Change Request
 
NHS Information Authority

NHS Data Model and Dictionary Service

Reference: Change Request 521
Version No: 1.5
Subject: KA34 Changes
Type of Change: Update to NHS Data Dictionary
Effective Date: Immediate
Reason for Change: Revisions to KA34 Ambulance Services Return were notified by DSCN 33/2004. This necessitated changes to data standards including RESPONSE CATEGORY and the KA34 Central Return Form Guidance in the NHS Data Dictionary.

Background:

DSCN 33/2004 reported that the setting and monitoring of Ambulance Category C call performance became locally determined from 1 October 2004. The revised performance requirements necessitated the separation of previously aggregated Category B and Category C call information and the discontinuation of collection of certain data in respect of Category C calls.

Changes to KA34 are effective from 1 October 2004.


Summary of changes:

Class Definitions
EMERGENCY TRANSPORT REQUEST    Change to Description
TRANSPORT REQUEST    Change to Description
 
Attribute Definitions
RESPONSE CATEGORY    Change to Description
RESPONSE TIME - AMBULANCE    Change to Description
URBAN OR RURAL INDICATOR    Change to Description
 
Central Return Forms
KA34 1    Change to Guidance Text
KA34 2    Change to Guidance Text
 

Name: Kevin Shine
Date: 10 February 2005
Sponsor: Department of Health, Statistics Division SD3G

Note: Additions shown in highlighted with a blue background. Deletions are shown using strikeout. Within the Diagrams deleted classes and relationships are shown as red in colour, blue is used for changed items and green is used for created items.

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EMERGENCY TRANSPORT REQUEST

Change to Class: Change to Description
A type of TRANSPORT REQUEST.

A request for emergency transport generally made via a 999 call, to an ambulance service. The ambulance service will be capable of categorising immediately life threatening calls.

Emergency response requires immediate deployment, even if other work is delayed, to provide initial treatment to the patient. In some cases the first emergency response on the scene may be a rapid response vehicle crewed by paramedic equipped to provide treatment at the scene or an approved 'first responder' (e.g. doctor, fire brigade, police) despatched by and accountable to the ambulance service responding, and may not be able to provide patient transport to hospital. In some cases the first emergency response on the scene may be a rapid response vehicle equipped with a defibrillator to provide treatment at the scene or an approved 'first responder' (e.g. doctor, fire brigade, police) equipped with a defibrillator, despatched by and accountable to the ambulance service responding, and may not be able to provide patient transport to hospital. Such response vehicles will be considered as non-ambulances.

The rapid response vehicle or first responder may be the only response if the ambulance service determines that the ambulance can be cancelled. Otherwise, a fully equipped emergency vehicle and fully trained crew of two, able to treat and transport the patient to hospital (an ambulance) will attend.

Requests for emergency transport include:

a. All accident and sudden illness patients
b. Maternity admissions, unless there is a clear indication to the contrary, e.g. that an ambulance is not required until a later specified time.
c. Other type of patient for whom an emergency procedure is necessary

Note: A maternity admission is an admission of a pregnant or recently pregnant woman to a maternity ward (including delivery facilities) except where the intention is to terminate the pregnancy.

This class is also known by these names:

Context Alias
plural EMERGENCY TRANSPORT REQUESTS


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TRANSPORT REQUEST

Change to Class: Change to Description

A request for transport made to an AMBULANCE SERVICE.

Each TRANSPORT REQUEST has a sub-type of EMERGENCY TRANSPORT REQUEST or URGENT TRANSPORT REQUEST or SPECIAL TRANSPORT REQUEST or TRANSPORT REQUEST. Each TRANSPORT REQUEST has a sub-type of EMERGENCY TRANSPORT REQUEST or URGENT TRANSPORT REQUEST or SPECIAL TRANSPORT REQUEST or PLANNED TRANSPORT REQUEST.

This class is also known by these names:

Context Alias
plural TRANSPORT REQUESTS


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RESPONSE CATEGORY

Change to Attribute: Change to Description

The classification of an EMERGENCY TRANSPORT REQUEST. See Call Category Definition http://www. gov.uk/assetRoot/04/08/90/84/04089084.xls

Classification:

a. Category A: immediately life threatening
b. Category B&C: other emergency calls which are not immediately life threatening
b. Category B: serious but not immediately life threatening
c. Category C: other emergency calls which are not immediately life threatening or serious

This attribute is also known by these names:

Context Alias
plural RESPONSE CATEGORIES


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RESPONSE TIME - AMBULANCE

Change to Attribute: Change to Description

The time taken for emergency services to respond to an emergency call with a fully equipped emergency vehicle and fully trained crew of two able to treat and transport the patient to hospital. The time taken for emergency services to respond to an emergency call with a fully equipped ambulance or car able to transport the patient to hospital in a clinically safe manner.

