In 2015, NHS England set out to redevelop its Ambulance Response Programme (ARP). Now, two and a half years after new measures were introduced, every ambulance service meets response time standards. By revising call categories to relieve strain on the emergency services, the remodel has also aided with resource provision.
Janette Turner, a Reader in Emergency and Urgency Care Research at the University of Sheffield, assisted with the planning and introduction of the changes. Turner’s role included evaluating the implementation of the new system, which enabled NHS England and Ministers at the Department of Health to reach decisions regarding the national adoption of the new approach.
The ARP was modified in multiple significant ways. Firstly, the three-tiered categorisation of emergencies was replaced by a new system involving five categories. This more thorough breakdown was particularly needed given that the previous model required at least 50% of all 999 calls to be responded to within eight minutes. With the UK’s emergency healthcare service number receiving 10 million calls each year, this specification meant call handlers could not always send the most appropriate service to an emergency.
To get emergency responders to a site within eight minutes might require sending the only available team instead. But Turner explains, “the biggest advantage of the new categories is that the highest category (category 1) is now about 10% of calls and captures the true life-threatening emergencies.”
Now, emergency services do not need to rush responses since there are more varied required response times that depend on the more thorough categorization process, making them better placed to effectively respond to the 1,100 – 4,500 calls on average received each day by England’s 10 regional ambulance services. By also allowing for more time to be used on call, dispatchers can better determine the urgency of a case and how best to respond.
After testing these changes in almost half of England’s services, Turner says they found that “a much higher number of patients were getting the right response the first time”, which the team estimated “made more than 10,000 extra available resources each week across England”. Moreover, the focus on providing the most appropriate resources led to “a 6.6% increase in the proportion of calls getting a response within eight minutes”.
Turner also emphasised that ambulance service staff responded positively to the remodel. The Association of Ambulance Chief Executives Managing Director, Martin Flaherty OBE, similarly highlighted how “control room staff and paramedics out on the road have welcomed the new system”, adding that the new model is “a common-sense approach that is long overdue”.
For Turner herself, “it was a privilege to work with NHS England and the Ambulance Response Programme as a valued partner throughout the entire process”, as she supported what she terms this “critical policy change”.
