Response Time Gathering

Bobby F made this Freedom of Information request to South Western Ambulance Service NHS Foundation Trust

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was successful.

Dear South Western Ambulance Service NHS Foundation Trust,

I am interested in how your response times are gathered from a start time to a finish time and how that relates to actual ambulance dispatch and actual arrival.

• What is the start time of a 999 Emergency Call?
• At what point is a 999 call deemed to be an actual Emergency Call?
• If a triage system is used at what point is a 999 call deemed to be an actual Emergency Call.
• At what point is an ambulance dispatched?
• Do you use a Pre-Alert system?
1. What is the Operational Procedure for that Pre-Alert System?
2. Are blue lights and sirens always used for Pre-Alert responses?
3. Under such a Pre-Alert system if an Ambulance arrives at the site of an Emergency before the call has been coded as an emergency how is that call then assigned a coding, that is what specific code is that call given?
4. If a generic code is given in the answer to question 3 do those coded responses appear in the Response Time Statistics as is or are they filtered out in some way?
5. If such calls are not filtered out what is the average percentage of such calls appearing in the Response Time Statistics?
• Is the arrival time of an ambulance time at person, at address or within a zone or an area?
1. If it is a zone or area how is that determined?
2. If there is a computer generated automatic ‘On Scene Time’ is that time overridden by a staff member actually pressing an ‘On Scene’ button?
3. If an automatic ‘On Scene’ is generated and then a manual ‘On Scene’ input is subsequently pressed, what time is actually used for statistical analysis?

Yours faithfully,

Bobby F

Information Governance, South Western Ambulance Service NHS Foundation Trust

2 Attachments

Dear Bobby F,

 

Thank you for your request for information regarding the recording of
response times which we received on 14 May 2014.

 

We will deal with this request in accordance with your right of access to
information we hold under the Freedom of Information Act and I attach a
leaflet containing further information about both your rights and our
obligations under this legislation. You will see from this that we are not
obliged to generate information we do not already hold in order to provide
what we are asked for, such as by collating data or formulating direct
answers to questions, but you are entitled to receive copies of records
(or extracts from them) that contain the information you have requested.

 

We will research the information you have requested and we will respond
providing what we hold no later than 12 June 2014 in accordance with the
timescales set by the Act.

 

We will inform you if:

a) We are unable to provide you with any of the information you have
requested, and explain the reason for this; and

b) Any fee that is payable for the information we are able to provide.

 

In the meantime, if you have any queries or require clarification on any
aspect of your request or how we will respond, please do not hesitate to
contact me.

 

Regards

 

Mary

 

Mary Bartlett | Information Governance Manager
South Western Ambulance Service NHS Foundation Trust

 

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Information Governance, South Western Ambulance Service NHS Foundation Trust

1 Attachment

Dear Bobby F

 

I refer to our acknowledgement on 16 May 2014 of your request for
information regarding the recording of response times under the provisions
of the Freedom of Information Act.  We are able to provide the following
information set out in the table below:

 

Please note that South Western Ambulance Service NHS Foundation Trust
(SWASFT) acquired the former Great Western Ambulance Trust (GWAS) on 1
February 2013. Prior to this date, SWASFT covered Somerset, Dorset, Devon
and Cornwall and the Isles of Scilly. These areas are now referred to as
the East and West Divisions of the organisation. GWAS covered the former
Avon area, Wiltshire and Gloucestershire. This area is now referred to as
the North Division of SWASFT.

 

Information Our Response
requested

 
1. What is All English Ambulance Services provide monthly system information at a national level
the start through the Ambulance Quality Indicators. The guidance for the measurement of 999 Response
time of a Times is issued on the Ambulance Quality Indicators section of NHS England and can be found
999 at the following link:
Emergency
Call? [1]http://www.england.nhs.uk/statistics/sta...

