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Hitting and missing targets by ambulance services for emergency calls: effects of different systems of performance measurement within the UK

By Gwyn Bevan and Richard Hamblin


Following devolution, differences developed between UK countries in systems of measuring performance against a common target that ambulance services ought to respond to 75% of calls for what may be immediately life threatening emergencies (category A calls) within 8 minutes. Only in England was this target integral to a ranking system of ‘star rating’, which inflicted reputational damage on services that failed to hit targets, and only in England has this target been met. In other countries, the target has been missed by such large margins that services would have been publicly reported as failing, if they had been covered by the English system of star ratings. The paper argues that this case-study adds to evidence from comparisons of different systems of hospital performance measurement that, to have an effect, these systems need to be designed to inflict reputational damage on those that have performed poorly; and it explores implications of this hypothesis. The paper also asks questions about the adequacy of systems of performance measurement of ambulance services in UK countries

Topics: RA0421 Public health. Hygiene. Preventive Medicine
Publisher: Wiley on behalf of the Royal Statistical Society
Year: 2009
DOI identifier: 10.1111/j.1467-985X.2008.00557.x
OAI identifier:
Provided by: LSE Research Online
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