New ambulance scheme aimed at cutting A&E admissions

A new pilot scheme being introduced by the North East Ambulance Service (NEAS) aims to reduce the load on Sunderland’s A&E departments by more than 1,825 attendances every year.

Funded by Sunderland Clinical Commissioning Group (CCG), the Mike SimpsonParamedic Pathfinder will train NEAS ambulance clinicians working in the area to use a ground-breaking clinical triage tool, which helps them to make extremely accurate face-to-face patient assessments and confidently choose the most appropriate place for treatment.  As well as A&E departments, this could include referral to a patient’s GP, being managed at home or by accessing Sunderland’s urgent care services, such as an urgent care centre or the Recovery at Home Team.  

Approximately 80% of patients in the Sunderland area who get an ambulance are taken to the Emergency Department. This is above the regional average of 76.82% but the new pilot is expected to reduce this figure by as many as five patients daily.

The Paramedic Pathfinder triage tool works by enabling ambulance clinicians to recognise symptoms rather than the need to make a definitive diagnosis. Ambulance clinicians work from the top of the Paramedic Pathfinder flow chart to the bottom and must eliminate all other possibilities before going onto the next step. This is the first time ambulance paramedics in the North East will use a face to face clinical triage tool to support their decision-making and mirrors how Emergency Departments operate across the country.

It’s estimated the scheme could save the NHS around £650k annually.

Jeannie Henderson from Sunderland CCG said: “There has been a 47% increase in emergency admissions over the past fifteen years, costing the NHS £12.5 billion. We need to look at ways to reduce the amount of patients being inappropriately transported to Emergency Departments and are confident this pilot scheme will prove extremely successful in doing just that. It has already been adopted by a number of other ambulance services across the UK with the overarching purpose of avoiding long and inappropriate transfers to Emergency Departments and maximising the use of the new Urgent Care Centres.”

Paul Aitken Fell, consultant paramedic at the North East Ambulance Service said: “The Paramedic Pathfinder scheme will support our ambulance clinicians even further to make the most appropriate and safe decisions about patients’ care, which will support Sunderland’s system of integrated care.

“Currently our ambulance clinicians will err on the side of caution taking patients with non-critical conditions to A&E based on their diagnosis. This system will ensure patients get the right care, in the right place, at the right time by giving our paramedics the confidence and endorsement to choose another option. As well as reducing the load on Sunderland’s A&E Departments, this will help improve the patients’ experience by providing care tailored exactly to their needs.”

North East Ambulance Service NHS Foundation Trust (NEAS) covers 3,200 square miles across the North East region.  It employs more than 2,500 staff and serves a population of 2.7 million people by handling all NHS 111 and 999 calls for the region, operating patient transport and ambulance response services, delivering training for communities and commercial audiences and providing medical support cover at events.

This is the latest project operated by NEAS which is designed to reduce the burden on emergency services. Others include the introduction of Advanced Practitioners, who offer a more in-depth triage and treatment for urgent care cases, and a system called Flight Deck, which helps hospitals manage their demand by providing real time updates on system-wide pressures.

In 2015/16 the service answered 1.160 million emergency 999 and NHS 111 calls, responded to 295,855 incidents that resulted in a patient being taken to hospital, treated and discharged, 19,949 patients with telephone advice and treated and discharged 85,021 patients at home.  In the same year, emergency care crews reached 132,948 Red incidents within the national target of 8 minutes.

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