title: Targeted response? An exploration of why ambulance services find government targets particularly challenging.
abstract: Ambulance services have historically found their targets particularly challenging. This article explores some areas of this multifaceted problem.
  
  
  
  Research articles, government publications and published audit data.
  
  
  
  Demand is increasing in many areas of healthcare, but whilst hospitals saw a 7% increase in demand in recent times, ambulance services saw nearly double that. The services ambulance trusts provide have evolved from that of a transport service to that of a mobile health provider, and they have become victims of their own success.
  
  
  
  Ambulance targets have never evolved to match evolving care. Ambulance personnel strive to avoid hospital attendance where appropriate, but this can be difficult for a 24-hour service, when not all referral pathways have 24-hour referral systems.
  
  
  
  We discuss why demand might be growing disproportionately for ambulance services, and challenge the appropriateness of the targets themselves.
  
  
  
  Possible formats for revised ambulance targets are discussed.
authors.affiliation: Critical Care Paramedic, South East Coast Ambulance Service, Brighton Ambulance Station, BN2 3EU, Elm Grove Brighton Mark.Durham@secamb.nhs.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: Durham
authors.affiliation: Advanced Paramedic Practitioner, 220 Waterloo Rd, SE1 8SD, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Faulkner
authors.affiliation: University of Southampton, University Rd, SO17 1BJ, Southampton, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Deakin
mesh_terms: D000552:Ambulances / Q000706:statistics & numerical data; D017598:Efficiency, Organizational / Q000592:standards*; D004632:Emergency Medical Services / Q000191:economics / Q000458:organization & administration / Q000592:standards; D004636:Emergency Service, Hospital; D006076:Government; D006301:Health Services Needs and Demand; D006801:Humans; D013222:State Medicine / Q000458:organization & administration; D014187:Transportation of Patients; D014218:Triage; D006113:United Kingdom
keywords: ambulance; targets; triage