Ambulance services given extra time to assess patient need

Currently, ambulance call handlers are given one minute to assess the severity of a patient’s condition and decide whether to send an ambulance.

Under the pilot scheme South West Ambulance Service Foundation Trust and London Ambulance Service Trust will test a three minute assessment period.

This will not apply to the most severe cases – the “red 1” category.

The pilots will begin in February and will cover a patient population of around 13 million people.

In a statement to Parliament, Jeremy Hunt said that in these pilot sites some “potentially life threatening” conditions will be upgraded from the “red 2” category to “red 1” to ensure they receive an ambulance as quickly as possible. These conditions may include overdoses or certain types of gunshot wounds.

The rest of the country will continue to operate under the current system, and data will be published alongside the pilot statistics.

Mr Hunt said he would not support a national rollout of the pilot unless there is clinical consensus that the proposed change will be “beneficial to patient outcomes”, “reduce overall clinical risk” and there is an “associated increase in operational efficiency”.

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He added that the aim is to reduce the number of vehicles sent to each 999 call.

Mr Hunt said there had been an “unprecedented increase in demand for ambulance services in the last two months” and in light of this, he had asked NHS England to “consider whether there were any changes which could be brought forward quickly in order to help ambulance services maintain, and perhaps even improve, clinical outcomes for patients”.

In a letter to Mr Hunt, NHS England’s national director for acute care Keith Willett wrote that “efforts to comply” with ambulance standards “in the face of steadily rising demand over time have led to a range of operational behaviours that appear increasingly inefficient” and which “have the potential to create a system with unnecessarily high and unevenly distributed clinical risk”.

He cited examples of blue light ambulances being sent to calls before the problem has been determined and sending multiple vehicles to one callout.

He added: “The majority of patients currently coded as red 2 do not ultimately derive clinical benefit from the arrival of an ambulance resource within eight minutes.

“However, attempts to comply with the eight minute standard lead to the operational inefficiencies described previously and detract from the response to other patients.”

Mr Hunt said he agreed that giving call handlers “very limited extra assessment time” would “ensure that ambulances are better deployed to where they are most needed and would allow a faster response time for those patients who really need it”.

Richard Webber, national spokesman for the College of Paramedics and a senior paramedic working in the NHS, said: “We are supportive of more time to assess patients to prevent ambulances being sent unnecessarily.”