Table 3.

Mean appraisal scores for each domain for each document.

Domain	AS1	AS2	AS3	AS4	AS5	AS6	AS7	AS8	AS9	AS10	AS12	AS13	AACE/RCEM
1. Scope and purpose	14	57	39	8	81	83	53	72	47	39	64	0	53
2. Stakeholder involvement	0	27	8	0	11	42	50	14	8	14	41	0	33
3. Rigour of development	13	21	2	2	4	4	4	6	2	4	8	2	5
4. Clarity of presentation	11	30	52	63	56	58	58	50	39	69	36	11	78
5. Applicability	0	6	10	16	33	44	25	21	29	2	14	8	18
6. Editorial independence	0	0	0	0	0	0	0	0	0	0	0	0	0
Appraiser approved	No	No	Yes	Yes	Yes	Yes	Yes	Yes	No	Yes	No	No	Yes
All	6	23	19	15	31	38	31	27	21	21	27	4	31

Scores are out of 100. Score of < 25 is a good score.

One additional ambulance service was omitted as no guidance or policies were sent.

Where trusts submitted multiple documents, the document that detailed specific pre-alert conditions was used.

AACE: Association of Ambulance Chief Executives; RCEM: Royal College of Emergency Medicine.