Ambulance response times are 'useless way' to measure success, says union
3:30pm Friday 22nd March 2013 in Gwent news
WALES’ eight-minute response time target for emergency ambulance calls has “absolutely no clinical basis”
and should be removed or its importance downgraded, according to a health union.
UNISON Cymru/Wales, which represents thousands of ambulance service personnel, is urging the team behind an ongoing Welsh Government reviewto recommend that targets become more patient-centred and based on outcomes for those patients.
The review is being led by Professor Siobhan McClelland, professor of health policy and economics at University of Glamorgan.
The union argues that the eight-minute target – for arriving at the scene of category A emergency calls, and known in the service as A8 – does not measure patient care and is “arguably a barrier to better patient care.”
It continues: “It is obviously very important that patients are not left waiting any longer than necessary for an ambulance.
“But... there is just no global evidence for, or correlation between, eight-minute response times leading to better patient care.
“Indeed, the ludicrous situation is actually created whereby a seven minutes 59 seconds response time that concludes with a patient dying would be marked an A8 ‘success’; while an 8:01 response time with the patient surviving would be an A8 ‘failure’.”
Emergency response times remain the key standard against which the ambulance service in Wales is judged, and a gradual deterioration in performance was the reason why former health minister Lesley Griffiths ordered the service reviewlate last year.
Performance across much of Gwent has fallen in the past year, in line with the Wales trend.
In January, 56.7 per cent of category A calls in Monmouthshire made A8, 11.7 per cent down on January 2012. In the four other council areas of Gwent, performance was down between 2.1 per cent and 10.7 per cent.
Professor McClelland’s review report is due later this spring.
Ideas for improvements
UNISON is also calling for action to solve problems that continue to exist around the hand-over of patients to accident and emergency departments, which can lead to ambulances being parked up instead of back on the road.
The union also wants to see improved training and career development programmes, more skills for paramedics, and a beefing-up of alternatives to calling 999, such as NHS Direct and the First Responder system.
“We need to ensure that people have confidence in all the other avenues for access to healthcare, such as NHS Direct Wales and GP services,” said Darron Dupre, head of the UNISON Cymru/Wales Ambulance Sector.
“These services need to be always accessible and available, so that 999 and A&E is not the default location for adults and children who are not seriously ill or injured,”
“We are also calling for some paramedics to be up-skilled so that they can diagnose and treat patients at the scene, which can again reduce admittance to hospital, as well as producing more development opportunities for ambulance staff.
“There is a lot of scope to build the Welsh Ambulance Service into a world-class service, and UNISON wants to be a part of that development.”