Dilemmas of ambulance professionals in attending an emergency within eight minutes: The ethics of target setting

The Chapter argues that performance measurement poses numerous challenges. Given the multiplicity of objectives and the stakeholder complexities in the context of public sector organisations, defining and measuring performance becomes more difficult. In the absence of effective monitoring of the performance indicators, performance measures can produce undesirable consequences. In that sense, performance indicators are means to assist in making responsible management decisions and are not mechanical substitutes for good judgment, sound ethical principles or leadership. The chapter concludes that the ambulance response times targets are ‘misleading’ in not being representative of the work being done by ambulance trusts. A patient can have an ambulance within eight minutes but can still have a poor experience of emergency care. Whether current measures of ambulance performance match the organisation’s aspirations is difficult to answer.