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Performance measurement and the UK emergency ambulance service Unintended consequences of the ambulance response time targets

Performance measurement and the UK emergency ambulance service Unintended consequences of the... Purpose – The purpose of this paper is to assess the performance measurement in the UK NHS ambulance service documenting various unintended consequences of the current performance framework and to suggest a future research agenda. Design/methodology/approach – The paper reviews the literature on ambulance performance targets and documents several unintended consequences of the current performance system through an in‐depth case study analysis based on interviews with Trust staff and policy experts along with observation of performance review meetings in the chosen Trust. Ethical approval for the study was obtained from a local NHS research ethics committee. Findings – Significant unintended consequences of the ambulance performance targets based on response times have been systematically documented, which are likely to put the target under spotlight, especially that of the eight‐minute response. The current policy focus to reform the eight‐minute target by making it more stringent has the potential of jeopardising the reform agenda based on developing clinical skills of the paramedics and introducing clinical management in the service. Practical implications – The paper makes an objective assessment of the sustainability of the current policy framework and identifies future lines of enquiry for further research. Originality/value – This paper makes an original contribution in identifying and documenting the disjuncture between stated and unintended consequences of ambulance performance measurement, which will be of value to academics, practitioners and policy makers. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Public Sector Management Emerald Publishing

Performance measurement and the UK emergency ambulance service Unintended consequences of the ambulance response time targets

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Publisher
Emerald Publishing
Copyright
Copyright © 2011 Emerald Group Publishing Limited. All rights reserved.
ISSN
0951-3558
DOI
10.1108/09513551111147132
Publisher site
See Article on Publisher Site

Abstract

Purpose – The purpose of this paper is to assess the performance measurement in the UK NHS ambulance service documenting various unintended consequences of the current performance framework and to suggest a future research agenda. Design/methodology/approach – The paper reviews the literature on ambulance performance targets and documents several unintended consequences of the current performance system through an in‐depth case study analysis based on interviews with Trust staff and policy experts along with observation of performance review meetings in the chosen Trust. Ethical approval for the study was obtained from a local NHS research ethics committee. Findings – Significant unintended consequences of the ambulance performance targets based on response times have been systematically documented, which are likely to put the target under spotlight, especially that of the eight‐minute response. The current policy focus to reform the eight‐minute target by making it more stringent has the potential of jeopardising the reform agenda based on developing clinical skills of the paramedics and introducing clinical management in the service. Practical implications – The paper makes an objective assessment of the sustainability of the current policy framework and identifies future lines of enquiry for further research. Originality/value – This paper makes an original contribution in identifying and documenting the disjuncture between stated and unintended consequences of ambulance performance measurement, which will be of value to academics, practitioners and policy makers.

Journal

International Journal of Public Sector ManagementEmerald Publishing

Published: Jul 12, 2011

Keywords: Ambulances; Response time targets; Performance measures; Unintended consequences; Perversity; National Health Service

References