Yes, most managers are focussed on the 8 minute measure for category A (life-threatening) calls. Our commissioners, i.e. the London health area managers who pay us to provide emergency ambulance services and who monitor our performance, as well as the Healthcare Commission, who award us our "stars" every year, are very interested in all our performance measures. The main measures are the category A first response within 8 minutes and an ambulance within 14 minutes, for category B (an emergency, but probably not life-threatening) an ambulance within 14 minutes, for category C (not really an emergency) an ambulance or a call back within 30 minutes. There is also a requirement to get the patient to hospital no more than 15 minutes late for GP urgent calls, i.e. where a doctor asks for urgent transport to hospital for a patient, giving a specific time when they should be where (usually within two or three hours). Apart from that, several other things are considered when the performance of English ambulance trusts is assessed. Among these are the survival rate after cardiac arrest, pain management, financial management, risk management, thrombolysis (we don't do that in London) and even staff related indicators. Look at http://www.nhs.uk/England/AboutTheNhs/StarRatings/AmbulancePI.cmsx. Michael.