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24
Aug

What next for England’s ambulance services?


The next steps on the delivery of new ambulance service national standards will be outlined at the Health and Care Innovation Expo 2017 (September 11 – 12, Manchester Central).

The Ambulance Response Programme (ARP), which sees faster response times for the most seriously ill and new response categories aimed at giving better outcomes for patients, was approved by Health Secretary Jeremy Hunt in July.

England’s 11 Ambulance Trusts immediately began the crucial delivery phase of the programme with the aim of most of them going live by October as part of a series of Urgent and Emergency Care initiatives aimed at taking pressure off busy A&Es this winter.
Professor Jonathan Benger, NHS England’s National Clinical Director for Urgent Care, will provide an update at the Pop-Up University during the Expo.

“Ambulance Trusts have now moved into the critical delivery phase of programme,” he explains.
“As they continue to give the fastest response to the sickest patients, their focus is on implementing the four new 999 categories and the development of the workforce.

“They are also beginning to change their vehicle fleets and response models to deliver the overall objectives of the ‘Keogh Review’ of urgent and emergency care, with an emphasis on reduced conveyance to hospital through greater use of ‘hear and treat’ and see and treat’ where it is safe and appropriate to do so.”
These changes to the way services operate follow the largest study of an ambulance system ever completed. Over the course of almost two years more than 14 million calls were included, with no adverse or safety incidents identified.

The ARP trials have shown the new system could bring faster treatment for those needing it, save 250 lives a year, mean up to 750,000 more calls a year get an immediate response and drive improved care for stroke and heart attack patients.

Professor Benger adds: “The new targets will remove ‘hidden’ and long waits suffered by millions of patients, including reducing lengthy waits for the frail and elderly. The new system is backed by the Association of Ambulance Chief Executives, the Royal College of Emergency Medicine, the Stroke Association and the British Heart Foundation amongst others.

“Call handlers will change the way they assess cases and will have slightly more time to decide the most appropriate clinical response. Cardiac arrest patients can be identified quicker than ever before, with evidence showing this could save up to 250 lives every year.

“The redesigned system will focus on ensuring patients get rapid life-changing care for conditions such as stroke rather than simply “stopping the clock”. Currently one in four patients who need hospital treatment – more than a million people each year – undergo a ‘hidden wait’ after the existing eight minute target is met because the vehicle despatched, a bike or a car, cannot transport them to A&E.

“Ambulances will now be expected to reach the most seriously ill patients in an average time of seven minutes. The ‘clock’ will only stop when the most appropriate response arrives on scene, rather than the first.

“This will free up more vehicles and staff to respond to emergencies. Currently, three or even four vehicles may be sent to the same 999 call to be sure of meeting the eight minute target, meaning that across the country one in four are stood down before reaching their destination.”

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