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The purpose of this paper is to explore the organisational cultures of two different parts of the emergency service, the police and the ambulance service.

Semi-structured interviews with 45 police officers and ambulance staff sought to understand more about the relationships between these two distinctly different professions who work together closely and regularly in often very difficult situations.

Interviews with police officers and ambulance staff revealed the strong and harmonious working relationship between the two professions and an existence of both shared organisational characteristics and shared cultural characteristics. These cultural characteristics, identified as both explicit and tacit in nature provide the “glue” which not only binds each organisation together but which appears to cement a longer term, tangible link between the police and ambulance services.

This paper reveals a new dimension within cultural analyses of occupational groups by considering the shared cultural characteristics of two groups within the emergency services, police officers and ambulance staff. This potential for cultural boundary crossing is explored in detail.

An “event” tree technique was used alongside conventional methods for structuring and reporting an audit of ambulance services in Lancashire, UK, for patients with suspected acute myocardial infarction (AMI) and cases of cardiac arrest. The audit covered 4,100 patients attended by ambulance crews. Cross tabulations showed that audit targets were not achieved for recording heart rhythms in non‐arrest cases, administering aspirin and intravenous cannulation. The event tree, linked electronically with the audit database, demonstrated explicitly that only one‐third of non‐arrest patients received all three procedures. With cardiac arrests, the event tree showed that survival rates to hospital were similar for patients in ventricular fibrillation who were defibrillated regardless of whether or not they received anti‐arrhythmic drugs. Interpretation of their performance levels is facilitated by the event‐tree technique that allows relationships between clinical procedures and outcomes of ambulance journeys to be displayed.

The purpose of this paper is to analyse the culture change management programme in one UK NHS ambulance service, documenting various perverse consequences of the change management and suggest further research implications.

The paper reviews the literature on “culture” and “culture change” and identifies several perverse consequences of a culture change management programme through an in-depth case study analysis, based on interviews with trust staff and policy experts along with non-participant observation. Study was given ethical approval by the local NHS research ethics committee.

Significant negative consequences of the culture change management programme in the ambulance service are systematically documented. The paper argues that any worthwhile study of organisational culture change management must take into account the perverse consequences of such a process and its overall impact on employees.

These findings come from detailed investigation from only one large ambulance trust in the UK. However they have significant implications for the organisational “culture-performance” debate.

The paper draws out several policy and practice implications from this empirical study. Any meaningful evaluation of culture change initiatives should be seen not only in relation to success in achieving planned objectives, but also by keeping in mind negative consequences of culture change programmes.

This paper makes an original contribution in identifying and systematically documenting the disjuncture between stated and unintended consequences of ambulance culture change management programme, which will be of value to academics, practitioners and policy makers including theory building.

Emergency services face increasing frontline pressure to support those experiencing mental health crises. Calls have been made for police and ambulance staff to receive training on mental health interventions, prevention of risk and inter-professional collaboration. Mental health simulation training, a powerful educational technique that replicates clinical crises for immersive and reflective training, can be used to develop competencies in emergency staff. This study aims to evaluate the effectiveness of mental health simulation training for police and ambulance staff.

In total, 199 participants from the London Metropolitan Police Service and London Ambulance Service attended a one-day simulation training course designed to promote effective and professional responses to mental health crises. Participants took part in one of six simulated scenarios involving mental health crisis before completing structured debriefs with expert facilitators. Participants’ self-efficacy and attitudes towards mental illness were measured quantitatively using pre- and post-course questionnaires while participants’ perceived influence on clinical practice was measured qualitatively using post-course open-text surveys.

Statistically significant improvements in self-efficacy and attitudes towards mental illness were found. Thematic analyses of open-text surveys found key themes including improved procedural knowledge, self-efficacy, person-centred care and inter-professional collaboration.

This study demonstrates that mental health simulation is an effective training technique that improves self-efficacy, attitudes and inter-professional collaboration in police and ambulance staff working with people with mental health needs. This technique has potential to improve community-based responses to mental health crises.

The purpose of this paper is to evaluate the time, place and ambulance types specified on the ambulance patient registry forms for cases transferred through 112 EMS in the Bozcaada and Gökçeada island districts of the province of Çanakkale.

The universe of the descriptive – cross-sectional epidemiological study was composed of the ambulance patient registration forms of the cases which were transferred from Bozcaada and Gökçeada islands between January 1, 2009 and December 31, 2013.