The response time starts when details of the telephone number of the caller, the exact location of the incident and the nature of the chief complaint have been ascertained. The response time ends when the emergency response vehicle arrives at the scene of the incident.

The prior arrival of a rapid response vehicle crewed by a paramedic equipped to provide treatment at the scene, or an approved first responder despatched by and accountable to the ambulance service, counts in calculation of the RESPONSE TIME - NON-AMBULANCE.

This attribute is also known by these names:

Context Alias
plural RESPONSE TIME - AMBULANCES


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URBAN OR RURAL INDICATOR

Change to Attribute: Change to Description

An indication of whether an AMBULANCE SERVICE is in an Urban or Rural environment. This is calculated on the basis of population density in the area served by the AMBULANCE SERVICE. An AMBULANCE SERVICE is considered 'Urban' if its population density is over 2.5 per acre and 'Rural' if under 2.5 per acre. An AMBULANCE SERVICE is considered 'Urban' if its population density was over 2.5 per acre in 1991 and 'Rural' if under 2.5 per acre in 1991.

Classification:

a. Urban
b. Rural

This attribute is also known by these names:

Context Alias
plural URBAN OR RURAL INDICATORS


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KA34 1

Change to Central Return Form: Change to Guidance Text

KA34 - Ambulance Services

Contextual Overview
  1. The Department and Regional Offices require summary details from NHS HEALTH CARE PROVIDERS on ambulance activity. The return provides performance management measures of response time; these are also required by trusts for ambulance service internal monitoring and for defining service agreements.

  1. The Department requires summary details from NHS HEALTH CARE PROVIDERS on ambulance activity. The return provides performance management measures of response time; these are also required by trusts for ambulance service internal monitoring and for defining service agreements.

  1. The information monitors new: ‘Your guide to the NHS’ targets and the standards introduced following a review of ambulance performance standards in 1996-97. The new standards require that, by 2001, all ambulance services will be expected to reach 75% of immediately life-threatening calls within 8 minutes, with further progress thereafter.

  1. The information originally monitored: ‘Your guide to the NHS’ targets and the standards introduced following a review of ambulance performance standards in 1996-97. The standards required that, by 2001, all ambulance services would be expected to reach 75% of immediately life-threatening calls within 8 minutes, with further progress thereafter.

  1. The information is required to inform strategic policy development, to provide data to the Healthcare Commission for performance and activity assessment, to ensure that Spending Review bids reflect changes to overall demand and to inform the development of ambulance trust reference costs.

  1. Information based on the return is published annually in the Department of Health Statistical Bulletin 'Ambulance services; England'.

    Completing Return KA34 - Ambulance Services
  1. The central return KA34 is completed by NHS HEALTH CARE PROVIDERS - Trusts providing an AMBULANCE SERVICE.

  1. The return KA34 relates to activity taking place over a 12 month period, between 1 April of one year and 31 March of the following year. The return is made annually and submitted within one month of the end of the year to which it relates.

  1. The return KA34 relates to activity taking place over a 12 month period, between 1 April of one year and 31 March of the following year. The return is made annually and submitted within one month of the end of the year to which it relates. For the year 2004/05 changes were introduced mid-year; the first 6 months collect information on Emergency Calls Category B & C together while the second 6 months collect information on Category B & C separately. Subsequent years collect information on Emergency Calls Category B & C separately throughout the year see Call Category Definitions http://www.dh.gov.uk/assetRoot/04/08/90/84/04089084.xls

  1. The return requires the ORGANISATION CODE and ORGANISATION NAME of the NHS Ambulance Trust - the NHS HEALTH CARE PROVIDER of the AMBULANCE SERVICE.

