Ambulance services: Rise in number of patients treated entirely at the scene

New figures from the Health and Social Care Information Centre (HSCIC) show in 2012-13(2) almost two million patients were treated at the scene(3) by ambulance services without needing onward transportation, a 10 per cent rise on last year's figure (1.81 million). Of these patients more than one in three (34.2 per cent) had been assessed by the call handler as falling into Category A, which meant their condition was potentially life threatening.5

Today's Ambulance Services, England: 2012-13 report shows control rooms received 9.08 million emergency calls in 2012-132, a rise of more than half a million (6.9 per cent) on 2011-12 and one in three of these was recorded as Category A (32.5 per cent, or 2.95 million).5 The national standard response percentages for Category A calls are for vehicles to arrive on scene within:

  • 8 minutes by an emergency response vehicle in 75 per cent of cases
  • 19 minutes by a fully equipped ambulance in 95 per cent of cases

Today's report shows that for ambulance services in England in 2012 -134: The national average for responding to Category A Red 1 incidents with the target time of eight minutes was 74.0 per cent. Seven of the 12 ambulance trusts reached the national standard of 75 per cent. The percentage of Category A calls (Red 1 and Red 2) that resulted in an ambulance arriving within 19 minutes was 96.0 per cent.

The West Midlands Ambulance Service responded to the largest proportion of Category A Red 1 calls within eight minutes at 78.9 per cent and the East Midlands Ambulance Service responded to the smallest proportion (70.0 per cent).

HSCIC Chair Kingsley Manning said: "Our figures highlight a substantial rise in the number of patients who were treated entirely at the scene by ambulance services. "This data is of significance given the recent debates about pressures on accident and emergency departments, how NHS resources are used and the best way of delivering patients excellent care".

  1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). The trusted source of authoritative data and information relating to health and care, HSCIC plays a fundamental role in driving better care, better services and better outcomes for patients. 

    It supports the delivery of IT infrastructure, information systems and standards to ensure information flows efficiently and securely across the health and social care system to improve patient outcomes. Its work includes publishing more than 130 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.
  2. Figures stated are for the full year from April 2012 - March 2013 and are comparable with previous year's information.
  3. Treatment at the scene applies to those patients who were treated at the scene (with or without clinical intervention) by the ambulance service and as a result of that treatment did not require onward transportation for further treatment. It is unknown whether further treatment of those treated at the scene was not necessary because of the severity of the incident or whether this is because of the level of treatment provided by ambulance trusts.
  4. Figures stated are for 10 months only from June 2012 - March 2013 and are not comparable with previous year's information. From June 2012 Category A calls were divided into Red 1 (most urgent/time critical) and Red 2 (serious but less time critical). The HSCIC now works with NHS England to collect this information (also known as Ambulance Quality Indicators) via NHS England's collection Unify2 data collection - AmbSYS System Indicators; this affects both category A 8 minute and 19 minute response times. Due to differing clock start times it is not possible to split previous years into these new categories therefore no direct comparisons can be made with previous years. Unify2 is a web based collection tool which Ambulance trusts complete to provide figures to NHS England which have been taken from the Ambulance trusts own incident recording systems.
  5. Calls and responses: Calls are received by the ambulance service. The number of calls and emergency responses will not match as there may be multiple calls recorded for one incident and category C calls may be resolved over the telephone without the need for an emergency response. It is therefore not possible to make any direct annual numerical comparisons between categories with 2011-12 and earlier years. 
    Category A: presenting conditions (Red 1 and Red 2) which may be immediately life threatening and should receive an emergency response i) within 8 minutes irrespective of location in 75 per cent of cases. ii) if a fully equipped ambulance vehicle needs to attend the incident it must arrive within 19 minutes of the request for transport being made in 95 per cent of cases. 
    Red 1 calls: are the most time critical and cover severe conditions such as cardiac arrest patients who are not breathing and do not have a pulse. 
    Red 2 calls: are serious but less time critical and cover conditions such as stroke and fits.
    Category C: presenting conditions which are not immediately serious or life threatening. For these calls the response time standards are not set nationally but are locally determined.
  6. The way in which response times are measured changed on 1 April 2008, which means timing data prior to 2008-09 is not fully comparable with the figures in this report.
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