Summary of ambulance response time data in the UK

The section provides links to the ambulance response time data that each nation currently publishes, along with details of the statistical producer, the frequency of publication, and an overview of the data.

England

The NHS England Ambulance Quality Indicators Data is published monthly by NHS England.

The dataset includes the mean and 90th centile ambulance response times for a given month. The response times are reported in hours, minutes, and seconds. Data is given:

• by ambulance response category
• for England overall
• for the English regions
• for the separate NHS ambulance services of England

Northern Ireland

The Northern Ireland emergency care and ambulance statistics are published annually by the Department of Health Northern Ireland.

The dataset presents mean ambulance response times by month and ambulance response category for Northern Ireland and Local Commissioning Group. The response times are reported in hours, minutes, and seconds.

Scotland

The Scottish Ambulance Service Unscheduled Care Operational Statistics are published weekly by the Scottish Ambulance Service. They are official statistics in development.

The dataset presents the median and 90th percentile ambulance response time by week, for each of the ambulance response categories for Scotland and NHS Board. The response times are reported in hours, minutes, and seconds.

Wales

Data about the ambulance services in Wales is published monthly by Welsh Government.

The data include:

• mean and median ambulance response times for immediately life-threatening calls in Wales
• the proportion of immediately life-threatening calls in Wales that are responded to within the target of 8 minutes

Data are available by Local Health Board and month. The response times are reported in minutes and seconds.

Calls to each UK nation’s ambulance service are assigned an ambulance response category based on the information the call handler receives about the incident.

Each ambulance response category has different response standards including, for example, the target time in which an incident should be responded to. The quickest response standards are given to the most urgent ambulance response category. Depending on the information the call handler receives, an ambulance service can change which ambulance response category an incident is assigned at any point before an ambulance arrives at the scene.

Scotland and Wales use ambulance response categories that are unique to their ambulance service. England and Northern Ireland use ambulance response categories outlined by the NHS England Emergency Call Prioritisation Advisory Group (ECPAG).

Ambulance response categories for England and Northern Ireland

The ambulance response categories used by England and Northern Ireland are outlined by the NHS ECPAG. Although both nations use the same guidance, their ambulance services are run separately. This means there are minor differences in how incidents are assigned to categories. Both nations also use different response standards. This means the data providers discourage users from making direct comparisons of these data.

The categories are as follows:

• “C1” refers to life-threatening incidents
• “C1T” is a subset of the C1 category and refers to life-threatening incidents where patient transportation in an ambulance service vehicle is needed — most C1 incidents are also C1T
• “C2” refers to emergency incidents
• “C3” refers to urgent incidents
• “C4” refers to less urgent incidents

Ambulance response categories for Scotland

The Scottish Ambulance Service (SAS) implemented a new Clinical Response Model (CRM) for Emergency 999 Calls in November 2016. The CRM aims to save more lives by more accurately identifying patients with immediately life-threatening conditions, such as cardiac arrest. It also aims to save more lives by sending matched resource more effectively to patients based on their clinical need. The model uses a colour-coded system which categorises 999 calls in terms of need.

The colour-coded categories are as follows:

• “Purple” refers to incidents where a patient is identified as having a 10% or higher than 10% chance of having a cardiac arrest
• “Red” refers to incidents where a patient is identified as having a likelihood of cardiac arrest between 1% and 9.9%, or having a need for resuscitation interventions such as airway management above 2%
• “Amber” refers to incidents where a patient is likely to need diagnosis and transport to hospital or specialist care
• “Yellow” refers to incidents where a patient has a need for care but has a very low likelihood of requiring life-saving interventions — for example, this could include patients who have tripped or fallen but not sustained any serious injury

Ambulance response categories for Wales

As a result of the Strategic Review of Welsh Ambulance Services, also known as the McClelland review, the Welsh Ambulance Services NHS Trust (WAST) introduced a new clinical response model from 1 October 2015. The response model aims to provide a more timely and clinically appropriate response to patients.

The categories for the response model are as follows:

• “Red” refers to immediately life-threatening incidents
• “Amber” refers to incidents that are serious, but not immediately life-threatening
• “Green” refers to neither serious, nor life-threatening incidents

Ambulance response standards are the target times in which incidents should be responded to. Different ambulance response standards apply to the different ambulance response categories. These operational choices are reflected in the ambulance response time data.

Ambulance response standards for England

The mean ambulance response standard of incidents within the C1 category is 7 minutes, with the 90th centile of all incidents within this category being responded to within 15 minutes. For C1 in England, there is no standard for the arrival time of the transporting vehicle, known as the C1T time.

