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SHOWCASE – Hall C
Participating Trusts
Great Western Ambulance Service NHS Trust
London Ambulance Service NHS Trust
North East Ambulance Service
South Central Ambulance Service
South East Coast Ambulance Service NHS Trust
South Western Ambulance Service NHS Trust
Our urgent care and out-of-hours services work closely with GPs and social services
to find the right solutions for patients. At the AMBEX Conference this year we are
showcasing our Hub for Health and Social Care which is run in partnership by GWAS
and Gloucestershire PCT, and involves working closely with Gloucestershire County
Council Community and Adult Care Services. Last year the ‘Hub’ took 108,500 calls
‘out-of-hours’. Making full use of emergency care practitioners, district nursing
services, domiciliary care services, the emergency duty social work team and directly
employed doctors, the “Hub” is preventing inappropriate admission to hospital.
Located within this second control room are our Clinical Telephone Advice team,
Urgent Care Desk, Patient Transport Service Central Services, Emergency Care
Practitioners and the Emergency Bed Service.
By working alongside each other, they have been able to help reduce the number of
Category C and non-urgent calls responded to by A&E ambulances and also better
match the clinical skills of staff with the needs of the patients they are being sent to
treat.
This showcase will describe how ambulance services have developed over time from
being simple ambulance dispatch hubs to become complex clinical assessment
centres capable of reducing hospital accident and emergency department attendance
rates. In the North East of England this has been achieved by applying two separate
innovative strategies, euphemistically badged as: ‘See and Treat’ and ‘Hear and
Treat’. The NHS Pathways clinical assessment tool embedded into our Contact
Centre software acts as the first-line filter ensuring where appropriate, patients are
referred to alternative pathways of care. Attending ambulance crews provide a
second such filter.
The Clinical Audit Report System used by SCAS greatly increases the efficiency of
the Trust in its ability to audit, monitor, manage and report clinical effectiveness.
Clinicians compile electronic portfolios for professional registration; while clinical
records can be referenced for governance issues highlighting clinical risks
automatically; reporting to national and localized targets is achievable within minutes
rather than weeks of data collection. Clinical management of frequent callers
represents a first for the ambulance community showing in detail, individual patients
and locations, enabling targeted investigations to make better use of the Trust’s
resources.
The needs of patients are changing; the range of conditions that the ambulance
service now treats is more diverse and complex than ever before. The service must
therefore adapt to meet these changing needs and developing complexities. One of
the ways in which South East Coast Ambulance Service NHS Trust is doing this is
through the development of new clinical roles in line with the AHP career framework.
• Paramedic practitioners have undergone further education and training
providing them with advanced assessment skills meaning they can
diagnose and treat minor illness and injury at home or in the community;
• Critical care paramedics have undergone further education and training
equipping them with the specialist skills needed to safely treat and
transport severely ill and injured patients.
We have recently introduced a Clinical Supervisor team into our Clinical Hubs. This
presentation provides a discussion of the benefits we have found, including:
• Average of 850 999 calls transferred to other health care pathways per month
in 2007/2008.
• 90% of calls sent to the clinical supervisor group went to other health care
pathways.
• Model for the training of clinical supervisors in collaboration with Plymouth
University.
• Utilisation of a multidisciplinary team concept (paramedics, nurses, ECP’s) as
opposed to many other single discipline models.
• Advice to crews including access to TOXBASE.
• ‘Saved’ approx £2 million of ambulance utilisation.