How Ambulance Trusts can use data effectively to transform productivity 

Ambulance Trusts across the UK are under growing pressure to improve response times to meet the NHS’s ambitious target to achieve an average 18-minute Category 2 response time by 2028/29, but current performance is still falling short, with an average of 30 minutes in 2026/27 so far. The lowest performing trusts averaged 40 minutes. Since the Ambulance Response Programme (ARP)  standards were introduced in 2017, only two trusts have ever achieved the target, and it has never been met nationally.

As Trusts continue to grapple with the challenge of more demand, increasingly complex patient needs, and hospital handover delays, a more complex flow problem has emerged across the whole urgent and emergency care system. This is putting increasing pressure on NHS leaders to find solutions through data and use it to target points for improvement and efficiency.

18-minutes represents an ambitious target. Most ambulance trusts will need to take a transformational approach, as opposed to an incremental approach, if they are to achieve this over the next three years. As systems move towards integrated models of urgent and emergency care, ambulance services must harness the data they already hold and utilise it to improve productivity, reduce unwarranted variation, and deliver safer, faster care.

Today’s performance gap presents an opportunity to rethink longstanding operational rhythms, strengthen relationships across the system, and use data-driven insights to shift resources to where they’ll have the greatest impact. Working collaboratively, removing barriers for frontline staff, and aligning incentives across services has the potential to drive significant improvements across Trusts.

Which begs the question, how can Ambulance Trusts use their data intentionally to enhance productivity and boost performance? We set out five practical steps to strengthen response time across the urgent and emergency care system and deliver better patient outcomes.

1. Reduce conveyance by strengthening non-urgent care pathways

Too many patients still attend Accident and Emergency (A&E) when they can be safely treated outside the hospital. Conveyance decisions have a significant impact on performance. The more patients taken to the hospital, the fewer crews available for new calls.

Ambulance Trusts can use patient data to understand which patients are most likely to be conveyed and identify where better alternative pathways could be offered. This can help accelerate alternative clinically supported pathways, such as:

• Call Before Convey, which enables paramedics to speak to A&E consultants before making a conveyance decision
• Virtual Wards, allowing patients to be assessed and treated from home
• Urgent Community Response (UCR) teams, which rapidly support patients in the community to avoid hospital attendance.

By analysing local variation in pathway usage, Trusts can pinpoint where additional training or clinical support is needed. Ambulance crews would benefit from a Single Point of Access (SPA) or Urgent Care Coordination Hub to simplify referrals and ensure crews can make confident, quick decisions.

2. Increase Hear & Treat through confident clinical decision-making

Many paramedics and clinicians are conducting telephone triage without consistent access to the information they need. By increasing the use of effective Hear & Treat care, Trusts can free up time and resources by reducing unnecessary dispatches.

Trusts can use telephony and triage data to identify where gaps in capability, information, or pathway knowledge are holding back performance and implement improvement procedures such as:

• Providing dedicated training on remote clinical assessment
• Giving staff access to patient records and primary care booking systems
• Enabling clinical rotations across 111 and 999 services to deepen colleagues’ understanding of urgent and emergency care pathways.

This will ensure clinicians feel confident making remote decisions that avoid dispatching an ambulance unnecessarily – without compromising safety.

3. Improve productivity by reducing unwarranted variation

For many Ambulance Trusts, operational variation is one of the biggest barriers to improved performance. Abstractions and vehicle downtime (out-of-service periods) create avoidable reductions in fleet and crew availability, and data highlights substantial differences between Trusts. To reduce operational variation and smooth out service differences, Trusts should:

• Use internal and external benchmarking to identify best practices
• Track key operational metrics through productivity reporting
• Introduce Team-Based Working, enabling crews to influence performance through shared data and regular feedback.

This isn’t about pushing crews harder. It’s about giving operational managers the granular insight they need to plan more effectively, reduce avoidable downtime, and make more efficient decisions about shift patterns, vehicle allocation, and abstraction management.

4. Reduce on-scene time through clinically-led quality improvement

On-scene time varies widely across patient cohorts, but offers an opportunity for ambulance crews to take control of this performance level. By identifying cohorts with the greatest variation in on-scene time or conveyance, Trusts can focus on their quality improvement (QI) efforts where they have the most impact.

A clinically led QI approach enables teams to:

• Understand which variations in on-scene time are clinically warranted
• Assess the trade-offs between longer assessment, conveyance, reattendance, and safety
• Develop targeted interventions that reduce unwarranted variation without adding risk.

Easily accessible, quality data is essential to this process: ensuring clinicians can make informed decisions, refine their approaches, and track the outcomes for patient safety and system flow.

5. Work collaboratively with hospitals to tackle handover delays

Delays in hospital handovers are the single biggest driver of missed response time targets. To hit this target and improve patient outcomes, crews must reduce wait times outside A&E to avoid knock-on effects to the next call out. When Category two performance drops, patient safety is compromised, and ambulance availability is severely reduced.

To streamline handover, Trusts should work with acute partners to design data-driven approaches that keep patients safe and crews moving, including implementing:

• Cohorting, allowing crews to hand over multiple patients simultaneously
• Treat & Go, enabling hospital clinicians to assess patients on ambulances and discharge them home where appropriate
• Hospital Ambulance Liaison Officers (HALOs), who coordinate the flow of patients and prioritise the ambulance queue

By quantifying the performance impact of delays, Trusts and commissioners can ensure handover challenges are accurately represented in system reporting and improvement plans.

A system-wide approach driving meaningful change to urgent and emergency care

Designing and delivering productivity programmes grounded in data, supported by strong system partnerships, is key to enabling transformative productivity shifts across Ambulance Trusts. These programmes quantify where improvements will have the greatest impact, help shift resources closer to home, and create shared models of working that benefit patients and staff across the system.

Achieving the 18-minute Category Two response time target is challenging. But with the right data, structured collaboration, and a strong operational grip, Ambulance Trusts can make meaningful progress towards the NHS’s 2028/29 standards, improving outcomes and delivering faster care when it matters most.