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People who call for an ambulance are positive about their telephone advice but improvements still needed, national survey finds

8 July 2014
  • Media

In the first survey of its type, almost 3,000 people gave their views of ‘Hear and Treat’ services – a ‘999’ service, in which trained call handlers give medical advice over the telephone to avoid ambulances and paramedics being sent out when they are not needed.

The survey asked people, amongst other things, whether they felt reassured by staff, whether they were treated with dignity and respect, whether they understood the advice given to them and whether they received an explanation if an ambulance was not sent out.

Callers were asked about the advice they were given during their ‘999’ call. The survey found the majority of respondents had confidence in staff, that they were treated with respect and dignity and were reassured.

Almost three quarters (74%) had complete confidence in the first call handler they spoke to, 71% were reassured by the first call handler and 87% said they were completely treated with dignity and respect. Eleven percent noted that they did not have confidence in the first call handler that they spoke to.

While nearly two thirds (63%) of respondents who only spoke to one call handler felt the reasons for not getting an ambulance were completely explained to them, 27% felt this was not explained fully. 

Comparing the results of whether callers agreed with the decision to send an ambulance, 17% of callers speaking to just one call-handler disagreed with the decision not to send an ambulance despite receiving a full explanation of the reasons.

The results indicate that callers were more likely to disagree with the decision to not send an ambulance if they were not told the reason why, regardless of whether they spoke to one call handler or received clinical advice from a second person.

Although the majority of people were positive overall about the advice given, a minority did not always understand or agree with the advice given at the end of the call, as the following results showed:

  • 83% of people said they were able to completely understand the advice, with 7% who did not understand the advice.
  • 13% of people did not agree with the advice
  • 16% of people did not receive an explanation of the advice

Professor Sir Mike Richards, Chief Inspector of Hospitals at the Care Quality Commission, said: “This ambulance survey shows some positive results. Almost half of the callers rated the service very good, and the majority of people seem to have confidence in their call handlers and are being treated with dignity and respect.

“When someone rings ‘999’ they are in obvious distress and they need to be listened to and allowed to discuss their concerns. In most cases, this seems to be happening.

“As ‘Hear and Treat’ is a telephone advice service, it is really important that clear instructions are given, which people understand and can follow. With seven percent of people reporting that they did not understand the advice that was given to them, ambulance trusts must look into this further.

“We value the importance of public feedback and how people’s experiences are driving improvements. We expect NHS trusts to use the survey findings to identify where improvements are required.”

David Griffiths, National Professional Advisor for Ambulance and Urgent Care at the Care Quality Commission, said: "The results of this survey demonstrate a high level of overall satisfaction, although there are some areas for improvement.

“Ambulance services continue to experience increases in the number of 999 calls they receive, so it is important that everyone recognises the need to use ambulance resources wisely. This is a particularly true in rural areas where travel distances and time to hospitals can be very considerable.

“We expect to see improvements in the areas which we have identified, so that ambulance services provide ’Hear and Treat‘services that are safe and effective.”

Callers were also asked to rate their overall experience out of 10. Over three quarters (76%) were very positive, giving it a score of 8 or more, with 47% giving it the maximum rating of 10.

The full national results, as well as individual results for each of the ten ambulance trusts, are available on CQC’s website. We will also be tweeting the results using  #ambulancesurvey


Last updated:
30 May 2017

Notes to editors

  • Callers are categorised as ‘Hear and Treat’ by the ambulance service as those who do not have serious or life threatening conditions, or who did not otherwise require an immediate ambulance crew response. Callers are triaged and expected that the reason for their call can be resolved through telephone advice. In some cases, the caller may then need to have an ambulance crew or paramedic sent out if their condition worsens or more information comes to light.
  • Almost half of those responding to the survey were the patient themselves (48%), with the remainder calling on behalf of someone else.
  • HSCIC’s statistics on ambulances says in 2012-13 there were 364,965 non-emergency calls in England that were resolved through telephone advice only.
  • Over 2,900 responded to the telephone survey. (The sample for the survey included all callers aged 18 years or older who had received clinical advice from the ambulance service when they called 999 between 1 December 2013 and January 2014.)
  • Later this summer, CQC will be carrying out its first inspection under the new inspection approach, with formal ratings due to begin in January 2015. Full details can be found below.

  • There are two different types of triage system that are used by ambulance trusts in England which are NHS Pathways, and the Medical Priority Dispatch System (MPDS). A caller may speak to more than one person and their experience may vary.  With NHS Pathways, the call taker will ask the caller several questions thorough a series of triage assessments. MPDS uses a small number of clinical questions and the caller receives a call back from a clinician within a time frame determined by the severity of the condition.
  • Out of the ten ambulance trusts involved in the survey, six use MPDS and four use NHS Pathways. Isle of Wight ambulance service was not able to be included due to not receiving a high enough volume of calls.