NEW targets will be developed for emergency ambulance services and A&E in Wales from next month, rebalancing current measures to take in more than just response and waiting times.
The aim is to develop targets with a stronger emphasis on the quality of the care and its outcome.
Speed will remain a key factor for paramedics called out to suspected heart attacks and strokes, though this will be linked more to ensuring they get to the appropriate hospital for the appropriate scans and treatment as quickly as possible.
And ambulance service performance in dealing with patients who have suffered a fractured hip will also be measured differently, focusing particularly on pain management and administration of pain relief.
The Francis Report and last spring’s McClelland Report into ambulance services in Wales each questioned the meaningfulness of blanket eight-minute response targets for emergency call-outs.
From next month, the aim in Wales is to begin to build targets that also involve a measure of the care and treatment provided for patients.
The ambulance service work with heart attacks will focus on a particular type, known as a STEMI, in which a blood clot develops in a blood vessel in the heart. The aim is to develop a target that includes elements such as arrival at the scene, assessment of the patient, preparation for and delivery of treatment with a clot-busting drug, and how many patients receive this within an hour. For fractured hips, the focus will be on how effectively paramedics manage a patient’s pain.
With stroke patients, the emphasis will be on compliance with factors such as measuring blood glucose, blood pressure, and undertaking the FAST (face, arms, speech, time) test. The aim is to prepare the ground for the hospital stroke team, so scans and, if necessary, clot-busting drugs can be administered more quickly.
For A&E, two new targets will be trialled, one based on clinical priority, and another on waiting times from arrival to when treatment begins. The latter is different to the current four-hour target, which measures the time from arrival until the patients leaves the department.
The existing targets will continue to be measured and published.