Contextual Overview
- The Department of Health requires summary details from NHS Health Care Providers on ambulance activity. The Ambulance Services Data Set (KA34) provides performance management measures of response times; these are also required by NHS Trusts for Ambulance Service internal monitoring and for defining service agreements.
- The information originally monitored 'Your guide to the NHS' targets and the standards introduced following a review of ambulance performance standards in 1996-97. The standards required that all Ambulance Services would be expected to reach 75% of immediately life-threatening calls within 8 minutes irrespective of location and that all incidents that require a fully equipped Ambulance vehicle (car or Ambulance) must have a vehicle, able to transport the PATIENT in a clinically safe manner (Emergency Ambulance), arrive within 19 minutes of the TRANSPORT REQUEST being made in 95% of cases.
- The information is required to inform strategic policy development, to provide data to the Care Quality Commission for performance and activity assessment, to ensure that Spending Review bids reflect changes to overall demand and to inform the development of Ambulance Service reference costs.
- Information based on the data set is published annually in the Health and Social Care Information Centre's Statistical Bulletin 'Ambulance services; England'.
Collection and Submission of the Ambulance Services Data Set (KA34)
- The Ambulance Services Data Set (KA34) is completed by NHS Trusts providing Ambulance Services.
- The Ambulance Services Data Set (KA34) relates to ACTIVITY taking place over a 12 month period, between 1 April of one year and 31 March of the following year. The return is made annually and submitted within one month of the end of the year to which it relates, online to the Health and Social Care Information Centre via the Omnibus Survey system.
- The Ambulance Services Data Set (KA34) requires the ORGANISATION CODE and ORGANISATION NAME of the NHS Ambulance Trust - the NHS Health Care Provider of the Ambulance Service.
Synopsis of the Ambulance Services Data Set (KA34)
| Part 1 | Emergency and Urgent Calls: |
| The following are sub-divided by RESPONSE CATEGORY A, B and C. | |
| 01 | Total number of emergency and urgent calls received; |
| 02 | The number of TRANSPORT REQUEST INCIDENTS that resulted in an Emergency Response arriving at the scene of the incident. For RESPONSE CATEGORY A calls, the total of lines 04 and 05 should equal this total; |
| 03 | The number of TRANSPORT REQUEST INCIDENTS that resulted in an Emergency Response arriving at the scene of the incident within 8 minutes (not required for RESPONSE CATEGORIES B or C calls); |
| 04 | The number of TRANSPORT REQUEST INCIDENTS where, following the arrival of an Emergency Response, the control room subsequently decided that no Emergency Ambulance was required (not required for RESPONSE CATEGORY C calls); |
| 05 | The number of TRANSPORT REQUEST INCIDENTS that resulted in an Emergency Ambulance able to transport a PATIENT arriving at the scene of the incident (not required for RESPONSE CATEGORY C calls); |
| 06 | The number of TRANSPORT REQUEST INCIDENTS that resulted in an Emergency Ambulance able to transport a PATIENT arriving at the scene of the incident within 19 minutes (not required for RESPONSE CATEGORY C calls).; |
| 07 | The number of calls resolved through telephone advice only (not required for RESPONSE CATEGORIES A or B calls). |
Part 1 Additional Guidance
EMERGENCY CALLS RESOLVED BY TELEPHONE TOTAL is not required for RESPONSE CATEGORY National Code A 'Category A: immediately life threatening - presenting conditions which require a fully equipped Emergency Ambulance to attend the incident'.
- EMERGENCY RESPONSE WITHIN 8 MINUTES TOTAL and EMERGENCY CALLS RESOLVED BY TELEPHONE TOTAL are not required for RESPONSE CATEGORY National Code B 'Category B: serious but not immediately life threatening'.
- EMERGENCY RESPONSE WITHIN 8 MINUTES TOTAL, EMERGENCY RESPONSE NO AMBULANCE REQUIRED TOTAL, EMERGENCY RESPONSE AMBULANCE ARRIVED TOTAL and EMERGENCY RESPONSE WITHIN 19 MINUTES TOTAL are not required for RESPONSE CATEGORY National Code C 'Category C: other emergency calls which are not immediately life threatening or serious'.
| Part 2 | Patient Destinations: Emergency and Urgent: |
| 08 | Total number of emergency and urgent PATIENT TRANSPORT JOURNEYS to ACCIDENT AND EMERGENCY DEPARTMENT TYPES 1 and 2, sub-divided by RESPONSE CATEGORIES A, B and C. |
| 09 | Total number of emergency and urgent PATIENT TRANSPORT JOURNEYS to ACCIDENT AND EMERGENCY DEPARTMENT TYPES other than types 1 and 2, sub-divided by RESPONSE CATEGORIES A, B and C. |
| 10 | Total number of PATIENTS treated at the scene only, sub-divided by RESPONSE CATEGORIES A, B and C. |
| Part 3 | Patient Journeys: Non-Urgent: |
| 11 | Total number of non-urgent journeys sub-divided into Special Transport Requests and Planned Transport Requests. |
Only the first Emergency Ambulance to arrive at the scene of the TRANSPORT REQUEST INCIDENT should be included in lines 05 and 06 where more than one Emergency Ambulance has been despatched.
Timing of Emergency Response Times
In order to calculate the response time, the 'clock starts' at the TRANSPORT REQUEST CALL CONNECT TIME and the 'clock stops' on the TRANSPORT REQUEST FIRST RESPONSE ARRIVAL TIME or the AMBULANCE ARRIVAL TIME at the scene of the TRANSPORT REQUEST INCIDENT.
An Emergency Response within 8 minutes means 8 minutes 0 seconds (i.e. 480 seconds) or less. Similarly, 19 minutes means 19 minutes 0 seconds or less.
Cross-border Transport Requests
A TRANSPORT REQUEST/TRANSPORT REQUEST INCIDENT that crosses more than one Ambulance Service's boundary should be reported by only one Ambulance Service.
Each NHS Ambulance Service is responsible for reporting on the performance of all Emergency Transport Requests for which it receives the initial TRANSPORT REQUEST. This includes TRANSPORT REQUESTS received by an Ambulance Service that relate to TRANSPORT REQUEST INCIDENTS occurring outside its recognised boundary and TRANSPORT REQUESTS relating to TRANSPORT REQUEST INCIDENTS within or outside its boundary that are subsequently transferred to another Ambulance Service for response.
An Ambulance Service should not report, or report on the performance relating to, any TRANSPORT REQUEST INCIDENT where another Ambulance Service received the initial TRANSPORT REQUEST, even if the TRANSPORT REQUEST was transferred to and dealt with by that Ambulance Service. NHS Trusts responsible for dealing with any cross-border TRANSPORT REQUESTS should advise the NHS Trusts who received the initial TRANSPORT REQUEST of all appropriate clock times for performance reporting purposes.
Where an NHS Ambulance Service asks another NHS Ambulance Service to undertake a TRANSPORT REQUEST on its behalf, the responsibility for dealing with the TRANSPORT REQUEST in the most appropriate way passes to the receiving Ambulance Service once it has accepted it.
Air Ambulances
Air Ambulances are managed locally by Ambulance Services and financed through charitable funding. Any PATIENT TRANSPORT JOURNEY provided by air Ambulance should, therefore, not be included in the Ambulance Services Data Set (KA34).