Abstract
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.
Acknowledgements
We are grateful for the assistance given to us by staff of the ambulance service referred to in the article and by the director of public health at the relevant health authority. Funding for the research on which this article was based was provided by a former district health authority, to whom we are also grateful. An earlier version of this article was presented at the British Accounting Association annual conference in 2008. We thank the participants for their constructive comments. We are also grateful to the anonymous referees of this journal for their insightful comments and to the Deputy Editor for her advice and encouragement.