Of the transfers made, 28.1 percent were in the year 2012, 39.5 percent were in summer, 16.6 percent were in July, 17.9 percent were on Monday, 37.1 percent were between 12.00 and 17.59 h and 61.5 percent were from Gökçeada island. Ground ambulances were more common in the transfers from Bozcaada island, while ambulance boat and helicopter ambulance were more common for transfers from Gökçeada island. Helicopter-Emergency Medical Service (HEMS) (p<0.001), which is commonly preferred for patient transfers, inversely affects the use of Ambulance Boat-Emergency Medical Service (BEMS) and ground ambulances. Transfers from Bozcaada island were found to be shorter in duration, and the number of transfers from Bozcaada island between 00.00 and 05.59 h were found to be higher than from Gökçeada island (p<0.001), while the number of transfers via ground ambulance between 00.00 and 05.59 h were found to be higher than the other ambulance types (p<0.001).

This study reveals the current state of the various referral routes from the islands.

This paper is the first study to demonstrate the characteristics of patients referred from the island belongs to Turkey.

This paper critiques the notion that a single approach to performance improvement can alone be responsible for significant organisational transformation. We draw on phenomenological case study evidence, placed in the context of an ongoing series of studies of the nature and prevalence of best practice benchmarking in the UK, including large‐scale questionnaire surveys and longitudinal case studies of the rich experiences of a number of practitioners and organisations. We argue that complex approaches to performance improvement such as benchmarking, however technically powerful they may be, are only as effective as the people who apply them and their compatibility with the organisational context in which they are used. The contribution of such methods is often difficult to separate from other variables. In addition to internal organisational characteristics, external contextual factors play an important part both in establishing a need to use such approaches, and encouraging commitment to their use. Some of the clearest examples of the distortion of the potential impact of new management practices by the wider policy context can be found in public services such as the National Health Service, from which examples are drawn in this paper.

The application of BS 5750: Part 2 to the wide range of Ambulance Service activities demonstrates service‐wide commitment to quality assurance and should lead to “customer” confidence and an improvement in competitiveness. Cambridgeshire′s Ambulance Service makes significant strides towards accreditation.

The purpose of this paper is to carry out queuing analysis to analyse patient load in outpatient and inpatient services to facilitate more realistic resource planning.

The paper adopts an analytical approach based on real life data (e.g. not a priori or an academic one where data are mingled to fit a theoretical stance) in accordance with the service level prescribed by the hospital administration. A service level is usually specified in terms of admissible range of queuing characteristics, such as mean patient waiting time, reduction of inordinate delays, incidences of minimum delays, average queue length, etc. which the management of a health organisation may decide to aim and control.

Queuing analysis reported in this case study provides a basis for estimating medical staff size and number of beds, which are two very important resources for outpatient and inpatient services in a large hospital, and all other hospital resources in one way or another depend on them.

The study challenges and aims to replace thumb‐rule approaches, which can be very conveniently carried out with efficient computer aids available at present for any hospital. Queuing analysis provides valuable insights into a hospital system, though it may not be the best approach as several underlying assumptions may not always hold true. In hospitals, for example, there can be several interacting queues, many of which could be cyclic with interaction among them. Accordingly, treatment of each queue individually, independent of others may not be a valid assumption.

Medical staff (doctors) and beds are very basic hospital resources, which largely depend on the hospital load in terms of arrival rates of patients in outpatient and inpatient services. When hospitals are adequately staffed and equipped in terms of beds and other key resources, it is unlikely that patients will turn away to other hospitals for treatment and there will be all round satisfaction with the hospital performance.

The authors do not claim the findings to be novel or unique but rather more well‐documented and comprehensive in coverage than available in existing literature. The practice‐based themes such as this well‐documented case study may evoke global interest as a multiplier effect for using such methodologies for resource planning in hospitals.

Summarizes the management of change in a high profile public service with more than its fair share of political influences. Demonstrates the scale of change possible, given a clear strategy and a strong managerial commitment. Argues that this leads to high productivity, quality and value for money, with a strong element of organizational loyalty and ownership of the end product.

The purpose of this paper is to analyse the socio-material practices through which organisational understanding of patients is accomplished in order to prioritise calls and mobilise emergency medical services at the gateway of the healthcare system.

The methodology of this paper is an ethnographic study of the co-ordination of collective action in an emergency services control room in the Welsh NHS, with data generation and analysis informed by Translational Mobilisation Theory.

Mobilisation of emergency medical services entails the translation of callers' undifferentiated problems into response priority categories, which are used by dispatch operators to mobilise crews. A central actor in these processes is the computerised Medical Priority Dispatch System. While designed to enable non-clinically qualified call handlers to triage calls in a standardised way, the system constrains caller–call handler interaction, which negatively impacts the categorisation process. Analysis of these interactional difficulties and associated mitigation strategies highlights opportunities for intervening to support co-ordination at this healthcare boundary.

Orthodox approaches to improving interface management are founded on a conceptualisation of “patients” as immutable actors in care transfer processes. Translational Mobilisation Theory brings into view the multiple versions of the “patient” produced by healthcare systems and offers a framework for analysing the mechanisms of action necessary to create organisational understandings of patients at boundary crossings. While the ambulance control centre is a singular case, the paper illustrates the value of attending to these processes in interface organisation.