandonment rate This indicator will ensure that we and other ambulance services are not having problems with people phoning 999 and not being able to get through
Time to answer calls It equally important that if people/patients dial 999 that they get call answered quickly. This indicator will therefore measure how quickly all 999 calls that we receive get answered
Service experience All ambulance services will need to demonstrate how they find out what people think of the service they offer (including the results of focus groups and interviews) and how we are acting on that information to continuously improve patient care.
Category 1 seven-minute mean response time This indicator measures the speed of all ambulance responses to the scene of potentially life-threatening incidents and measures that those patients who are most in need of an emergency ambulance gets one quickly
Time to treatment by an ambulance-dispatched health professional It is important that if patients need an emergency ambulance response, that the wait from when the 999 call is made to when an ambulance-trained healthcare professional arrives is as short as possible, because urgent treatment may be needed