  1. The return requires information on:

  2. a. Emergency Calls (Categories A, B&C):
    a. Emergency Calls:
      The following are subdivided by Category A, B & C.
    i. Total number of emergency calls received in the year;
    ii. The number of calls that resulted in an emergency response arriving at the scene of the incident;
    iii. The number of calls that resulted in an emergency response arriving at the scene of the incident within 8 minutes;
    iii. The number of calls that resulted in an emergency response arriving at the scene of the incident within 8 minutes (from 1 October 2004 this is no longer required for Category C calls);
    iv. The number of calls where following the arrival of an emergency response no ambulance is required;
    v. The number of calls that resulted in an ambulance able to transport a patient arriving at the scene of the incident;
    vi. The number of calls that resulted in an ambulance able to transport a patient arriving at the scene of the incident within specified urban or rural target response times.
    v. The number of calls that resulted in an ambulance able to transport a patient arriving at the scene of the incident (from 1 October 2004 this is no longer required for Category C calls);
    vi. The number of calls that resulted in an ambulance able to transport a patient arriving at the scene of the incident within specified urban or rural target response times (from 1 October 2004 this is no longer required for Category C calls).
    b. Patient Journeys: Emergency (Categories A, B&C):
    i. Total number of emergency PATIENT TRANSPORT JOURNEYS.
    b. Patient Journeys: Emergency:
    i. Total number of emergency PATIENT TRANSPORT JOURNEYS sub-divided by Categories A, B & C.
    c. Patient Journeys: Urgent:
    i. Total number of urgent patient journeys
    ii. Arrival time in relation to requested arrival time: number not more than 15 minutes late
    d. Patient Journeys: Non-Urgent:
    i. Total number of special or planned journeys

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KA34 2

Change to Central Return Form: Change to Guidance Text

KA34 - Ambulance Services

Part 1: Emergency Calls (Categories A, B&C)
Part 1: Emergency Calls
  1. Part 1 of KA34 requires information on EMERGENCY TRANSPORT REQUESTS by RESPONSE CATEGORY.

    Category A: Immediately Life Threatening Calls (column 4)
  1. Part 1 of KA34 requires information on EMERGENCY TRANSPORT REQUESTS by RESPONSE CATEGORY. Include any URGENT TRANSPORT REQUESTS, SPECIAL TRANSPORT REQUESTS and PLANNED TRANSPORT REQUESTS which, after interrogation and the agreement of the caller, are treated as EMERGENCY TRANSPORT REQUESTS

    Category A: Immediately Life Threatening Calls (column 4)
  1. A count of the number of EMERGENCY TRANSPORT REQUESTSS with a RESPONSE CATEGORY classification of Category A: immediately life threatening.

    Category B&C: Other Emergency Calls (column 5)
  1. A count of the number of EMERGENCY TRANSPORT REQUESTS with a RESPONSE CATEGORY classification of Category A: immediately life threatening.

    Category B&C: Other Emergency Calls (column 5)
  1. A count of the total number of EMERGENCY TRANSPORT REQUESTS with RESPONSE CATEGORY classifications of Category B: serious but not immediately life threatening and Category C: other emergency calls which are not immediately life threatening or serious. This count applies to calls from April to September 2004.

    Category B (column 6)
  1. A count of the number of EMERGENCY TRANSPORT REQUESTSS with a RESPONSE CATEGORY classification of Category B&C: other emergency calls which are not immediately life threatening.

    Total number of Emergency Calls (line 01)
  1. A count of the number of EMERGENCY TRANSPORT REQUESTS with a RESPONSE CATEGORY classification of Category B: serious but not immediately life threatening.

    Category C (column 7)
  1. This line counts the total number of EMERGENCY TRANSPORT REQUESTSS received. If there have been multiple calls to an incident, count all calls in this line.

    Number of calls resulting in an emergency response arriving at the scene of the incident (line 02)
  1. A count of the number of EMERGENCY TRANSPORT REQUESTS with a RESPONSE CATEGORY classification of Category C: other emergency calls which are not immediately life threatening or serious.

    Total number of Emergency Calls (line 01)
  1. This line counts the number of EMERGENCY TRANSPORT REQUESTSS for which a RESPONSE TIME - NON-AMBULANCE or RESPONSE TIME - AMBULANCE has been recorded.

    Number of calls resulting in an emergency response arriving at the scene of the incident within 8 minutes (line 03)
  1. This line counts the total number of EMERGENCY TRANSPORT REQUESTS received. If there have been multiple calls to an incident, count all calls in this line. From 1 October 2004, requests classified as Category B and Category C are recorded separately

    Number of calls resulting in an emergency response arriving at the scene of the incident (line 02)
  1. This line counts the number of EMERGENCY TRANSPORT REQUESTSS for which a RESPONSE TIME - NON-AMBULANCE or RESPONSE TIME - AMBULANCES has been recorded and the response time is less than or equal to 8 minutes and 0 seconds.

    The response time is the elapsed time from receipt of an emergency call to the time that an emergency response vehicle (ambulance or non-ambulance) arrives at the scene of the incident. The clock starts when the following details about the call have been ascertained (which may be prior to allocation of the despatch code).

    a. caller's telephone number
    b. exact location of the incident
    c. nature of the chief complaint.

