Ensuring patients get the right response

Bosses at the Welsh Ambulance Service NHS Trust (WAST) will breathe a sigh of relief as the first full set of data to be published measuring clinical care, operational efficiency and patient experience for the service since the implementation of a new clinical response model, were largely positive.

The Welsh Government announced plans to implement a new clinical response model in July 2015, with a pilot trial running for 12 months from October 2015. One of the key changes to the service during this trial is the move to having only the most serious calls—categorised as Red (immediately life-threatening)—as requiring a response time target (Welsh Government, 2016). All other calls still receive an appropriate response, and this is either through face-to-face or telephone assessment, based on clinical need. For example, for Amber calls a range of clinical outcome indicators have been introduced to measure the quality, safety and timeliness of care being delivered, alongside patient experience information (Welsh Government, 2016). This data is to be published quarterly.

Between 1 October 2015 and 31 December 2015, 70.6% of Red calls received a response arriving at scene within 8 minutes or less, against the Wales national target of 65% (Emergency Ambulance Services Committee, 2016). It was also revealed that 14 489 incidents did not result in a conveyance to a hospital or another destination. However, some Ambulance Quality Indicators are still under development and will not be published until the next quarterly report on 27 April 2016. It is then that information will be provided on the reasons for not conveying patients to a hospital or another destination. Also, due to changes to the trial that came into effect from 11 November, as a result of revised technical guidance, data for December is not comparable to that for October or November.

However, it is interesting to note that results from a staff survey, which included responses from 167 EMS front-line staff, revealed an overall feeling within the service that the new clinical response model has not led to more appropriately categorised calls, improved patient safety, improved quality of service delivery or improved patient experience (WAST, 2016). While the number of respondents is low, it does paint a compelling picture of staff conception of the new model, although unfortunately we will have to wait until April before we can gain a greater understanding of its effectiveness.

The move by WAST to a new response model is a brave one, and intended to ensure the service is providing the right response for patients dependent on their clinical need. While some may complain that doing away with almost all response time targets relieves pressure from the service, it is arguable that they are outdated and do not always result in the best care for the patient. Only time will tell whether this is truly the case.

References

Emergency Ambulance Services Committee (2016) Welsh Ambulance Services NHS Trust National Collaborative Commissioning: Quality and Delivery Framework Ambulance Quality Indicators: October—December 2015. http://bit.ly/1Pj54ds (accessed 1 February 2016)

Welsh Ambulance Service NHS Trust (2016) Clinical Modernisation Programme. http://bit.ly/1P9vBq6 (accessed 1 February 2016)

Welsh Government (2016) Ambulance services in Wales, December 2015. http://bit.ly/1WXbeBH (accessed 1 February 2016)

Taken from Journal of Paramedic Practice, published 8 January 2016.