LAS advanced paramedic on duty
Almost half of patients who call 999 for an ambulance can avoid hospital under a “perfect day” scenario, a trial has found.
London Ambulance Service tested its new strategy for treating more patients at home or at the scene during a 16-hour period, from 8am until midnight, on Monday across north east London.
Of the 642 patients who sought emergency help, 331 – a total of 51.6 per cent – had to be taken to hospital. LAS regards this as a “significant” reduction on its 58 per cent average under normal conditions.
LAS manager Stephen Hines runs the Call A Colleague desk
It meant that 61 fewer ambulances went to A&E as the number of “non conveyances” increased from an average of 250 patients to 311 during the trial.
LAS, which sees about four million patients a year, is seeking to provide more bespoke care to patients and deliver care “as close to home as possible”.
Ambulance services across the country face an increase in demand of at least 38 per cent over the next decade and are seeking to avoid “unnecessary” trips to A&E.
LAS chief medical officer Dr Fenella Wrigley said: “We dispatched the right resource to give us the best chance to treat them where they were, rather than take them in the traditional way to an A&E department, which we know will be really busy.
“That means that we are freeing up valuable space at A&Es for those patients that really need to be treated there. This is better for patients and better for the NHS.”
LAS staff in Bow Emergency Operations Centre
The pilot involved greater collaboration with community health services, social services and GPs.
LAS call handlers were able to call upon advanced paramedics who can provide higher levels of care, a physician response unit that dispatches a hospital doctor and paramedic in a fast car, and paramedics specially trained to help elderly fallers.
There was easier access to GPs, including out of hours appointments, and additional support from end of life services.
LAS helps about 90,000 elderly fallers and 150,000 people with mental health issues a year and wants to treat more out of hospital.
Dr Kate Adams, a GP in Hackney and clinical lead for urgent and emergency care in north east London, said: “We worked together to direct people to the best services, to reduce ambulance call outs and the number of people being taken to hospital.
“This means patients with less urgent problems have a better experience and avoid sitting round in hospital when not required and also enable high priority life or death situations to be treated more quickly.”
- An edited version of this story appears in the Evening Standard.
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