    The clock stops when the emergency response vehicle (ambulance or non-ambulance) arrives at the scene of the incident.

  1. This line counts the number of EMERGENCY TRANSPORT REQUESTS for which a RESPONSE TIME - NON-AMBULANCE or RESPONSE TIME - AMBULANCE has been recorded. From 1 October 2004 Categories A, B and C are recorded separately.

    Number of calls resulting in an emergency response arriving at the scene of the incident within 8 minutes (line 03)
  1. This line counts the number of EMERGENCY TRANSPORT REQUESTS for which a RESPONSE TIME - NON-AMBULANCE or RESPONSE TIME - AMBULANCE has been recorded and the response time is less than or equal to 8 minutes and 0 seconds. From 1 October 2004 this detail is not required for Category C.

    The response time is the elapsed time from receipt of an emergency call to the time when the first emergency response vehicle (ambulance or non-ambulance) arrives at the scene of the incident. The clock starts when the following details about the call have been ascertained (which may be prior to allocation of the despatch code).

    a. caller's telephone number
    b. exact location of the incident
    c. nature of the chief complaint.

    The clock stops when the emergency response vehicle (ambulance or non-ambulance) arrives at the scene of the incident.

  1. Where both a RESPONSE TIME - NON-AMBULANCE and a RESPONSE TIME - AMBULANCES have been recorded for the same EMERGENCY TRANSPORT REQUESTS, then the shortest recorded response time should be used to determine if response time is less than or equal to 8 minutes and 0 seconds.

  1. If there have been multiple calls to an incident, count only one call per incident in this line.

    Number of calls where following the arrival of an emergency response no ambulance is required (line 04)
    Number of calls where following the arrival of an emergency response no ambulance is required (line 04)
  1. This line counts the number of EMERGENCY TRANSPORT REQUESTSS with a RESPONSE - AMBULANCE CANCELLED classification of Yes, ambulance cancelled as no longer required. If there have been multiple calls to an incident, count only one call per incident in this line.

    Number of calls resulting in an ambulance able to transport a patient arriving at the scene of the incident (line 05)
  1. This line counts the number of EMERGENCY TRANSPORT REQUESTS with a RESPONSE - AMBULANCE CANCELLED classification of Yes, ambulance cancelled as no longer required. If there have been multiple calls to an incident, count only one call per incident in this line. From 1 October 2004 the Categories A, B and C are recorded separately.

    Number of calls resulting in an ambulance able to transport a patient arriving at the scene of the incident (line 05)
  1. This line counts the number of EMERGENCY TRANSPORT REQUESTSS for which a RESPONSE TIME - AMBULANCES has been recorded. If there have been multiple calls to an incident, count only one call per incident in this line.

    Number of calls resulting in an ambulance able to transport a patient arriving at the scene of the incident within 14 minutes (Urban Services) and 19 minutes (Rural Services) (line 06)
  1. This line counts the number of EMERGENCY TRANSPORT REQUESTS for which a RESPONSE TIME - AMBULANCE has been recorded. If there have been multiple calls to an incident, count only one call per incident in this line. From 1 October 2004 this detail is not reqired for Category C.

    Number of calls resulting in an ambulance able to transport a patient arriving at the scene of the incident within 14 minutes (Urban Services) and 19 minutes (Rural Services) (line 06)
  1. This line counts the number of EMERGENCY TRANSPORT REQUESTSS for which a RESPONSE TIME - AMBULANCES has been recorded and the response time is:

    a. less than or equal to 14 minutes and 0 seconds for an AMBULANCE SERVICE with an URBAN OR RURAL INDICATOR classification of Urban.
       
    or  
       
    b. less than or equal to 19 minutes and 0 seconds for an AMBULANCE SERVICE with an URBAN OR RURAL INDICATOR classification of Rural.

    The response time is the elapsed time from receipt of an emergency call, to the time that the ambulance arrives at the scene of the incident. The clock starts when the following details about the call have been ascertained (which may be prior to allocation of the despatch code).

    a. caller's telephone number
    b. exact location of the incident
    c. nature of the chief complaint.

    The clock stops when the ambulance arrives at the scene of the incident.

