What are the benefits?

1. It will enable comparative clinical audit
2. Unless we are measuring pre-hospital care against the same variables it is impossible to draw any comparison or conclusion and the data again becomes meaningless.
   If future collaboration and comparisons are to be made, common data sets and definitions must be used. Also, in this new age of clinical governance, collaboration, national service/ performance frameworks, and benchmarking, it is vital that all data collection is uniform and accurate i.e. the minimum data set is adopted as common practice, otherwise poor information will become an excuse for poor performance and the real reasons for disparities in the provision of pre-hospital health care will not be uncovered.
   As stated previously, the minimum data set is not an audit tool in itself. However, by adopting the minimum data set robust clinical audit tools can be developed into which truly comparative information can be fed and firm conclusions drawn without any disclaimers covering the quality and definition of the data.
3. It will facilitate the implementation of integrated care pathway's.
4. It is equally important that the collection of this minimum data set goes hand in hand with the collection of data on patient progress through A&E and beyond. Only when measurable outcomes can be collected will we be able to truly evaluate the service we provide in the pre-hospital environment. We must be able to close the audit loop and evaluate the outcome of care. This should include common ways of following patients through the health care system and linking the relevant pre-hospital, hospital and other health care databases.
5. It will focus risk management policies

Clinical governance equates to clinical responsibility. Taking the example of the Bolam principal - peer opinion states that if the majority of other processional clinicians would have done exactly the same under the given circumstances, then protection for the action is guaranteed. This has relevance to clinical risk, clinical governance and the closure of the paramedic title. Through governance, education and the obligation to audit practice, each individual will be responsible for their actions. It is therefore vitally important that, to achieve the security of the Bolam principal, the minimum data set must be recorded to allow for clinical audit and clinical risk management. This includes the recording of pertinent negatives (i.e. why something was not done) to ensure all clinical decisions are documented.

We must therefore, in conjunction with the minimum data set, collect all data from all patient report forms (PRF'S) to ensure we know we are doing the right things and doing the right things right. The minimum data set should be recorded somewhere and somehow whether on the PRF or elsewhere as long as all databases are able to be cross-referenced and the data is retrievable. This will not mean prescriptive PRF designs or content. Hopefully however, greater collaboration and the adoption of a common data set with common audit tools will lead to sharing of good ideas and best practice creating a streamlining of PRF designs.

6. It will result in clinically effective practice.
   Without a minimum data set we can't produce a robust evidence base from which decisions on clinical effectiveness can be based. Only when true comparisons are made through benchmarking of identical data sets and definitions can a robust evidence base be built.

Examples:

1. South East Ambulances Clinical Audit Group - Although a regional evidence based protocol was developed for the treatment of pre-hospital hypoglycaemia, there were several large obstacles which had to be tackled in order to compare data sets collected by the seven collaborating services. These included different standards/ protocols and differing data sets. Some services had to collect extra data whilst others ignored data they already collected.
2. National Service Frameworks - unless all UK ambulance services are collecting the same data it would be impossible to benchmark performance and decide which is the most clinically effective practice based on the evidence.
3. Nationally recommended protocols/ standards - a commonly adopted minimum data set will allow for direct comparison of which standards/ protocols are effective. Again benchmarking exercises can highlight good practice and lead to the development of common standards based on the evidence, with the minimum data set as their foundation.