On 1 April 2011, a set of ambulance service clinical quality indicators were introduced. These look at performance across a range of areas, rather than a narrow focus on time. The clinical quality indicators measure both the quality of care delivered by ambulance services (reported as "Systems" measures e.g. the time to treatment) and the clinical outcomes of patients (reported as "Clinical Outcome" measures e.g. survival to discharge) who receive care from NHS ambulance services.
From 1 April 2011, target ‘B19’ (95% of category B, serious but not immediately life-threatening calls should be responded to within 19 minutes) was removed as it had no clinical justification.
A new clock start system was introduced on 1 June 2012 for Red 2 category A ambulance patients, which are calls relating to patients presenting serious but less time-critical conditions. This allows more appropriate ambulance resources to be provided to patients based on their clinical needs and will enable the prioritisation of Red 1 calls (the most time-critical calls, which include cardiac arrest patients who are not breathing and do not have a pulse, and other conditions such as airway obstruction).
For Red 2 patients, the measurement of ambulance response times will use a clock start position that is the earliest of:
(i) the point at which the chief complaint of the call has been identified;
(ii) a vehicle has been assigned to the call; and
(iii)a 60 second cap from Call Connect.