I am today announcing the publication of the University of Sheffield report on the ambulance response programme and subsequent recommendations by Sir Bruce Keogh, NHS England’s national medical director. The report evaluates a series of pilots that I announced to the House in my written statement of 6 January 2015, intended to support ambulance services in England to maintain and improve clinical outcomes for patients in the face of unprecedented increases in demand. Copies of the report and Sir Bruce’s recommendations are attached.
Based on the extensive evidence base detailed in the report, NHS England is proposing a new framework of ambulance performance standards and related operational changes that are focused on patients’ clinical needs and will help the service to operate more efficiently. In particular:
enabling ambulances to dispatch resources much more clearly based on the clinical needs of patients ensuring the consistent delivery of very rapid responses to those who genuinely need them, through putting in place a four tier response time based on the clinical needs of patients;
introducing specific standards for stroke and heart attack, aimed at ensuring patients start the right treatment in hospital as quickly as possible;
improving performance management of “tail” waits by introducing mean and 90th centile measures; and,
achieving greater consistency and transparency for less urgent calls by bringing all response standards into a consistent national framework.
These ambulance response times are more stringent than anywhere else in the UK. Moreover, evidence from the pilots suggest that these changes will be beneficial for rural populations, narrowing the gap which currently exists in the time it takes for an ambulance resource to transport patients to hospital.
In my statement in January 2015 I said I would apply the following three tests before extending the ambulance response programme:
there is clear clinical consensus that the proposed change will be beneficial to patient outcomes as a whole, and will act to reduce overall clinical risk in the system;
there is evidence from the analysis of existing data and piloting that the proposed change will have the intended benefits, and is safe for patients; and,
there is an associated increase in operational efficiency. The aim is to reduce the average number of vehicles allocated to each 999 call and the ambulance utilisation rate.
I have accepted Sir Bruce’s advice that these tests have been met. I am authorising NHS England to implement the ambulance response programme recommendations in all ambulance services in England so that patients across the country will benefit from the improvements seen in the pilot ambulance services.
1. Report on Ambulance Response Programme (ARPReport_Final.pdf)
2. Letter with Sir Bruce Keogh's recommendations (13.7.17 Jeremy Hunt - Ambulance Response Programme letter.pdf)
The above documents can be viewed online at: