Standard 7: Emergency Dispatch

Why it matters. A caller in an emergency waits on the line, and every second matters. A set answer time, measured at all hours, shows whether the service is answering fast enough.

Sample. Review the call records for 200 calls chosen at random over the last month, across all shifts, including night shifts.

1. Calls are answered within the set time.

Method. Check the time answered against the ring time on each call in the sample.

Evidence to show. Call triage and response record (EDP-FRM-001).

Pass when. At least 90% of sampled calls are answered within the set time.

2. Answer time is measured and reported.

Method. Check the monthly report for the answer times and the measure used.

Evidence to show. Monthly operations report.

Pass when. Every month has a report with the answer times.

3. Calls are answered at all hours.

Method. Check the answer times on night and weekend shifts.

Evidence to show. Call triage and response record.

Pass when. Night and weekend calls meet the same set time.

Immediate fail (any one means the criterion is not met)

• An emergency call is not answered for longer than the set time, with no escalation.

Why it matters. Each call must be sorted by how urgent it is, using a recognised protocol. Without it, the caller who sounds calm can wait behind the one who is dying.

Sample. Review 50 calls from the last month for triage, including 20 high-priority calls.

1. Each call is triaged with a recognised protocol.

Method. Check the protocol recorded for each call in the sample.

Evidence to show. Call triage and response record.

Pass when. Every sampled call records the protocol used.

2. The response matches the clinical priority.

Method. Compare the priority and the response for each high-priority call.

Evidence to show. Call triage and response record.

Pass when. At least 90% of high-priority calls have a matching response.

3. The triage decision and the response are recorded.

Method. Check each call record for the decision and the response.

Evidence to show. Call triage and response record.

Pass when. Every call has both recorded.

Immediate fail (any one means the criterion is not met)

• A high-priority call receives a low-priority response.

Why it matters. The nearest suitable resource must reach the caller within a set time. Measuring dispatch time, and giving the caller clear instructions while they wait, closes the gap between call and arrival.

Sample. Review the dispatch time register for the last month, and 30 dispatches including 10 high-priority.

1. The nearest suitable resource is dispatched within the set time.

Method. Check the dispatch time for each sampled dispatch.

Evidence to show. Dispatch time register (EDP-REG-001).

Pass when. At least 90% of sampled dispatches are within the set time.

2. Dispatch times are measured.

Method. Check the register for a measured time on every dispatch.

Evidence to show. Dispatch time register.

Pass when. Every dispatch has a measured time.

3. The caller is given instructions while help is on the way.

Method. Check the call records for pre-arrival instructions for each high-priority call.

Evidence to show. Call triage and response record.

Pass when. At least 90% of high-priority calls have instructions recorded.

Immediate fail (any one means the criterion is not met)

• A call is not dispatched, or the caller is left with no instructions.

Why it matters. Call takers who have not been trained in recognising emergencies, or in giving instructions before arrival, make the first decisions that matter most. Training and its record make that competence visible.

Sample. Review the training and competence records for all call takers and dispatchers in post, and observe 5 calls on the day.

1. Call takers and dispatchers are trained in the protocols.

Method. Check the training record for each person in post.

Evidence to show. Call-taker training and competence register (EDP-REG-002).

Pass when. Every person in post has protocol training recorded.

2. Training covers recognising emergencies and giving pre-arrival instructions.

Method. Read the training content and check the record for each person.

Evidence to show. Training outline.

Pass when. Training includes both areas and is recorded for each person.

3. Training is refreshed.

Method. Check the refresher dates.

Evidence to show. Call-taker training and competence register.

Pass when. Every person has refresher training in the last 12 months.

Immediate fail (any one means the criterion is not met)

• A call taker who has not been trained answers emergency calls.

Why it matters. A call record is the evidence for what the service did. Each call needs its time, triage, response and outcome, and must be kept private as the rules require.

Sample. Review 100 call records from the last month chosen at random.

1. Each call is recorded with its time, triage, response and outcome.

Method. Check each record in the sample for the four items.

Evidence to show. Call triage and response record (EDP-FRM-001).

Pass when. At least 90% of records have all four items.

2. Records are complete.

Method. Check each record for completeness.

Evidence to show. Call record.

Pass when. At least 90% of records are complete.

3. Records are kept private under the retention rule.

Method. Check the access list and the retention settings.

Evidence to show. Records policy and access list.

Pass when. Access is limited to named staff, and retention meets the rule.

Immediate fail (any one means the criterion is not met)

• A call has no record of its time, triage or response.

Why it matters. When the power, phone lines or the system fail during a busy shift, calls must still be answered. A back-up that has been tested is the only way to know it will work.

Sample. Review the back-up test log for the last 12 months and the record of each failure in the period.

1. A back-up exists for power, communication and equipment.

Method. Read the back-up plan and check each item.

Evidence to show. Back-up policy (EDP-POL-002).

Pass when. Back-ups exist for power, communication and equipment.

2. Each back-up is tested on schedule.

Method. Check the test log against the schedule.