  1. This line counts the number of EMERGENCY TRANSPORT REQUESTS for which a RESPONSE TIME - AMBULANCE has been recorded and the response time is:

    a. less than or equal to 14 minutes and 0 seconds for an AMBULANCE SERVICE with an URBAN OR RURAL INDICATOR classification of Urban.
       
    or  
       
    b. less than or equal to 19 minutes and 0 seconds for an AMBULANCE SERVICE with an URBAN OR RURAL INDICATOR classification of Rural.

    From 1 October 2004 this detail is not reqired for Category C.

    The response time is the elapsed time from receipt of an emergency call, to the time that the first ambulance arrives at the scene of the incident. The clock starts when the following details about the call have been ascertained (which may be prior to allocation of the despatch code).

    a. caller's telephone number
    b. exact location of the incident
    c. nature of the chief complaint.

    The clock stops when the ambulance arrives at the scene of the incident.

  1. If there have been multiple calls to an incident, count only one call per incident in this line.

  1. Note that both RESPONSE TIME - NON-AMBULANCE and RESPONSE TIME - AMBULANCESS count towards the 8 minute standard, but only RESPONSE TIME - AMBULANCES counts towards the 14/19 minute standard.

    Part 2: Patient Journeys: Emergency (Categories A, B&C)
    Total number of emergency patient journeys (line 07, column 7)
  1. Note that both RESPONSE TIME - NON-AMBULANCE and RESPONSE TIME - AMBULANCE count towards the 8 minute standard, but only RESPONSE TIME - AMBULANCE counts towards the 14/19 minute standard.

    Part 2: Patient Journeys: Emergency
    Total number of emergency patient journeys (line 07, columns 9-12)
  1. This counts the total number of PATIENT TRANSPORT JOURNEYS made as a result of EMERGENCY TRANSPORT REQUESTS for each RESPONSE CATEGORY. Each patient conveyed is counted as an individual emergency patient journey. Include any URGENT TRANSPORT REQUESTS, SPECIAL TRANSPORT REQUESTS and PLANNED TRANSPORT REQUESTS which, after interrogation and the agreement of the caller, are treated as EMERGENCY TRANSPORT REQUESTS.

  1. This counts the total number of PATIENT JOURNEYS made as a result of EMERGENCY TRANSPORT REQUESTSS for all RESPONSE CATEGORIES. Each patient conveyed is counted as an individual emergency patient journey.

    Part 3: Patient Journeys: Urgent
    Total number of urgent patient journeys (line 08, column 9)
  1. Column 9 counts the total for Category A.
    Column 10 counts the total for Category B & C combined for the period April to September 2004.
    Column 11 counts the total for Category B from October 2004.
    Column 12 counts the total for Category C from October 2004.

    Part 3: Patient Journeys: Urgent
  1. This counts the total number of PATIENT JOURNEYS made as a result of URGENT TRANSPORT REQUESTS.

    Arrival Time in relation to Requested Arrival Time: Number not more than 15 minutes late (line 09, column 9)
  1. Exclude any URGENT TRANSPORT REQUESTS which, after interrogation and the agreement of the caller, are treated as EMERGENCY TRANSPORT REQUESTS.

    Total number of urgent patient journeys (line 08, column 14)
  1. This counts the number of PATIENT JOURNEYS made as a result of URGENT TRANSPORT REQUESTS, where the difference between the ARRIVAL TIME REQUESTED and the actual ARRIVAL TIME recorded is 15 minutes or less.

  1. This counts the total number of PATIENT TRANSPORT JOURNEYS made as a result of URGENT TRANSPORT REQUESTS.

    Arrival Time in relation to Requested Arrival Time: Number not more than 15 minutes late (line 09, column 14)
  1. This counts the number of PATIENT TRANSPORT JOURNEYS made as a result of URGENT TRANSPORT REQUESTS, where the difference between the ARRIVAL TIME REQUESTED and the actual ARRIVAL TIME recorded is 15 minutes or less.

    Part 4: Patient Journeys: Non-Urgent
    Total number of special/planned journeys (line 10, column 11)
    Total number of special/planned journeys (line 10, column 16)
  1. This counts the total number of PATIENT JOURNEYS made as a result of SPECIAL TRANSPORT REQUESTS and PLANNED TRANSPORT REQUESTS.

  1. This counts the total number of PATIENT TRANSPORT JOURNEYS made as a result of SPECIAL TRANSPORT REQUESTS and PLANNED TRANSPORT REQUESTS.

  1. Exclude any SPECIAL TRANSPORT REQUESTS and PLANNED TRANSPORT REQUESTS which, after interrogation and the agreement of the caller, are treated as EMERGENCY TRANSPORT REQUESTS or URGENT TRANSPORT REQUESTS .


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