Mark Durham1, Mark Faulkner2, Charles Deakin3. 1. Critical Care Paramedic, South East Coast Ambulance Service, Brighton Ambulance Station, BN2 3EU, Elm Grove Brighton Mark.Durham@secamb.nhs.uk. 2. Advanced Paramedic Practitioner, 220 Waterloo Rd, SE1 8SD, London, UK. 3. University of Southampton, University Rd, SO17 1BJ, Southampton, UK.
Abstract
INTRODUCTION OR BACKGROUND: Ambulance services have historically found their targets particularly challenging. This article explores some areas of this multifaceted problem. SOURCES OF DATA: Research articles, government publications and published audit data. AREAS OF AGREEMENT: Demand is increasing in many areas of healthcare, but whilst hospitals saw a 7% increase in demand in recent times, ambulance services saw nearly double that. The services ambulance trusts provide have evolved from that of a transport service to that of a mobile health provider, and they have become victims of their own success. AREAS OF CONTROVERSY: Ambulance targets have never evolved to match evolving care. Ambulance personnel strive to avoid hospital attendance where appropriate, but this can be difficult for a 24-hour service, when not all referral pathways have 24-hour referral systems. GROWING POINTS: We discuss why demand might be growing disproportionately for ambulance services, and challenge the appropriateness of the targets themselves. AREAS TIMELY FOR DEVELOPING RESEARCH: Possible formats for revised ambulance targets are discussed.
INTRODUCTION OR BACKGROUND: Ambulance services have historically found their targets particularly challenging. This article explores some areas of this multifaceted problem. SOURCES OF DATA: Research articles, government publications and published audit data. AREAS OF AGREEMENT: Demand is increasing in many areas of healthcare, but whilst hospitals saw a 7% increase in demand in recent times, ambulance services saw nearly double that. The services ambulance trusts provide have evolved from that of a transport service to that of a mobile health provider, and they have become victims of their own success. AREAS OF CONTROVERSY: Ambulance targets have never evolved to match evolving care. Ambulance personnel strive to avoid hospital attendance where appropriate, but this can be difficult for a 24-hour service, when not all referral pathways have 24-hour referral systems. GROWING POINTS: We discuss why demand might be growing disproportionately for ambulance services, and challenge the appropriateness of the targets themselves. AREAS TIMELY FOR DEVELOPING RESEARCH: Possible formats for revised ambulance targets are discussed.