For the first time today, the people of East London have decided that they don't need an ambulance, so I can quickly write an entry while supping a cup of tea.

I turned up to work today, only to find a poster in our station telling us that if we manage to reach 90% of priority calls within 8 minutes, then two Team leaders will come and wash the cars of those on duty on that day.

This leads to two questions - first, just how desperate are management to get our response rates up, and secondly, shouldn't Team Leaders have better things to do with their time than washing our cars?

Although I do admire their attempt to 'think outside the box'

The eight minute respone time is the main gauge of our success dictated to us via the government, this is called the ORCON time. As far as anyone knows, the eight minutes has no obvious basis in clinical practice - the best guess anyone can come up with is that the government considered it a good time because that is how long they have to vote when the Division Bell rings.

At the moment the complex is reaching around 68% of all these calls within 8 minutes - the only problem is that it is supposed to be 75%. This is considered Not Good, and so there is a rush to try and get that percentage up. As part of that plan we have these incentives, and a number of Rapid Response Cars have been funded across the area. The RRU's are supposed to get to a job in under 8 minutes - then if the patient is seriously ill provide immediate treatment, if the patient isn't ill, then there is little for the RRU to do.

If we get 75% or more, then we get more funding, if we get less... Well we get less funding.

Today I can tell you that the ORCON percentage is probably below the required 75%, because throughout the day our Dispatchers have been putting out general broadcasts for ambulances - so there have been more jobs than there are free ambulances.

This is the problem - we, as ambulance crews, don't hang about and dawdle to our emergency calls, we genuinely try to get to these calls as quickly as possible. But given traffic conditions, the size of our area, the actual lack of ambulances (and the staff to crew them), there is little we can do to improve the times.

I mean, if we drove any faster, we'd probably have half the fleet off the road being repaired after crashing into other road users.