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Ambulance Clinical Quality Indicators

Ambulance clinical quality indicators (ACQIs)


Since 1 April 2011, a new set of performance indicators has been introduced for all ambulance services in England.  The new ambulance clinical quality indicators, aim to provide the public with the information they need to be able to see the quality of care being delivered by ambulance services.

As well as maintaining fast response times for the most seriously ill patients, the data also show that ambulance services are using their clinical skills to treat patients or transport them to the most appropriate services.

A dashboard, which has comparative data for all English ambulance services has been developed. This contains a narrative section which provides a brief overview of each of the indicators and further explanation around our performance. For a similar narrative on any other ambulance service you will need to view the dashboard on their website at

Please click on the link below to access the dashboard. Please note that when you open this Excel document, you will need to select Enable Macros.


What are the Clinical Quality Indicators

  • Outcome from acute ST-elevation myocardial infarction (STEMI - a type of heart attack)
    This indicator requires ambulance services to ensure delivery of rapid assessment and treatment for patients experiencing this type of heart attack, as this is crucial to the cardiac care pathway which aims to restore coronary blood flow thereby improving patient outcomes. 
  • Outcome from cardiac arrest - return of spontaneous circulation
    This indicator will measure how many patients who are in cardiac arrest but following resuscitation have a pulse/ heartbeat on arrival at hospital.
  • Outcome from cardiac arrest - survival to discharge
    Following on from the second indicator, this one will measure the rate of those who recover from cardiac arrest and are subsequently discharged from hospital. 
  • Outcome following stroke for ambulance patients
    This indicator will require ambulance services to measure the time it takes from the 999 call to the time it takes those F.A.S.T-positive stroke patients to arrive at a specailist stroke centre  so that they can be rapidly assessed for treatment called thrombolysis.
  • Proportion of calls closed with telephone advice or managed without transport to A&E (where clinically appropriate)
    This indicator should reflect how the whole urgent care system is working, rather than simply the ambulance service or A&E, as it will reflect the availability of alternative urgent care destinations (for example, walk-in centres) and providing treatment to patients in their home.
  • Re-contact rate following discharge of care (i.e. closure with telephone advice or following treatment at the scene)
    If patients have to go back and call 999 a second time, it is usually because they are anxious about receiving an ambulance response or have not got better as expected. Occasionally it may be due to an unexpected or a new problem.  To ensure that ambulance trusts are providing safe and effective care the first time, every time, this indicator will measure how many callers or patients call us back within 24 hours of the initial call being made.
  • Call abandonment rate
    This indicator will ensure that we and other ambulance services are not having problems with people phoning 999 and not being able to get through.
  • Time to answer calls
    It equally important that if people/patients dial 999 that they get call answered quickly. This indicator will therefore measure how quickly all 999 calls that we receive get answered.
  • Service experience
    All ambulance services will need to demonstrate how they find out what people think of the service they offer (including the results of focus groups and interviews) and how we are acting on that information to continuously improve patient care.
  • Category A 8 minute response time
    This indicator measures the speed of all ambulance responses to the scene of potentially life-threatening incidents and measures that those patients who are most in need of an emergency ambulance gets one quickly.
  • Time to treatment by an ambulance-dispatched health professional
    It is important that if patients need an emergency ambulance response, that the wait from when the 999 call is made to when an ambulance-trained healthcare professional arrives is as short as possible, because urgent treatment may be needed.
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