What do users value about the emergency ambulance service?

The problem: Response times have been used as a key quality indicator for measuring the quality of ambulance services but are criticised for their narrow focus. As outcomes become the focus of commissioning of emergency services, better measures of quality need to be considered including those that reflect the patient perspective. The aim of this study was to investigate patients’ experiences of emergency ambulance use and identify the processes and outcomes important to service users. The approach: We employed a qualitative design, using semi-structured interviews with a purposive sample of people who had recently used a 999 ambulance in the East Midlands. We recruited patients of different age, sex, geographical location, and ambulance service response including patients that received telephone advice only, those that were treated by clinicians at home and others that were transported to hospital. Our topic guide included questions on what users perceived worked well or needed to be improved, before identifying what was particularly important to them. Findings: We interviewed 22 service users. Eleven men and eleven women with a range of different clinical conditions participated;13 were aged 65 years and over.. Four issues were valued: a timely response, information giving, a professional relationship and smooth transition along the prehospital care pathway (from call handling to transfer to acute care). Patients valued a short waiting time for help. Perceptions of timeliness were affected; by expectations, explanation about when a response would arrive and what to do while waiting. Patients welcomed information about their condition, the assessment and treatment being given, and what was going to happen to them. The efficient execution of technical skills and smooth transition through the prehospital pathway from call handler to hospital were also appreciated. These aspects of care offered reassurance which was highly valued by patients who were anxious and in a