NAO calls for new ambulance data systems

Ambulance services need to develop data systems and procedures quickly, so organisations can collect and share information to measure performance, according to the National Audit Office (NAO).

The auditor's new report, Transforming NHS Ambulance Services, says this is one of the measures needed to make poorly performing trusts more efficient. While it focuses on the implications of the eight minute response target for seriously ill patients, it includes recommendations on the use of data to improve outcomes.

The report says the service collects a wide range of performance data, but that the NHS Information Centre requests different interpretations, different dispatch systems are in use, and ambulance services define some metrics differently. The ability of services to generate performance information, and the quality of data on treatment costs, is also variable.

Some commissioners have specified a minimum dataset within their contracts, but there is no standard set across the service, which makes it difficult to benchmark performance against that of other trusts.

In addition, no ambulance services can accurately identify the final treatment pathway of the patient, and are therefore unable to monitor how well they are doing in taking people to the most appropriate places of care.

The report says they need to develop data systems that can link different organisations. Developing the systems would help to provide a fuller measurement of performance based on outcomes.

Electronic patient record forms, which are being trialled in some parts of England and have been used by the Scottish Ambulance Service since 2008, can make it easier to share information and track patients through the system. However, there have been problems with the interfaces between different hospital systems.

The report points out the wide differences in cost per incident between trusts, and says that if all 11 adopted best practice being used in at least one it could save the NHS £165m a year.

Amyas Morse, head of the National Audit Office, said: "The time taken to respond to calls has until recently been the be all and end all of measuring the performance of ambulance services. Illustrating the principle that what gets measured, gets done, the result has been a rapid response to urgent and emergency calls. However, this led to an increase in the number of multiple responses to incidents equating to millions of unnecessary ambulance journeys.

"It is welcome that the (health) department has now introduced new measures and a new broader performance regime but improvements to the whole urgent and emergency care system will depend on its working more coherently."

This article was originally published at Guardian Government Computing.

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