Ambulance services should be assessed on reassurance and response time

Ambulance services should be assessed on how reassured patients and their families feel during an emergency as well as on response times, researchers have found.

The report from  the University of Lincoln and University of Sheffield in the UK found that offering reassurance to patients and their families alleviates anxiety, fear or panic. These  aspects of care can be as important as other NHS performance measures such as response times, the study said.

The reassurance was gained  from the continuous presence of healthcare staff, whether by telephone or in person, being involved in the handover process if they were taken to hospital, and a more informal style of communication by clinicians.

The study was carried out with patients and relatives who had received care from the East Midlands Ambulance Service NHS Trust (EMAS), which serves a population of around 4.8 million people across five counties of England. It covered call-outs for conditions ranging from kidney stones, high fevers, breathing difficulties, and severe abdominal pain, to anxiety attacks, medicinal side effects, injuries, and stroke.

Lead author, Fiona Togher and colleague Viet-Hai Phung, researchers who work with Professor Niro Siriwardena in the Community & Health Research Unit at the University of Lincoln, carried out the study with Professor Alicia O'Cathain and Janette Turner from the University of Sheffield.

Fiona said: "There is an increasing need to assess the performance of emergency ambulance services using measures other than the time it takes for an ambulance to arrive on scene. Patients and their families are often extremely anxious, and they value the reassurance from ambulance service staff that they were receiving appropriate advice, treatment and care.

"Our findings demonstrate that a fast response and high standard of clinical care, although important, may not be sufficient for a good patient experience. The implication of this is that the proportion of users reporting that they feel reassured by the ambulance service response should be measured alongside current measures such as response times and clinical performance indicators.

"Our findings could be used to inform the development of a standardised measure of patient experience for ambulance services."

The study concluded there was an "increasing need" to consider other factors in the performance of ambulance trusts in addition to response times. The performance of ambulance services is currently judged on how quickly they reach emergency patients following a 999 call.

The national target is to reach 75 per cent of the most serious 'Red 1 and Red 2' cases within eight minutes. For non-life threatening conditions, response time targets are set locally.

The findings have been presented to the National Ambulance Services Clinical Quality Group and the National Ambulance Services Research Steering Group, and the report will also be sent to the Association of Ambulance Chief Executives Group.

The research is part of a wider five-year programme to improve pre-hospital care across the NHS. The study has now been published in the journal Health Expectations.