EMERGENCY ambulance response in the county is now on notice to improve.
Talks between Herefordshire Clinical Commissioning Group (HCCG) and West Midlands Ambulance Service (WMAS) are underway as to how improvements can happen.
HCCG buys and shapes health and care services. WMAS has the contract to provide ambulance services.
The HCCB governing body has been told that ambulance response to Red 1 calls - the most urgent - in the county became a "significant issue" over the past year.
While eight minute target performance picked up in February, it fell to 61% in March - well below the 75% expectation.
Following regional contract negotiations, WMAS proposes to to re-invest fines money into improving Red 1 response, with the HCCG asking for a remedial action plan.
In real terms, demand on the county's 999 ambulance is increasing year-on-year.
In 2011-12 WMAS took an overall 19,528 calls from the county.
Figures for the past year show demand has jumped by some 20% since.
All told, the service responded to 10,528 Red 1 & 2 calls across the county over 2013-13 – an average 28 a day.
Red calls are classed as immediately life threatening and come with an eight minute response time.
Just over 66% of Red 1 calls – cardiac arrest or life threatening traumatic injuries – made the eight minute target.
Nearly 76% of Red 2 calls – all other life threatening emergencies – made the target.
Green calls, a category ranging from serious but not life threatening to telephone assessment totalled 14,921 with target response rates between 95%-99%.
Large parts of the Golden Valley and the north-west of the county as “areas of concern” over Red 1 response performance.
There are also Red 1 response concerns recognised east of Ledbury and north of Leominster.
Red 2 performance is stronger with concern recognised in responding to emergencies on the county’s border extremities.
WMAS currently budgets for 107 operational staff in Herefordshire with 97 posts currently filled.
On current demand that’s 262 calls for each.