Ambulance services achieve high rating

Ambulance services in England have been given a strong endorsement for the way they deal with people who have non-urgent medical problems.

Survey results released by the Care Quality Commission show that most of those who responded to the survey had a positive experience of the way they were looked after. It was the first national survey targeted specifically at people whose conditions were assessed by
ambulance call handlers as Category C - defined as non-urgent or non-life threatening.

The survey covered Category C calls to all England's 11 ambulance trusts during the month of July 2008. Almost 4,000 people returned their questionnaires, a response rate of 45%. Seventy-three percent of respondents rated the overall care they were given as 'excellent', while a further 25% said it was 'good' or 'very good'. Most people (82% of those who were attended by ambulance staff at the scene) said their care and treatment were 'definitely' explained in a way they could fully understand, while 15% felt it was explained 'to some extent'.

Cynthia Bower, Chief Executive of the Care Quality Commission, said: "To enable
Improvements to be made to the quality of care that the NHS provides, it is vital that people are asked about their experiences and what they think of their local health services.

"It is really encouraging to see that patients are so positive about the way ambulance trusts handle non-urgent calls. While more broadly there are aspects of the ambulance service that need to improve, patients have given trusts a real vote of confidence in this area.That is very good news."

Over a full year (2007-08), 7.2 million calls were made to the emergency ambulance services, of which over a quarter (2.1 million) were classed as Category C. This covers a wide range of conditions, from earache or fainting to minor wounds or non-dangerous injuries.

Almost all (98%) of the respondents were attended 'at the scene' by the ambulance service (either by an ambulance or by someone in a car or on a motorcycle). Although there is no target waiting time for Category C cases, of those who responded to the survey just 4% felt
that help should have arrived 'a lot sooner' and 8% said it could have been 'a bit sooner'.

Survey respondents had a high level of trust and confidence in ambulance staff who attended them at the scene (which in 81% of cases was their own home). Ninety-one per cent of respondents 'definitely' had trust and confidence in staff and 90% were 'definitely' reassured by them.

Nearly a quarter of the respondents (23%) were not taken to hospital by ambulance. Of these, 95% agreed with the decision. Just over half (53%) of those not taken to hospital were referred to another organisation or another part of the NHS, such as their GP, a nurse, an accident and emergency department or NHS Direct.

Of those respondents who were experiencing pain at the time, 75% felt the ambulance staff had done everything they could to control their pain, while 19% said they had 'to some extent', and 6% believed they had not done everything they could.

The survey, which was coordinated by the Picker Institute, also asked people how they were dealt with over the telephone. The survey showed that in most cases someone else had called on behalf of the respondent - less than a third (29%) had spoken to the control room themselves. Of those respondents who had spoken directly to a control room operator, most had found them to be reassuring and courteous.

As well as deciding on the level of response, control room operators may pass the caller on to clinically trained staff who can assess the patient's needs and provide advice over the phone.
Of the survey respondents who said their call was passed on to a telephone adviser, 55% rated the quality of advice they were given over the phone as 'excellent', 33% as 'very good', 9% as 'good' and 2% as 'fair'. One per cent said it was 'poor' or 'very poor'.

Commenting on the Care Quality Commission's survey of 'Category C' emergency ambulance users, Ambulance Network Director Liz Kendall said: "This survey shows patients think the ambulance service is offering fantastic care. "Our staff do a great deal more than arrive quickly for 'blue light' emergencies. They are also are very good at explaining patients' conditions, offering advice when people need it most and reassuring them.

"There is always more we can do to improve the quality of care we provide, but these results are a huge vote of confidence in the ambulance service from patients and the public."