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NHS England has announced a new set of ambulance service standards which will apply to all 999 calls for the first time.
The new targets are to be applied to every single 999 patient for the first time and aim to provide faster treatment for those needing it to save 250 lives a year. They also aim to end ‘hidden waits’ for millions of patients, ensure up to 750,000 more calls a year get an immediate response, drive improved care for stroke and heart attack, and update a ‘decades-old’ system.
Call handlers will change the way they assess cases and will have more time to decide the most appropriate clinical response. The system will focus on ensuring patients get rapid life-altering care for conditions such as stroke rather than simply ‘stopping the clock’.
According to NHS England, ambulances will now be expected to reach the most ill patients in an average of seven minutes. This will free up more vehicles and staff to respond to emergencies. The targets will also help to make patients in rural areas, especially those who are frail and elderly, less disadvantaged than they can currently be.
The new system is backed by the Association of Ambulance Chief Executives, the Royal College of Emergency Medicine, the Stroke Association and the British Heart Foundation amongst others. It comes after paramedics have called for the modernisation of a service developed and introduced in 1974, as well as criticism of the current system from the National Audit Office and Health Select Committee.
Bruce Keogh, National Medical Director of NHS England, said: “Patients across the country deserve to benefit from the significant improvements seen in the trial areas, from ambulances reaching cardiac arrests in London 30 seconds faster to the one minute improvement on stroke responses in the West Midlands. These changes, together with ambitious new clinical standards for heart attack and stroke patients, will end the culture of ‘hitting the target but missing the point’. They will refocus the service on what actually counts: outcomes for patients.”
Juliet Bouverie, chief executive of the Stroke Association, said: “We support the recommendations of the Ambulance Response Programme. It is vital that all stroke patients get to a stroke unit as quickly as possible in order to get lifesaving treatment to minimise the impact of their stroke. Under the current system, the first responder to a stroke patient could be on a motorbike – but this vehicle can’t transport the patient to hospital meaning they have to wait even longer for a second ambulance to arrive. By allowing ambulance call handlers a little more time to determine what is wrong with a patient, it ensures that stroke patients can be identified and that the right vehicle – a two crew ambulance – can be sent out immediately to get the patient to hospital quickly and safely so that they can be treated at a stroke unit.”
Simon Gillespie, chief executive of the British Heart Foundation, said: “When someone suffers a cardiac arrest, heart attack or stroke, it is absolutely vital that emergency services attend as quickly as possible to improve their chances of survival and reduce the risk of long-term disability. In the case of a cardiac arrest, by-standers should start CPR immediately and continue until the emergency services arrive.
“Following promising trial results, when the new system is introduced more widely we would expect emergency services to attend these life-threatening events more rapidly to ensure that every victim has the best chance of survival. The BHF will work with the NHS to monitor how well the new system works in practice and that the potential to save more lives is realised.”