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Ambulance calls and cancellations: policy and implementation issues

James Radcliffe (Faculty of Health, Staffordshire University, Stoke‐on‐Trent, UK)
Geoffrey Heath (Faculty of Economic and Management Studies, Keele University, Keele, UK)

International Journal of Public Sector Management

ISSN: 0951-3558

Article publication date: 10 July 2009




The purpose of this paper is to explore the issues around the considerable increase in emergency calls experienced by a large county ambulance trust and implications for the implementation of government policy in relation to the English National Health Service Ambulance Service.


The paper involves a literature review and the analysis of the ambulance service data based on emergency call outs, and discussions with senior ambulance and health authority personnel.


Increased calls were mainly explained by a large increase in cancellations, especially after the vehicle had arrived at the scene. The term “cancellation” is potentially misleading and may carry connotations of wasted resources. There was little evidence of inappropriate calls and no single cause of cancellations or any simple solution. Instead, a wide range of actions were included, many of which seem potentially worthwhile. However, the way the data are presented disguises their diversity and potential value. This reflects the tension between policy and practice, and organisational culture and performance measurement regime.

Research limitations/implications

This is a single case study and is limited by the parameters of the data base gathered by the ambulance service as part of their normal operational procedures.

Practical implications

This paper gives support to the enhanced role of the ambulance paramedic and the need to recognise this changing role through a more appropriate approach to performance measurement. The present emphasis on response times and transportations to hospital may result in undervaluing activities at the scene.


The paper identifies a key area where research into policy and governance issues has been limited and presents recommendations for future analysis.



Radcliffe, J. and Heath, G. (2009), "Ambulance calls and cancellations: policy and implementation issues", International Journal of Public Sector Management, Vol. 22 No. 5, pp. 410-422.



Emerald Group Publishing Limited

Copyright © 2009, Emerald Group Publishing Limited

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