From the pre-hospital literature: Arrive in 9 min and the patient lives – “failure”; arrive in 8 min and the patient dies – “success”

his qualitative study explores paramedic’s attitudes to the government’s target that category A calls must receive a response within 8 min. The study consisted of a purposive sample of 20 paramedics from nine ambulance stations with a mean length of service of 19 years. Semi-structured interviews informed by a loose topic guide were conducted and analysed using a constant comparative method. Paramedics’ accounts of response time targets and their attendant strategies had three main strands: their inadequacy as a performance indicator, their detrimental effects on patient care; and their detrimental effect on the health, safety and well being of paramedics. It was felt that response time targets dominated ambulance service culture and practice at the expense of other quality indicators such as quality of care, delay in transporting patients to hospital, the skill level of first responders, and the vulnerability of the figures to “fiddling”. Paramedics argued that they have seen no evidence that response time targets improve patient care, a claim which appears to be supported by the literature discussed in this study. This study is particularly relevant in today’s climate of “call connect” (Department of Health, 2007) and highlights that response times are a poor, narrow and overly simplistic quality indicator. S Christopher, British Paramedic Association Research and Audit Committee Price L. Treating the clock and not the patient: ambulance response times and risk. Qaul Saf Health Care 2006;15:127–30