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Improving ambulance response times - call connect performance improvement sign-off (Gateway number: 7122)

  • Last modified date:
    4 October 2007

Purpose: To set out a checklist of questions recommended by DH for use by SHAs and PCTs in signing off ambulance trust performance improvement plans, and to provide more detail on the operation of the capital incentive scheme for ambulance trusts.

Background

Currently the clock starts for measuring ambulance response times when 3 pieces of key information has been obtained (location, telephone number and chief complaint).  From 1 April 2008, the clock will start earlier - when the call is connected to the ambulance control room.  Ambulance trusts and PCTs will be assessed against this new standard from 2008/09 onwards.

Ambulance trusts have been asked to develop performance improvement plans (Duncan Selbie letter, June 2006, reference 6795) by the end of September.  It is the responsibility of Commissioners and SHAs to assure themselves that the plans developed for reaching 75% of Category A calls within 8 minutes by 1 April 2008 against call connect are sufficient and sustainable over the longer-term, and to hold trusts to account over delivery of the plans and the target performance.  Trusts are able to receive capital monies for improvement milestones met in 2006/07.

Where trusts do not improve performance in line with their agreed trajectory the Department of Health will agree with SHAs timely and effective support and or intervention as necessary.

Checklist

Key questions that SHAs and Commissioners will wish to address and which DH will consider when quality assuring plans include:

  • Is there a detailed programme plan supporting the PIP, a dedicated programme lead and  governance and stakeholder arrangements providing sufficient accountability/performance management and oversight of the improvement programme?
  • Is the analysis of the current (i.e. baseline position) robust and does it demonstrate good understanding of the reasons for the current position and barriers to achievement of the required performance?
  • Is there a clear trajectory rooted in actions to address barriers with clear critical milestones?
  • Is the quality and specificity of data capture sufficient?
  • Does the plan identify and prioritise risks, and identify contingencies and actions to mitigate risks?
  • Are the assumptions about staff (including staff side considerations) and resource realistic?

Incentive scheme

As Duncan Selbie's letter of 30th June letter states, the incentive scheme should combine an initial payment with milestone payments for achieving agreed reductions in performance gaps in 2006/07.  The milestones are to reduce the performance gap between baseline performance (as defined below) and the 75% standard for Category A by 50%, 75% and 100%.

Measurement periods

The baseline period will be each trust's performance, as recorded on sitrep, for the four weeks average to Sunday 29th October.  Trusts will be deemed to have achieved a milestone if that level of improvement is averaged over any four week period.

For the small minority of trusts who are unable to report against call connect in all of their control rooms, payments will be reduced in line with the proportion of call volume that is being reported against call connect.  The baseline figure (for the purposes of the incentive scheme) will be calculated for the control rooms who are able to report at that time.

Payment

Initial payments were paid to SHAs in July via adjustments to Capital Resource Limits.  The remaining budget for the scheme has been divided equally between SHAs and allocated via CRL adjustments for August.  Should ambulance trusts become entitled to additional payments under the scheme (over and above the allocation made), SHAs will be expected to make these payments from underspends against other budgets.

Additional links

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