Abstract

Introduction: There is a compelling need to develop
clinical performance indicators for ambulance services in
order to move from indicators based primarily on
response times and in light of the changing clinical
demands on services. We report on progress on the
national pilot of clinical performance indicators for English ambulance services.
Method: Clinical performance indicators were developed
in five clinical areas: acute myocardial infarction, cardiac
arrest, stroke (including transient ischaemic attack),
asthma and hypoglycaemia. These were determined on
the basis of common acute conditions presenting to
ambulance services and in line with a previously
published framework. Indicators were piloted by
ambulance services in England and results were
presented in tables and graphically using funnel
(statistical process control) plots.
Results: Progress for developing, agreeing and piloting of
indicators has been rapid, from initial agreement in May
2007 to completion of the pilot phase by the end of
March 2008. The results of benchmarking of indicators
are shown. The pilot has informed services in deciding
the focus of their improvement programme in
2008 and 2009 and indicators have been adopted for
national performance assessment of standards of
prehospital care.
Conclusion: The pilot will provide the basis for further
development of clinical indicators, benchmarking of
performance and implementation of specific evidencebased
interventions to improve care in areas identified
for improvement. A national performance improvement
registry will enable evaluation and sharing of effective
improvement methods as well as increasing stakeholder
and public access to information on the quality of care
provided by ambulance services.