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However, ambulance services are concerned that without clarity over commissioning arrangements, the potential to improve care will be lost as confusion and conflicting priorities make it impossible for ambulance services to offer consistent standards of care to patients.

Our Ambulance Service Network (ASN) calls on the Government to urgently clarify these arrangements.  

The ambulance service works at three different levels:

• as a national service responding to major emergencies
• a regional service for major trauma (such as road traffic accidents) and stroke care
• a local service offering specific services such as those supporting older people when they fall. 

Coordination

Each level needs to be linked and coordinated with the other so the whole system can deal effectively with peaks in demand and patients can consistently get the right response every time. 

Published to coincide with the ASN annual conference on 8 November, An involving service also makes clear that, while response targets have helped improve ambulance services considerably, they were too inflexible to reflect the realities of geography and transport links on the ground. 

Performance based on outcomes

With a move to performance measurement based on outcomes, time will of course be an important factor - especially in the most serious cases. However, by concentrating ambulance services on how good the care they offer is, the move to outcomes should benefit patients across the board.  

This should help address complaints that the previous targets regime, by concentrating solely on response time, favoured urban areas where most hospitals are and road links are better. 

Volunteers

Many NHS ambulance services meet the challenge of providing high-quality care by working with local communities and using volunteers. For example, in some places, almost all patient transport is provided by a network of volunteers. A move to focus on patient outcomes could give ambulance services extra incentive to develop these services. 

Rural areas harder to get to

Ambulance Service Network Director Jo Webber said: "This report sets out all the innovative ways that ambulance trusts are working with the rest of the NHS to tackle the fact that rural areas are harder to get to.  

"Ambulance services are hopeful that new performance measures based on outcomes will help them by focussing effort on the care patients receive rather than solely on how quickly ambulances get to them. 

"But, to make this all work, we have to have clarity on how ambulance services are commissioned. At anyone one time, an ambulance service might simultaneously be asked to attend to a national emergency, deal with a motorway traffic accident and run services for older people who have fallen over. 

An involving service

Visit our publications library to read the report in full.

Contacts

Niall Smith
020 7074 3304
Niall.Smith@nhsconfed.org