50,000 patients a year avoiding emergency departments in the South

A new initiative led by South Central Ambulance Service (SCAS) is helping more than 50,000 patients a year receive the right treatment more quickly and often avoiding transfer to emergency departments.

It was launched as a pilot in 2019, known as 'urgent care pathways'.

It sees ambulance service clinicians take a leading role in assessing and treating patients in their homes when handling 111 or 999 calls and determining their next destination for ongoing care.

Within two years it had prevented more than 30,000 patient journeys to emergency departments having created more than 120 different healthcare pathways for clinicians to refer patients to directly.

Because of this, many of these were admitted directly into a specialist hospital service covering medical, surgical, paediatric, respiratory, frailty or mental health needs, transported to a treatment centre or referred onto a community service or their GP to be managed at home.

The project, which is now known as 'clinical pathways' focuses on moderately unwell patients with medical conditions, older patients who are frail with chronic conditions who are at risk of falls, those with respiratory conditions such as COPD and asthma, people in mental health crises or children who require a specialist paediatric assessment.

Ambulance staff are supported to assess patients at home and take a lead role in working with consultants in hospitals, community teams and GPs to determine a patient’s next steps.

The ambulance service says the system proved an invaluable asset during the COVID-19 pandemic for managing residents in care homes and avoiding the need for hospital admissions through treatment at home, referral to community services or by-passing emergency departments.

It is supported by a dedicated online directory - SCAS Connect - which was developed to categorise all urgent care options available across Berkshire, Buckinghamshire, Hampshire and Oxfordshire to assist staff with locating clinical and support services and making the right clinical decision in the community.

The app has inclusion and exclusion criteria for each service, opening hours, contact numbers, email addresses, what patients they will or won’t see, parking locations for ambulances, as well as links to current clinical guidance to aid decision-making.

The initiative has been backed by NHS England and similar models rolled out across other ambulance trusts.

Chris Jackson, Assistant Senior Operations Manager and Clinical Pathway Team lead at SCAS said: "The creation and effectiveness of SCAS Connect has been integral to the project as it gives clinicians everything they need to support them in making the right decision on care for the patients they are sent to.

He added, "If crews are working out-of-area then they still have access to everything they need to make the right clinical decision for every patient they see.