Reforming Emergency Care

1
Reforming Emergency Care

• Paul Leaman
• Director of Modernisation Service Delivery

2
Traditional Model of Ambulance Service
Paul Leaman Director of Modernisation Service
Delivery

• Patients enter our system via 999 calls or GP
• Ambulance / Rapid Response vehicle dispatched
• Patient either left at home or conveyed to
  hospital ( regardless of need )
• Next job.

3
Traditional methods need reform
Paul Leaman Director of Modernisation Service
Delivery

• The NHS needs to treat the Patient.
• In the best way
• In the appropriate place
• At the right time
• So how has the Ambulance Trust done this ?

4
Reforming Emergency Care EAS Style
Paul Leaman Director of Modernisation Service
Delivery

• Category C management
• Redirecting calls to NHSD
• Appropriate response
• Falls co-ordination
• Managing demand
• Sending the right response
• Reprioritisation of certain 999 calls
• Meeting the patients needs
• Spreading the load

5
Role of an Emergency Care Practitioner ( ECP )
Paul Leaman Director of Modernisation Service
Delivery

• Working as part of a Primary Care Team
• Face to face encounter with patients
• Clinical assessment
• Treat and transport
• Treat and transfer
• Treat and discharge
• In-hours or out-of-hours
• Delivering on unscheduled care

6
Phoebe with a cut head Take 1
Paul Leaman Director of Modernisation Service
Delivery

• Mum calls 999
• Crew turn up
• Phoebes crying
• Mums upset
• Crew take Phoebe to AE
• Phoebes still crying
• Phoebe and mum wait
• Phoebes head is glued
• Waits for taxi to go home
• Phoebe still crying
• Phoebe and mum get home
• Phoebe plays with her doll

7
Phoebe with a cut head Take 2
Paul Leaman Director of Modernisation Service
Delivery

• Mum calls 999
• Paramedic turns up
• Phoebes crying
• Mums upset
• Paramedic gets mum to make a cup of tea
• Mum stops crying
• Phoebes still crying
• Paramedic treats Phoebe
• Phoebe stops crying
• Carries on playing with her doll

• i

8
Paul Leaman Director of Modernisation Service
Delivery

Two men in green arrive
999 call
4 yr old with head injury
Phoebe crying
Ambulance Despatched
Wait for Ambulance
Ambulance arrives
Mum waits for childcare
Ambulance crew take Phoebe/mum
To wait in AE
And wait.
Phoebe's head is glued
Mum cries
Phoebe cries
18
Mum is given a head injury chart
Mum Phoebe wait for taxi
Mum Phoebe arrive home
Phoebe plays with doll - stops crying
Total time 6 hours
9
Paul Leaman Director of Modernisation Service
Delivery
999 call
999
4 yr old with head injury
Phoebe crying
Ambulance Despatched
Wait for Ambulance
Paramedic arrives
Mum puts kettle on
11
Phoebe stops crying
Paramedic glues head
Phoebe plays with her dolls
Total time 40 mins
Mum is given head injury card
10
Response to Phoebes head injury
Paul Leaman Director of Modernisation Service
Delivery

• Quicker
• Safer ( less steps less risk )
• Better outcome
• Better experience

11
Any Questions ?
Paul Leaman Director of Modernisation Service
Delivery