It is for strategic health authorities (SHAs), as the local headquarters of the national health service, and primary care trusts, as commissioners, to ensure that strategies for improving performance are delivered by ambulance trusts.
The Department, via the Recovery and Support Unit discusses performance at trust level with SHAs to ensure that SHAs work with local organisations to address performance issues, and if appropriate with support from the National Ambulance Performance Implementation Lead. However, performance is measured across the trust as a whole.