 

According to Ambulance Clinical Quality Indicator Guidance v1.3 Document 060613

 

1. For Category A (Red 1) Calls (the most time critical patients) the clock starts when the
call is presented to the control room telephone switch. This will be the case for all calls
received on control room telephone lines, from dedicated emergency lines or otherwise. For
calls that are electronically transferred to the computer aided dispatch (CAD) system from
another CAD the clock starts immediately when that call record is first received by an
ambulance trust system.

 

2. For Category A (Red 2) Calls (serious but less time-critical patients), the clock starts
the earliest of: a) chief complaint information is obtained, b) complaint (or Pathways
initial DX code) information is obtained), c) first vehicle assigned, d) 60 seconds after
Call Connect (i.e. 60 seconds after the time at which the call is presented to the control
room telephone switch).

 

For all other Categories of Calls (Green 1, Green 2, Green 3 and Green 4) the start time of
a 999 Emergency call is as per Category A (Red 2) calls.

 
2. At what All 999 calls are deemed to be actual Emergency calls at the point of origin – triage is
point is a undertaken to establish the exact priority of the call and the Trust’s most appropriate
999 call response. Through triage it may be determined the call is no longer a life-threatening
deemed to be emergency call.
an actual
Emergency  
Call?
3. If a Please note currently two different triage Systems are in use:
triage
system is  
used at what
point is a North Division – AMPDS (Advanced Medical Priority Dispatch System)
999 call
deemed to be East & West Division – NHS Pathways
an actual
Emergency  
Call.
All 999 calls are deemed to be actual Emergency calls at the point of origin – triage is
  undertaken to establish the exact priority of the call and the trust’s most appropriate
response. Through triage it may be determined the call is no longer a life-threatening
emergency call.

 
4. At what Dispatchers have the autonomy to dispatch resources at the Pre-Alert stage or to wait until
point is an a ‘Problem Text’ (North Division – AMPDS) or ‘Nature of Call’ (East & West Division – NHS
ambulance Pathways) has been inputted into the event by a call handler. Once the call has been coded
dispatched? and been assigned a final priority, dispatchers will review the nature of the call and
dispatch decisions already made to ensure that appropriate resources are assigned as per the
patients priority and condition.

 
5. Do you Yes
use a
Pre-Alert  
system?
All calls received via the 999 route will automatically generate a Pre-Alert event with the
location created as per the CLI (Caller Line Identification) address information if the call
is from a landline or as an approximate location ellipse for calls from a mobile phone.

 

Please note recent guidance received from the Department of Health (DH) on the use of the
term Pre-Alert:

 

“The decision to start a vehicle responding to a 999 call under emergency blue light
conditions can be made whilst the 999 call is still in progress within the Emergency
Operations Centre (EOC) and before the final full nature of the call has been exactly
determined. This is not “pre-alert”, but a valid response to a genuine emergency call whilst
the EOC staff continue to process the call to a point where the final coding is completed.
If as more information is gathered on the call, it becomes clear at any point that a
response under emergency conditions is not required then the responding vehicle can be
informed and then proceed under normal driving conditions. The term pre alert may be
misleading and the ambulance sector should give consideration to removing the term going
forward”

 
6. What is All Pre-Alert calls are assigned the same priority as the minimum level of ‘emergency’
the response (equivalent to a Green 2). Dispatchers have the autonomy to dispatch resources at
Operational the Pre-Alert stage or to wait until a ‘Problem Text’ (North Division – AMPDS) /’Nature of
Procedure Call’ (East & West Division – NHS Pathways) has been inputted into the event by a call
for that handler. Once the call has been coded and been assigned a final priority, Dispatchers will
Pre-Alert review the nature of the call and review dispatch decisions to ensure that appropriate
System? resources are assigned as per the patients priority and problem.

