London Ambulance Service Analysis


London Ambulance Service is the non-profit organization, which had an intention to improve the total quality of the performed services. Taking into consideration that the time of the reaction is crucially important for the clients of this organization, there is strong necessity to mention that the set time frame of 3 minutes for processing a single call could be essentially decreased by implementing the computerized system for processing calls and updating the database.

Originally, the level three analysis of any organization requires the analysis from several angles. This research presupposes the analysis from the following aspects:

  • System and Problems
  • Analysis and Possibilities
  • Recommendation and Justification

Moreover, each of the three aspects should be represented and supported by the checklists, templates and diagrams. The charts and schematic representation of the process flows will be also provided for the deeper understanding of the appeared problems, for the optimal recommendations could be provided.

System and Problems

The checklist for the case study is the following:

  • Customers
  • Products and services
  • Work Practices
  • Personnel
  • Information
  • Technologies
  • Environment
  • Work System as a whole

Basing on the representation of these aspects of organizational performance, the analysis of the allover performance should be represented. The customers of the organization are the patients of the ambulance service, thus, they need the response as quickly as possible, and moreover, they need to be provided the medical assistance and, often they need the urgent delivery to the ambulance station, thus, “product and services” aspect depends on this system.

Thus, the products and services entail the timely processing of the call, updating the database, locating the nearest ambulance car to the stated address (if the caller is unable to tell the address, the dispatcher locates the caller, and then sends the ambulance), and then the car delivers the patient to the nearest ambulance service. As it is mentioned in the case study, the dispatcher service divides the city into three parts, and then, after receiving calls, connects with the nearest to the address ambulance station, which then proceeds with the received information and accepts the patient.

The work practices are derived from the principle, described above. In relation to the IT project implementation, it should be emphasized that problems, which started in this aspect are associated with the improper project management, and violation of the basic managerial principles. The problem which appeared, prevented the personnel from performing their direct assignments, and violated the general principles of working performance.

Personnel of the organization are the workers of the dispatch center of ambulance service, who receive the calls, which come to the emergency service, and then provide the required assistance by sending the ambulance cars to the stated address, and often provide psychological and moral maintenance for people who are addressing ambulance. Often, these people are shocked, stressed, in hysterics, thus, the operators of the dispatching system should be professional stress psychologists in order to calm people down for getting to know the reason of the call, and the address, where the ambulance should be sent.

Informational aspect of the work is the most crucial, as the speed of the information flow defines whether the lives will be saved or not. The computerization of the dispatch system was initiated in order to accelerate the information flow, for quicker processing of the calls, and providing quicker assistance.

Technologies, which are used for the dispatching calls entail the hot phone line, GPS, computerized data base and two way radios for getting in touch with the ambulance services.

Environment presupposes the certain amount of emergency calls within the set period of time, and it is not subjected to essential changes, as people required, require and will be always requiring medical assistance. There is no sense in competence (from the perspective of business environment), moreover, additional services would be rather helpful.

Work system as a whole is effective enough, nevertheless, the development of IT sphere provides an opportunity for the improvement of the total organizational structure. Nevertheless, if the project is initiated, it should be managed properly, in order to avoid crucial and fatal consequences.

The template for analyzing the situation may be taken from the business practices. Originally, the environment and the situation in general may be analyzed with the help of PESTLE matrix.

Political The political aspect of the Ambulance Service activity can be regarded as the favorable, as any democratic political regime aims to create the best social circumstances for the citizens. Reliable activity, and the availability of the Ambulance Service, as well as any emergency service may be regarded as the highest degree of care about citizens, consequently, government only supports the initiatives of dispatch service improvement
Economic Economic factor is not least favorable, as the management of the London Ambulance Service is capable to assign the sufficient financial resources for implementing the costly technological project.
Social Social environment requires the existence of similar services, consequently the improvement of the work will be only appreciated. Nevertheless, the customers’ satisfaction does not influence the incomes of the organization, as the origin of the activity is based on non-profit principle.
Technological This sphere is one of the most crucial for the successful activity. It should be emphasized that the technological improvement is not of highest necessity, nevertheless, it would improve the allover working performance. Thus, the technological base is close to perfect, as the service has all the necessary technical opportunities for satisfying the callers.
Legal Organization, which is engaged in the sphere of saving people’s lives cannot be beyond law
Environmental Environment is not affected anyway by the activity of the organization

Analysis and Possibilities

The analysis of the problem revealed that the problem was caused by the improper management of the project. Originally, all the managerial problems are caused by the communicational gap between top management, project management, executors and the personnel, who will be using the opportunities of the project.

