The Ambulance Response Programme (ARP) aims to improve response times to critically ill patients. It will make sure that the best, high quality, most appropriate response is provided for each patient first time.
We expect the programme to improve outcomes for all patients contacting the 999 ambulance service, with a generally reduced clinical risk throughout.
There are three key elements of the programme:
- The use of a new pre-triage set of questions to identify those patients in need of the fastest response at the earliest opportunity (Nature of Call; NoC).
- Dispatch of the most clinically appropriate vehicle to each patient within a timeframe that meets their clinical need (Dispatch on Disposition; DoD).
- A new evidence-based set of clinical codes that better describe the patient’s presenting condition and response/resource requirement.
Current time-based ambulance response standards, applied in the face of rising demand, have led to a range of operational behaviours that appear increasingly inefficient. Trusts tell us that for most patients, 60 seconds to triage and dispatch a resource isn’t enough time.
This leads to sending resources before it has been determined what the problem is or sending multiple ambulances to the same patient then standing down the vehicles least likely to arrive first.
For serious, but non-life-threatening calls the programme is testing whether giving call handlers at certain Ambulance Trusts an additional 120 or 240 seconds to get all the information that they need, enables them to select the most appropriate clinical response.
As we know there are conditions where every minute counts in terms of saving a life (e.g. cardiac arrest) and/or preserving someone’s quality of life (e.g. stroke) and this programme helps to release significant resources to enable us to respond and treat these conditions more quickly and effectively.
Patient safety at the heart of the programme
Patient safety is paramount and measures have been put in place to ensure that the changes do not present an increased risk to patients.
Expert clinicians have examined the clinical need required for each of the 4000+ codes currently used and mapped this need to the most clinically appropriate ambulance staff and vehicle response.
This has then been sense-checked against the historic data we have about the number of calls for each condition and the clinical requirements of patients assigned that code.
Our partners and stakeholders
We are working with a number of partners to ensure this project achieves the necessary rigour and oversight including: an independent evaluation partner, an Expert Reference Group, a National Steering Group and a National Stakeholder Group.
There has been a positive response from ambulance clinicians involved and it has been welcomed by Ambulance Trusts, the College of Paramedics, the Association of Ambulance Chief Executives and the main ambulance unions.
- A letter from Professor Jonathan Benger, National Clinical Director for Urgent Care to Phillip Dunne regarding the Ambulance Response Programme Clinical Coding Trial
- A letter from Professor Keith Willett, Director of Acute Care for NHS England and Professor Jonathan Benger, National Clinical Director for Urgent Care to Phillip Dunne regarding the Ambulance Response Programme Evaluation Report on Dispatch on Disposition
- A letter from Professor Keith Willett, Director of Acute Care for NHS England, to Lord Prior of Brampton explains the progress of the Ambulance Response Programme.
- A letter from Professor Keith Willett, Director of Acute Care for NHS England, to Lord Prior of Brampton informing him of the decision for West Midlands Ambulance Service Foundation Trust (WMAS) to join the Ambulance Response Programme.