Figures include the number of ambulances sent to a call, the number of patients taken to A&E and the number of hours ‘lost’ due to handover delays
The Welsh Ambulance Service has released groundbreaking new data which provides an unprecedented insight into patients’ care and experience across the country.
The data, which will be published four times a year, gives the public a detailed analysis of a patient’s entire journey from their initial 999 phone call to their admission to hospital.
Twenty-four different Ambulance Quality Indicators (AQIs) are being used to track the service’s performance in a variety of different areas.
It includes the number of 999 calls answered at the service’s control rooms, the number of ambulances sent to a call, the number of patients taken to A&E and the number of hours “lost” due to handover delays.
Some of the key findings (between October 1, 2015 and December 31, 2015 unless stated otherwise):
- 113,391 calls made to 999
- 5,642 calls ended and no further action taken following a telephone assessment
- 4,725 calls made by 534 so-called “frequent” callers
- 56,737 incidents where at least one vehicle was sent to the scene. A total of 58% of calls had just one vehicle, 28% had two, 10% had three and 3% had four
- 34 patients whose heart had stopped and weren’t breathing when paramedics arrived were resuscitated and were alive when they reached hospital (in December 2015 only)
- 69,868 patients were taken to a major A&E unit, 1,394 were taken to a minor injuries unit, 1,692 were taken to a medical admissions unit and 2,906 were sent to other units such as maternity or mental health
- 12,233 hours lost due to patient handover delays to A&E
A change in the way performance was analysed came about following the McClelland review which looked at how the service should be improved.
Chief Ambulance Services Commissioner Stephen Harrhy said the move will provide a “rich source of information” and will help improve patient outcomes. He said:
The work we are doing in Wales is being looked at not just in the UK but across the world. This is an important day in terms of ambulance delivery.
One of the things that was made clear in the McClelland review was that we needed to make sure the ambulance service was clinically focused and is part of pre-hospital unscheduled care.
We don’t sit alone, we don’t work in silos, we are part of a joint and integrated system.”
This is genuinely a really important step for us. It places more information in the public domain than we’ve ever had before.”
As part of the new measures, in October the Welsh Ambulance Service decided to change its clinical model so only callouts deemed “immediately life-threatening” would be subject to an eight-minute response target.
Previously, 500 calls a day were categorised under the most serious category of “red” but under the new system only around 150 a day are now subject to the timed goals.
In December, 72.4% of people with life-threatening illnesses and injuries received an emergency response from the Welsh Ambulance Service within eight minutes in December 2015.
The expectation is that at least 65% of responses should arrive within that allotted timeframe.
Tracy Myhill, chief executive of the Welsh Ambulance Service, said:
Today’s figures reveal that for the third month in a row there has been an improvement in our response times.
Also significant is the data published by the Emergency Ambulance Services Committee, which for the first time in our history tells us how well we have been treating our patients – in addition to the time it has taken to reach the most critically-ill patients.
This meaningful data will help us understand how we have fared during the first three months of our clinical model pilot and will no doubt highlight some good performance as well as areas for improvement, and we’ll be looking at those very closely.
Our new response model puts the sickest patients first, and is designed to ensure that more of our busy ambulances are available for those whose situation really is life or death.”
The five-step patient journey
1. Help Me to Choose
This includes tracking the number of community engagement events the ambulance service holds, the number of visits to the NHS Direct website for advice and the number of frequent callers to the service
2. Answer My Call
This looks at the number of 999 calls answered, the number of calls dealt with on the phone without the need to send out an ambulance and the number of calls passed through to NHS Direct Wales
3. Come to See Me
This tracks the number of calls called as Red, Amber or Green. Between October and December 2015 there were 5,461 Red calls, 64,000 Amber calls and 13,668 Green calls.
It also looks at the number of Community First Responders (CFRs) at the scene. A total of 284 CFRs were called to Red calls between October and December.
4. Give Me Treatment
This was described by ambulance service representatives as the most interesting aspect of the new measures as it looks specifically at different injuries or illnesses.
– 96.2% of stroke patients received an appropriate “stroke care bundle” between October and December 2015
– 83.1% of older people who fell and suffered a suspected hip fracture were given pain-relieving medication
– 14,489 patients between October and December did not need to be sent to hospital
5. Take Me to Hospital
This looks at how many patients were sent for hospital treatment and which units they needed. It also looks at handover delays which have proved a real frustration for ambulance staff who end up being parked outside A&E departments. A total of 70.5% of patients were taken to hospital following a face-to-face assessment with a paramedic.
The Welsh Ambulance Service says it is planning on breaking down the figures for each health board in the near future.
The next set of statistics will be released in April. Dr Brendan Lloyd, medical director at the Welsh Ambulance Service said:
We welcome this first set of Ambulance Quality Indicators published today by the Emergency Ambulance Services Committee that helps us understand more about how the clinical care we are providing to our patients is helping them as opposed to just measuring the time we took to drive there, which is the measurement that was previously used.
Some AQIs are still under development but this first set of comprehensive data highlights some good performance as well as areas for improvement.”
