Ambulance review to reduce A&E visits

Thursday, 30 June 2005 12:00 AM

Ambulance services will be used to create a "mobile healthcare system", leading to more treatment in the home and at the scene.

Following a review of ambulance services, ambulance staff will be trained to treat patients with urgent non-life-threatening conditions at home rather than taking them to hospital in a move designed to cut down on unnecessary visits to A&E.

Ambulance staff will also be able to refer patients to social care services and prescribe a wide range of medications, while non-urgent callers to 999 will be offered more advice over the phone and referred to the local service that best suits their needs.

The year-long review, led by Peter Bradley, national ambulance adviser and chief executive of London Ambulance Service NHS trust, will also lead to an increase in the number of emergency care practitioners (ECPs), faster response times, and standardisation in the way response times are measured for category A life threatening conditions.

Health Minister Lord Warner said: "We will make sure that the ambulance services are able to respond to life-threatening emergencies as quickly as possible. But at the same time we are going to extend the role of ambulances and ambulance staff, so that they can not only be there in an emergency, but be there at other times to help people maintain their health.

"We believe that more than a million patients a year could avoid being taken to A&E by this new approach."

However, critics of the review believe the Government has missed an opportunity for much greater integration of emergency services.

Conservative Shadow Health Secretary Andrew Lansley said: "Whilst I welcome this review of ambulance services, I believe that ministers have missed an opportunity for much greater integration of emergency services. Patients need to know, whether they ring 999 or GP out of hours, that they will be given the most appropriate response to their emergency.

"Given the difficulty in many parts of the country in accessing doctors' out of hours services and the reported increased pressure on A&E departments, the Government must deliver a comprehensive and joined up approach to the provision of emergency care."

Liberal Democrat health spokesman Steve Webb said: "Ambulance services should be more integrated into the NHS so that the valuable skills of paramedics can be used to the full to get treatment to patients more quickly. We should examine new ways of providing services, but issues such as safety of staff responding to calls must be taken into account.

"It is vital that the motive here is not cost cutting. Getting people the best treatment, not the cheapest treatment, must be the priority.

"If ministers really want to improve ambulance services they should end the absurdity of ambulances queuing up outside hospitals waiting to deliver their patients. This alone would improve the efficiency of the service."

Which?, formerly the Consumers' Association, said the review raised a number of questions such as whether paramedics were properly trained for their extended role, and how many cases they would really be able to assess safely without taking patients to A&E where they benefit from diagnostic tools such as X-rays.

Frances Blunden, principal policy adviser, Which?, also said that action to standardise the measurement of category A calls was long overdue.

"Although Government action is long overdue, the move to standardise when the clock starts for category A calls to when the call is connected is welcome - something Which? has been calling for since 2002," she said.

"However, the crucial aspect here is when the clock stops. This should not be when the ambulance arrives at the scene, but when they reach the patient - this is what saves lives."

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