Role of Ambulance in Transforming Urgent & Emergency Care PDF
Preview Role of Ambulance in Transforming Urgent & Emergency Care
Ambulance Services Working Collaboratively with Community Partners John Black Medical Director, South Central Ambulance Service FT on behalf of the Association of Ambulance Chief Executives October 2017 National picture 2016/17 10 English NHS Ambulance Services 999 calls increased by 21% since 13/14 11.2 million 999 calls Includes 1.46 million transfers 111 > 999 Led to 6.9 million face-to-face attendances 52% conveyed to ED 38% treated at home & discharged or referred 10% telephone advice and/or referral 700,000 hours lost waiting to transfer care in ED South Central Ambulance Service (SCAS) Our services An integrated approach > Enabling people to access right care, first time Patient > Saving lives and improving outcomes Transport > Supporting people in their own homes SCAS NHS111 Emergency Service 999 Past Future Ambulance Services have visibility of the whole care system 225 patients taken to hospital Daily average per million 105 people treated at scene population 60 calls resolved with telephone advice 270 999 calls 435 referred to primary care 55 referred to other 550 111 calls on weekdays /nights services/agencies (more than double at weekends) 60 advised to take themselves to ED 30 GP requests for urgent 8 transported between care transport settings 320 journeys to and from 370 bookings for non-emergency outpatients patient transport 40 taken home after hospital discharge With data on demand trends, patient flow, Based on SCAS 2016-17 pathways, processes and local variation The Emergency / Urgent Picture 10% Life threatening 90% Urgent care Advances in cardiac care, Mix of acute / chronic, LTCs / complex and multiple health issues stroke, major trauma, cardiac arrest Increasing care closer to home Alternative destinations – Alternative destinations - UCCs Trauma Centres, PPCIs, Stroke Ambulance clinicians working Units alongside community, primary care, Acute service reconfigurations- social care, mental health in MDTs maternity, paediatrics, surgery Advanced and specialist paramedic roles - expanded clinical decision Clinical performance measures making, advanced clinical (AQIs) assessment, diagnostic & treatment skills Public health promotion/prevention role Plus, Resilience for major incidents & mass casualties - working with other emergency services and specialist response agencies Five Year Forward View & UEC Review “Helping patients get the right care, at the right time, in the right place…” (FYFV) “Ambulance services empowered to make more decisions, treating patients and making referrals in a more flexible way…” (FYFV) “Ambulance Services should maintain clinical hubs in their EOCs to ensure appropriateness and timeliness of responses...staffed by range of clinicians” (SFB) “Ambulance Service & CCGs should develop mobile urgent treatment service capable of dealing with more people at scene and avoiding unnecessary journeys to hospital” (SFB) “Clinicians working in the 999 system – through ‘H&T’ or ‘S&T’ models - should have unrestricted referral rights to all other services in the UECN, including social care services, with free flow of information and feedback” (CMAS) “Effective urgent care services will be supported by the immediate availability of relevant patient information” (CMAS) “We cannot deliver the necessary change without investing in our current and future workforce” (FYFV) NHS England publications Health and Social Care Transformation Emergency 999 As an example, SCAS has a role in 6 STPs Bedfordshire, Luton and Milton Keynes Thames Valley PTS Frimley (part) Hampshire Frimley (part) (excl IoW) NHS111 Surrey Heartlands Sussex & East Surrey Tendency to overlook Ambulance Services in STPs Support to NHS infrastructur doctors, e nurses and Nurses, midwives midwives and health visitors Scientific, therapeutic, C M technical staff and G Doctors P hospital / support communit y Mobile clinicians / Paramedics Coordination Centre / support staff Indicative workforce Tiny but essential cogs in a very big machine based on FTE in England SCAS strategic themes Care coordination and integrated urgent care Mobile care and emergency responses Expanded patient transport and logistics SCAS as a partner in local care systems NHS Ambulance Service 2020 & Beyond www.aace.org.uk
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