Ambulance calls and cancellations: policy and implementation issues

摘要

Purpose - The purpose of this paper is to explore the issues around the considerable increase inrnemergency calls experienced by a large county ambulance trust and implications for thernimplementation of government policy in relation to the English National Health Service AmbulancernService.rnDesign/methodology/approach - The paper involves a literature review and the analysis of thernambulance service data based on emergency call outs, and discussions with senior ambulance andrnhealth authority personnel.rnFindings - Increased calls were mainly explained by a large increase in cancellations, especially afterrnthe vehicle had arrived at the scene. The term "cancellation" is potentially misleading and may carryrnconnotations of wasted resources. There was little evidence of inappropriate calls and no single causernof cancellations or any simple solution. Instead, a wide range of actions were included, many of whichrnseem potentially worthwhile. However, the way the data are presented disguises their diversity andrnpotential value. This reflects the tension between policy and practice, and organisational culture andrnperformance measurement regime.rnResearch limitations/implications - This is a single case study and is limited by the parametersrnof the data base gathered by the ambulance service as part of their normal operational procedures.rnPractical implications - This paper gives support to the enhanced role of the ambulancernparamedic and the need to recognise this changing role through a more appropriate approach tornperformance measurement. The present emphasis on response times and transportations to hospitalrnmay result in undervaluing activities at the scene.rnOriginality/value - The paper identifies a key area where research into policy and governancernissues has been limited and presents recommendations for future analysis.