Abstract

Background
Response times are currently the dominant indicator for measuring the quality of emergency ambulance services in the United Kingdom. However, there is a recognised need to consider wider measures of quality. We aimed to investigate patients’ experiences of the ambulance service to understand the processes and outcomes important to them.
Methods
We employed a qualitative design, using semi-structured interviews and a topic guide with a purposive sample of people who had recently used the ambulance service in the East Midlands. We recruited patients of different age, sex, geographical location, and ambulance service response including ‘hear and treat’ patients that received telephone advice only, ‘see and treat’ patients that were treated by clinicians on-scene and ‘see and convey’ patients that were transported to hospital.
Results
We interviewed 22 service users, including eight with their spouses. We found that users who had experienced different types of ambulance service response valued similar aspects of their care. The outcome they reported valuing the most was reassurance that they were receiving appropriate advice, treatment and care. A timely response was also valued, not from the perspective of clinical need but because it allayed anxiety quickly. The processes which delivered reassurance were: the professional behaviour and communication of staff, a short wait for help and continuity during transfers within the service and to hospital.
Implications
New measures of quality of emergency ambulance services should address users’ psychosocial as well as their clinical needs, and the processes which offer the outcome of reassurance to users.