Exploring the utility of current performance measures for changing roles and practices of ambulance paramedics

This article explores the relationship between the changing roles of ambulance paramedics, the causes of increasing call outs in the UK and in other countries and the need for improvements in process and outcome measures to reflect these changes. It also reflects on the application of ‘Lean’ techniques to the modernization of ambulance services, although with some scepticism. Moreover, it is contended that changing roles have moved far in advance of existing performance measures, contributing to misunderstandings between healthcare professionals and service users.