The mean ambulance response standard of incidents within the C2 category is 18 minutes, with the 90th centile of all incidents within this category being responded to within 40 minutes.

For incidents within the C3 category, the ambulance response standard is that the 90^th centile of all incidents in this category should be responded to within 120 minutes.

For incidents within the C4 category, the ambulance response standard is that the 90^th centile of all incidents in this category should be responded to within 180 minutes.

Ambulance response standards for Northern Ireland

The mean ambulance response standard of incidents within the C1 category is 8 minutes, with the 90th centile of all incidents within this category being responded to within 15 minutes. In addition, the mean standard for the arrival time of the transporting vehicle, or the C1T time, is 19 minutes, with a 90th centile of 30 minutes.

The mean ambulance response standard of incidents within the C2 category is 18-minutes, with the 90th centile of all incidents within this category being responded to within 40 minutes.

For incidents within the C3 category, the ambulance response standard is that the 90^th centile of all incidents in this category should be responded to within 120 minutes.

For incidents within the C4 category, the ambulance response standard is that the 90^th centile of all incidents in this category should be responded to within 180 minutes.

Ambulance response standards for Scotland

The median ambulance response standard of incidents for each category are as follows:

• Purple category incidents have a median ambulance response standard of 6 minutes, with the 95th centile of all incidents within this category being responded to within 15 minutes
• Red category incidents have a median ambulance response standard of 7 minutes, with the 95th centile of all incidents within this category being responded to within 18 minutes
• Amber category incidents have a median ambulance response standard of 15 minutes, with the 95th centile of all incidents within this category being responded to within 30 minutes
• Yellow category incidents have a median ambulance response standard of 20 minutes, with the 95^th centile of all incidents within this category being responded to within 60 minutes

Ambulance response standards for Wales

Only Red calls have a set response standard. 65% of these types of calls are expected to have an emergency response at the scene within 8 minutes.

“Clock start time” refers to when the ambulance service starts recording how long it takes for an ambulance to respond to an incident. An incident will have different clock start times in each country, depending on the ambulance response category it is assigned to.

Clock start times in England and Northern Ireland

For C1 and C1T incidents, clock start times are recorded at the earliest of the following:

• the incident is clinically coded by the call handler
• the first resource is assigned
• within 30 seconds of call connect

For C2, C3 and C4 incidents, clock start times are recorded at the earliest of the following:

• the incident is clinically coded by the call handler
• the first resource is assigned — this resource is usually an ambulance
• within 240 seconds of call connect

If the ambulance response category is changed to C1 at any point during the call, the clock start time restarts.

Clock start times in Scotland

For all incidents, clock start times are recorded when the chief complaint has been established from the call and the incident is first assigned to an ambulance response category.

The clock start time does not factor in possible upgrading or downgrading that may occur depending on the patient condition. For example, a call may start out as a yellow call and be upgraded to a purple call some time later, but only the total time from the first call received is shown. The starting point is always set for the colour category first determined, not the final colour category assigned. Where delays occur, clinical advisors maintain contact with the patient, checking their condition on an ongoing basis, and upgrading when appropriate.

Clock start times in Wales

For “Red” incidents, clock start times are recorded when the patient’s location and the chief complaint has been established.

For “Amber” and “Green” incidents, clock start times are recorded when the patient’s location and the dispatch code have been established from the call.

“Clock stop time” refers to when the ambulance service stops recording how long it has taken for an ambulance to respond to an incident.

Clock stop times in England

For C1 incidents, the clock stop time is recorded when the first ambulance response resource arrives on scene.

For C1T incidents, the clock stop time is recorded when vehicle arrives to transport the patient.

For C2, C3 and C4 incidents, the clock stop time is recorded when the first ambulance resource arrives on scene. But if a patient needs transporting, the clock stop time is recorded when the transporting vehicle arrives.

Clock stop times in Northern Ireland

For C1, C2, C3 and C4 incidents, the clock stop time is recorded when the first ambulance response resource and Rapid Response Vehicle (RRV) arrives on scene.

For C1T incidents, the clock stop time is recorded when a vehicle arrives to transport the patient.

Clock stop times in Scotland and Wales

Clock stop times are generated when the first ambulance or responder arrives at the scene of the incident. This can be recorded in one of three ways:

• when ambulance service tracked vehicles arrive within a 200m geo-fence of the incident location
• through a manual button press from ambulance service vehicles using the Mobile Data Terminal (MDT) to confirm they are on scene
• where a clinician, first responder, or ambulance resource confirms verbally to the Ambulance Control Centre (Scotland) or Clinical Coordination Centre (Wales) that they are on scene

The earliest of these three times is used for performance purposes.