Ambulance waiting time targets may be extended

Target waiting times for ambulances to reach some seriously ill patients could be lengthened.

Ambulance waiting time targets may be extendedA leaked NHS document includes plans to change the response time for some Red 2 patients – those with “serious but not the most life-threatening” conditions – from eight to 19 minutes in England.

It said the plans had been backed by Health Secretary Jeremy Hunt, subject to approval by ambulance trust bosses.

The government said no decisions had been made and the party has rejected suggestions from ambulance chiefs that it was told about the plan to change response times and raised no objections.

The leaked document, drawn up for the Association of Ambulance Chief Executives and dated 16 December, said NHS England had “explicitly stressed” the plans were confidential and “should not be disseminated beyond the group” involved in the discussions.

The document said there were existing plans for changes “after the general election” in May.

To many in the service, the general ideas are good – but there this concern it should have been a more thoughtful exercise where time was taken to consult widely and the public was involved in the process.

Paramedics say response times distort their ability to treat patients because they have to chase the clock. They also say some illnesses such as strokes, should be moved up a category.

The target for these changes was early January, according to the document, but it seems unlikely the proposals will now go ahead by then.

There are currently three main call types:

  • Red 1: Respiratory or cardiac arrest – response in eight minutes
  • Red 2: All other life-threatening emergencies, such as stroke and fits – response in eight minutes
  • Other response times are agreed locally

Ambulance trusts dealt with almost 8.5 million emergency calls in 2013-14 in England, an average of 16.1 calls per minute.

The national target is for ambulance trusts to reach 75% of Red 1 patients within eight minutes, and 95% within 19 minutes. The time starts as soon as an emergency call is connected.

Red 2 targets are currently the same, except that the “clock start” can be up to 60 seconds after a call is connected.

The changes proposed to Red 2 are:

A “small number” moved to Red 1 – those where a short extra wait “could have a potentially serious detrimental impact”
Just under half to keep the 75% within eight minutes target, but trusts will have up to three minutes from receiving a call before the clock starts
About 40% to have a 19-minute response target, as well as three minutes before the clock must start

The Red 2 category includes strokes and fits, but the document does not say which conditions would be put in each of the new categories.

It said the proposed changes could bring “substantial improvements”.

The document also said trusts would be able to cut the number of fast-response cars being used in favour of deploying more double-crewed ambulances, but it acknowledged the plans have not had the “breadth of exposure that would normally be expected”.”

The leak comes after it emerged on Friday that pressures in England’s A&E units had hit record levels, with the lowest percentage of patients seen within four hours since monitoring began in 2010 – NHS A&E has worst week in 2014.

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