Targeted response? An exploration of why ambulance services find government targets particularly challenging

Abstract

Introduction or background: Ambulance services have historically found their targets particularly challenging. This article explores some areas of this multifaceted problem. Sources of data: Research articles, government publications and published audit data. Areas of agreement: Demand is increasing in many areas of healthcare, but whilst hospitals saw a 7% increase in demand in recent times, ambulance services saw nearly double that. The services ambulance trusts provide have evolved from that of a transport service to that of a mobile health provider, and they have become victims of their own success. Areas of controversy: Ambulance targets have never evolved to match evolving care. Ambulance personnel strive to avoid hospital attendance where appropriate, but this can be difficult for a 24-hour service, when not all referral pathways have 24-hour referral systems. Growing points: We discuss why demand might be growing disproportionately for ambulance services, and challenge the appropriateness of the targets themselves. Areas timely for developing research: Possible formats for revised ambulance targets are discussed.