NHS England undertook a review of urgent and emergency care in 2013. Following publication of this review a number of work programmes were developed to support implementation of the review’s key principles; the Ambulance Response Programme (ARP) is one of these initiatives.

The 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, and sets out to improve outcomes for all patients contacting the 999 ambulance service, with a generally reduced clinical risk throughout the whole patient group.

The key elements of the programme are:

• The use of a new set of pre-triage 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 prioritisation codes that better describe the patient’s presenting condition and subsequent response/resource requirement.
• A full review of ambulance service measures and quality indicators.

In September 2015 NHS England engaged Sheffield University’s School of Health and Related Research (ScHARR) to independently monitor, analyse and evaluate the ARP. The recommendations developed as a result of this publication are outlined in the letter to Jeremy Hunt, Secretary of State for Health.