The communication flow looks the following:

The communication

If at least one of the links are missing, or the communication flow is stopped between any components of the scheme, the project is condemned to failure. The analysis of the case study revealed that the communication between performers and personnel was not properly adjusted. The results are obvious.

The results

As for the matters of project implementation, and project management in general, the following chart should be represented:

As it may be seen, the process requires two parallel flows. Taking into consideration the communication chart, it should be stated that the project implementation requires more the communication of the performers with the personnel, as only personnel will be using the new opportunities of the technological base, and perform their work using the new rules and principles of call and data processing. Moreover, the IT specialist should be included into the team of dispatchers. He or she will have to observe the work of the equipment and software, debugging it, and finding the mistakes, if some appear.

In accordance with the checklist, analyzed in the System and Problems chapter, it should be stated that the possibilities, which the properly managed process will offer, are related to the issues of personnel management. HR management strategies also require improvement in the London Ambulance Services. Thus, training of the personnel and qualification improvement are regarded to be the integral components of any project implementation. Neither training, nor qualification improvement in general were arranged for dispatchers, thus, when the system failed, no one could solve the technical problem and restore the workability of the system at least partly.

Ambulance Cover Performance
Graph 1 (Ambulance Cover Performance).

The represented graph shows the financial resources that the government allocated for the Ambulance services in London. The year of the case study (1992) the services were sufficient for the implementation of the new projects, nevertheless, the failure of the project caused the decrease of the financial support for the following year. The fact is that, the system was finally debugged and implemented, nevertheless, the technical maintenance required equal financial support.

As for the possibilities that should be analyzed, there is strong necessity to mention that the project should be oriented for the end user – patients of the Ambulance service. The managerial teams of the organization failed to achieve set goals and this caused disruption to the end users, and thus this organization aspect was lacking in quality service provisions under the new working system. The third level customer of the working system also failed, the developers of the working system failed to provide a working product, which reflects in end user service provision, and the governmental agencies failed to ensure that the new working system was of an operational standard before the activation of the work system.

Recommendation and Justification

The recommendations, which should be given to the London Ambulance Service are related with the improvement of the managerial system, and HR strategies. The fact is that, these problems could be avoided if the Ambulance Service management took care of the project development, and assigned a person responsible for this project. The results show that the project was implemented without proper plan, and without any preparation and preliminary research of the situation.

The recommendation system of the present analysis should be based on the checklist, offered in the beginning of the paper.

  • Customers. This aspect of the activity should become the orienting point of the allover activity. The satisfaction of the end-users defines the effectiveness of the operational structure and system in general.
  • Products and services. This aspect should be represented as the detailed plan of the activity, and further improvement if one is planned or intended.
  • Work Practices. The practices of the activity are close to perfect, nevertheless, the technical aspect of the allover performance will be required. Anyway, it should not change or violate the practices.
  • Personnel. The personnel should be technically trained, and be able to solve at least minor technical problems, or the IT specialist should be included into the team.
  • Information. The information flow, and the communication process are the essential factors of the successful activity of the Ambulance Service. The communicational gap has caused essential problems in project implementation process, thus, sufficient attention should be paid to it.
  • Technologies. The technological base of the project has been already discussed, nevertheless, the only recommendation that should be given is to observe the principle of non-interference. Thus, the technologies must not violate the working principles.
  • Work System as a whole is based on the upper discussed points, the observation of which will help to manage the system properly, and avoid breakdowns in future.


Level Three analysis of the London Ambulance Service revealed the original problem in the project implementation process, which caused the “complete nightmare” in London on October 26, 1992. Originally, the communication is the cornerstone of any managerial strategy, and the lack of communication among the structure components may cause serious drawbacks in the allover performance, which is confirmed on the example of LAS case study.

Reference List

Atler, S. 2006, ‘The work system method’, Work System Press, Larspur.

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