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Pilots will give 999 call handlers longer triage time

Experts say scheme will improve patient survival

Jo Carlowe

Friday, 16 January 2015

The NHS has today announced two new pilots aimed at reducing wasted ambulance journeys by giving call handlers longer triage time.

The schemes have been recommended by doctors and the ambulance service and agreed following clinical advice, published today, from senior clinical experts at NHS England. 

The new pilot schemes will test giving call handlers longer to deal with calls before deciding on the right response. 

Evidence shows that less than 10% of 999 calls are for genuinely life threatening conditions, yet ambulance services currently categorise around 40% of calls as such, partly because call handlers have only 60 seconds to gather the information they need before an ambulance vehicle must be sent.

To meet the current target of reaching 75% of patients who are categorised as “Red2″ within 8 minutes, Ambulance Trusts frequently send vehicles to 999 callers before they have determined the exact nature of the problem. They also send more than one vehicle, such as an ambulance and a Rapid Responder. This is known as ‘double dispatch’.

On average, over 20% of these vehicles are cancelled before reaching the scene, wasting resources which could be used for other patients.

Clinical experts believe extending the call handling time by 120 second for non-life threatening calls will reduce the number of double dispatches, freeing up more ambulances to respond to more patients, and will also allow the 999 response to be more accurately targeted to patient need.

As well as having more ambulances on the road, experience has shown that allowing extra time for a more detailed assessment increases the proportion of calls resolved through telephone advice (Hear and Treat) by up to 30%, freeing ambulances for patients who need to be treated at scene and taken to hospital. It also reduces the proportion of patients treated at the scene by around 10% and reduces the proportion of patients taken to hospital by around 10% thus reducing pressure on A&E departments.

The two pilots are proposed as London and South West Ambulance Services. They will give trained call handlers up to 120 seconds longer to get all the information they need from a person making a non-life threatening 999 call before deciding on the right response. The first pilot is due to start in February. 

Commenting, Professor Keith Willett, National Director for Acute Care, said: ‘We are piloting these new arrangements because on medical grounds, we believe they will increase the availability of ambulance vehicles and paramedic staff, providing patients with a better service and improving their chances of survival, especially those with the most serious conditions.

“It’s not about relaxing standards. By acting with slightly less haste on the calls, we believe we can get to more patients with more speed. Some conditions will be upgraded to Red1 status, requiring a more urgent response than is currently the case.”

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