Evidence to show. Back-up test log (EDP-REG-003).

Pass when. At least 90% of tests are done on schedule.

3. A failure is switched to the back-up within the set time.

Method. Check each real failure for the switch time.

Evidence to show. Back-up test log.

Pass when. Every real failure was switched within the set time.

Immediate fail (any one means the criterion is not met)

• The dispatch system fails and calls cannot be answered or sent on a back-up.

Why it matters. Reviewing a sample of calls shows where the protocols and the training fall short. The findings are useful only if they change the protocols and the training.

Sample. Review 50 calls chosen at random in the last month, across all shifts, using the review form.

1. A sample of calls is reviewed each month.

Method. Check the review record for each month.

Evidence to show. Call review form (EDP-FRM-002).

Pass when. Every month has a review of at least 1% of calls.

2. The review is random and across shifts.

Method. Check the sampling method and the shifts covered.

Evidence to show. Review sampling record.

Pass when. The sample is random and covers every shift.

3. Findings are used to improve the protocols and training.

Method. Check each finding for an action and its outcome.

Evidence to show. Call review form and action log.

Pass when. Every finding has an action, and at least 70% of actions are closed on time.

Immediate fail (any one means the criterion is not met)

• Calls are reviewed but no finding leads to any change.

Why it matters. A call that cannot be sent at once can become more urgent while it waits. A queue that is reviewed and escalated stops a waiting call from being forgotten.

Sample. Review the queue and escalation register for the last month, and every call queued for longer than the set time.

1. Queued calls are reviewed as the clinical picture changes.

Method. Check the review record for each queued call.

Evidence to show. Queue and escalation register (EDP-REG-004).

Pass when. Every queued call has a review record.

2. A call still waiting at the set time is escalated to the duty manager.

Method. Check each call queued beyond the set time for an escalation.

Evidence to show. Queue and escalation register.

Pass when. Every call beyond the set time has an escalation recorded.

3. Escalations are recorded with their outcome.

Method. Check each escalation for the outcome.

Evidence to show. Queue and escalation register.

Pass when. Every escalation has an outcome.

Immediate fail (any one means the criterion is not met)

• A queued call passes the set time with no escalation to the duty manager.

Why it matters. Call takers face cases the protocol does not cover. A clinician who can be reached at any hour gives them support before a decision is made alone.

Sample. Review every request for clinical advice in the last month, and the clinician rota for the same period.

1. A clinician is available to call takers at all hours.

Method. Check the rota for every hour in the period.

Evidence to show. Clinician rota.

Pass when. The rota covers every hour.

2. Cases outside the protocol and escalations go to a clinician.

Method. Check each case outside the protocol for a clinician involved.

Evidence to show. Clinical advice and escalation record (EDP-FRM-003).

Pass when. Every such case has a clinician recorded.

3. Each piece of advice is recorded with its outcome.

Method. Check each advice record for the advice and the outcome.

Evidence to show. Clinical advice and escalation record.

Pass when. Every advice record has an outcome.

Immediate fail (any one means the criterion is not met)

• A case outside the protocol is handled with no clinician and no record.

Why it matters. The moment a provider stops being responsible for a patient must be known to everyone. If it is unclear, the patient can be left without care at the handover.

Sample. Same as Standard 6 and the transfer standard: review 10 transfers from the last 3 months.

1. The transfer plan states the handover point.

Method. Read each transfer plan for the handover point.

Evidence to show. Transfer plan (PTR-FRM-002).

Pass when. Every plan states the handover point.

2. The transfer record shows when and to whom the patient was handed over.

Method. Check each transfer log for the time and the receiver’s name.

Evidence to show. Transfer log (AMT-FRM-001).

Pass when. Every handover has a time and a named receiver.

3. Handovers match the plan.

Method. Compare the planned and recorded handover points.

Evidence to show. Transfer plan and log.

Pass when. At least 90% of handovers match the plan.

Immediate fail (any one means the criterion is not met)

• A patient is handed over with no time or named receiver recorded.

Why it matters. Some transfers should go by ground, others by air or by escorted commercial flight. Without a clear rule, the decision is made under pressure and can be wrong. A written rule, and the right of the crew to refuse an unsafe transfer, protect the patient.

Sample. Review the transfer mode policy and 10 decisions from the last 12 months.

1. A written rule states who decides the transfer mode.

Method. Read the policy and check its review date.

Evidence to show. Transfer mode and right to refuse policy (PTR-POL-001).

Pass when. The policy names the decision maker and is current.

2. Each decision is recorded with its reason.

Method. Check each decision in the sample.

Evidence to show. Transfer log.

Pass when. Every decision has a reason.

3. The crew or escort can refuse without penalty.

Method. Check the policy for the refusal right and the refusal records.

Evidence to show. Refusal record.

Pass when. The refusal right is written and no refusal was penalised.

Immediate fail (any one means the criterion is not met)

• A transfer judged unsafe by the crew goes ahead with no decision recorded.