A good example of successful integration of public and private resourcing of the NHS is the new Intermediate Care Ambulance Transfer Service introduced for hospitals in central London in April.
There is a growing demand, particularly late in the hospital day and during the night, for a responsive ambulance service to transfer patients between hospitals, clinics and other locations for further care.
London Ambulance Service was finding it difficult to meet this need, given the increasing demands on its resources to respond to emergency 999 calls in the capital.
In September last year Medical Services, an independent provider of patient transport services to the NHS, detected a rise in noticeable demand for ICATS, with additional requests from London hospitals and started planning the new service.
The first step was to ensure staff members were given proper training for this work.
Joe Sheehan, managing director, explains: “Our company training programmes are continuous and we introduced additional courses for crews for the new service. The entry level grade for transfer ambulance crews is the BTEC First Person On Scene qualification with an additional module in cardiac monitoring but this will be replaced by the forthcoming BTEC ECA qualification. We have started to pair this staff with our EMT crews already in place.”
Next, Medical Services looked at operational needs, dispatch and control staff has undergone additional training to prepare for taking telephone requests for this service.
A criteria based system with an underlying clinical algorithm was put place to ensure journeys undertaken matched the company’s skills, equipment and ability to move patients efficiently and safely.
Calls are handled by staff using computerised CBD systems to make sure the patients to be transferred are suitable for intermediate care or whether they need paramedics or nurse/doctor escorts.
Extra people have been recruited for the new service and the company’s continuous investment in its fleet has been increased with a recent order totalling more than £3 million for new vehicles. By this coming winter it will have 80 ambulances and vehicles per shift to provide the 60 minute response time across London for transfers. This will be supported by the existing PTS fleet.
Homerton Hospital in east London, which has an existing contract with Medical Services for cardiology transfers, has been one of the first NHS trusts to use the new service.
According to Cliff Hammond-Read, deputy director of environment at Homerton, this was linked to the decision by London Ambulance Service to concentrate on its core business of 999.
Mr Hammond-Read says: “We envisage using this service for those patients such as bariatric patients who would benefit from the 60 minute response time. We have been impressed with the use of new vehicles and specially trained staff who understood their needs.”
Mr. Sheehan stresses that the new service does not compete with the London Ambulance Service.
“We are not providing an emergency service to the public, far from it. LAS provide Londoners with a world class ambulance service with great skill and dedication. I have the difficult task holding on to our best crews, many of whom aspire to continue their training and become qualified paramedics working for LAS. ICATS is a support service providing hospitals with an Intermediate Care Ambulance Transfer Service which is available 24/7 on demand across the patch.”
The immediate plan is to gradually introduce the new service to hospitals within central London and later extend it to cover other Trusts inside the M25 area within about a year.