Ambulance priorities changed

The Scottish Ambulance Service is to pilot a new response system which will see patients with immediately life-threatening conditions, such as cardiac arrest, or who have been involved in serious road traffic incidents, being prioritised and receiving the fastest response.

In less urgent cases, call handlers may spend more time with patients to better understand their health needs and ensure they send the most appropriate resource for their condition.

It is the first major change to the time-based targets system since 1974.

The Scottish Ambulance Service says the move follows similar changes in Wales and parts of England which have proven highly successful - leading to faster response times for critically-ill patients.

It will be introduced before the end of the year and piloted for 12 months.

Pauline Howie, Chief Executive, Scottish Ambulance Service, said:

“The new model is the result of the most extensive clinically-evidenced review of this type undertaken in the UK and focuses on improving patient outcomes, rather than simply measuring the time it takes to respond.

“It will allow us to respond faster to more patients with time-critical, immediately life-threatening conditions. In other situations, we will safely and more effectively identify and send the right resource first time for patients, resulting in better overall clinical outcomes.

“The focus on time based targets for ambulance responses has changed little in around 40 years and does not take account of the advances made in clinical development of pre-hospital care.

“Prior to the introduction of the new model, we will engage further with our staff, patients and stakeholders, maintaining the process throughout the pilot as part of a programme of continuous improvement.”

The Chief Medical Officer has reviewed the clinical evidence supporting the new response system and approved the implementation of this pilot. A report on the outcomes will be submitted to the Scottish Government at the end of the 12 month period.

Scotland’s Chief Medical Officer, Dr Catherine Calderwood, said:

“The Scottish Ambulance Service has undertaken a rigorous review of its clinical data, involving a full year of actual patient outcome data being analysed.

“What the analysis showed was that the current coding system does not always accurately identify some patients’ conditions as immediately life-threatening. And that other codes were getting an eight minute response, although the patient’s condition had no time critical response requirement.

“I am persuaded by the extensive clinical evidence that the Scottish Ambulance Service has put forward and know that patient safety is at the heart of these changes.

“We will keep this pilot under close review over the next 12 months to ensure that we are seeing the improvements to patient safety and patient outcomes that are expected.”

Examples of immediately life threatening calls which require an immediate response (Ave response time 2015/16 was 7.4 minutes):

· Patients who may be in cardiac arrest

· Patients involved in serious road traffic collisions

· Patients suffering acute anaphylactic shock

· Patients who are unconscious and not breathing

· Vulnerable patients, including pregnant women and young children

Examples of situations which will be given enhanced triage and receive a blue light response to ensure the most appropriate care (Ave response time for all 999 calls in 2015/16 was 11.2 minutes):

· Patients experiencing chest pain or possible heart attack symptoms

· Patients who are experiencing breathing problems

· Patients experiencing symptoms of stroke

· Patients with suspected serious fracture

• Scottish News