 
7. Are blue Ambulance staff are instructed to use emergency warning equipment when travelling to
lights and emergency calls which are either in the process of been triaged or are confirmed as Red1,
sirens Red2 or Green2 calls.
always used
for  
Pre-Alert
responses?
8. Under North Division – If help arrives prior to completion of AMPDS triage, the triage is
such a ‘abandoned’ and the call is manually coded by the call handler using a non-AMPDS CAD
Pre-Alert override code. The specific over-ride code used is CABC (Crew arrived before coding). Any
system if an event where a vehicle unit arrives at scene before dispatch code is established, the event
Ambulance is categorised as a RED2 call and RED2 response as is used for a ‘running red’ call where a
arrives at crew come across an incident.
the site of
an Emergency  
before the
call has East & West Division - If an ambulance arrives at the site of an Emergency before the call
been coded has been coded as an emergency, the call is applied a DX014 Disposition (this disposition is
as an reported as a RED 2 as per a running call).
emergency
how is that  
call then
assigned a
coding, that
is what
specific
code is that
call given?
9. If a The responses are included in Response Time Statistics.
generic code
is given in
the answer
to question
3 do those
coded
responses
appear in
the Response
Time
Statistics
as is or are
they
filtered out
in some way?
10. If such North Division (AMPDS) – approximately 1.85% of reported calls
calls are
not filtered East & West Division  (NHS Pathways)– approximately 12% of reported calls.
out what is
the average  
percentage
of such Please note NHS Pathways has been designed to not only determine the appropriate priority
calls for emergency calls but what other services within the wider health care sector the caller
appearing in may be directed to if an emergency response is not found to be appropriate. As such a more
the Response in depth triage is used which leads to more arrivals on scene before triage is completed.
Time
Statistics?  
11. Is the Arrival time at address for resources that are tracked using GPS is based on when they are
arrival time within 200 metres of the incident. Resources not tracked will give the arrival time for when
of an they reach the address.
ambulance
time at  
person, at
address or Please note a legitimate arrival time can include the response arriving at a pre-arrival
within a rendezvous point when one has been determined as appropriate for the safety of attending
zone or an ambulance staff.
area?
 
12. If it is Within a 200 meter radius of the map reference of the property.
a zone or
area how is
that
determined?
13. If there The time used for reporting ‘on scene’ is the earliest time received (either from GPS
is a tracking or from crew pressing ‘on scene’ button) and is only overridden where there is a
computer reason to doubt the validity of the data received (eg GPS tracking failure, crew
generated inadvertently press ‘on scene’ in error).
automatic
‘On Scene  
Time’ is
that time The auto on scene time is not overridden by staff manually booking on scene. However, this
overridden is recorded within the Sequence of Events (SOE) of the incident.
by a staff
member
actually
pressing an
‘On Scene’
button?

 
14. If an See Above
automatic
‘On Scene’
is generated
and then a
manual ‘On
Scene’ input
is
subsequently
pressed,
what time is
actually
used for
statistical
analysis?

 

Please note that, under the Re-use of Public Sector Information
Regulations, if you wish to publish or otherwise use this information
besides for your own means, you will need to seek our permission to do so.

 

Please feel free to contact me if you require further clarification of the
information provided, or to discuss any aspect of the way in which we have
responded to your request. 

However, if you are dissatisfied with our response, you also have the
right to make use of the following complaints procedures:

 

In the first instance you may write to the Chief Executive of this Trust

 

Mr Ken Wenman

South Western Ambulance Service NHS Foundation Trust

Abbey Court

Eagle Way

Exeter  EX2 7HY

 

Mr Wenman will then either make arrangements for your complaint to be
reviewed and for the outcome to be communicated to you, or will convene a
panel of Trust Directors to consider an appeal against a decision to
withhold information.

 

If you are unhappy with the response to your complaint, or findings of the
Panel, you can contact the Information Commissioner at:

 

Information Commissioner’s Office,

Wycliffe House,

Water Lane,                                 

Wilmslow,

Cheshire.  SK9 5AF

 

Tel: 01625 545 700

Fax: 01625 524 510

 

 

Regards

 

Debbie

 

Debbie Bridge | Records Manager

South Western Ambulance Service NHS Foundation Trust

 

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References

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3. Our Webpage
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