Technology key to transformed ambulance services

Electronic patient records and the planned central repository for patient information will be vital components of many the changes needed to transform the ambulance service in England, a newly-published review predicts.

The review conducted by national ambulance adviser, Peter Bradley, says that the number of ambulance trusts needs to be reduced by at least 50% to ensure that they have the right capacity and leadership to make the changes. A consultation exercise over the next few months will determine the new trust boundaries.

The review also calls for greater efficiencies to be achieved in procurement citing the example of contracts with software providers that showed “100% variation in the value of contracts with ambulance services and significant variations in the benefit received by ambulance services from the terms and conditions of the contract.”

But the big gains to be made by using technology focus more on the national care record and its potential for providing information to ambulance staff attending emergencies and for actions taken by them to be recorded and transmitted to staff involved in the patient’s care later.

The review says that a patient record summary should be available to help them provide targeted, appropriate, quality clinical care. A minimum data set is specified including details of key medical conditions, allergies, medication, the patient’s last five contacts with NHS services and whether the patient has a history of violence or abuse towards NHS staff.

This kind of information will also support the ambulance service in providing an increasing range of other services including home visits on behalf of GPs and more work with primary care teams.

The review says: “Implementation of the NHS Connecting for Health electronic patient record should mean there is capability for ambulance staff to increasingly have the necessary information to provide appropriate patient care.

“The patient care record summary eventually should be available at the point of care. Work should be undertaken to establish the degree to which this can currently be achieved and the connectivity medium the ambulance clinician at the scene and the NHS care records service [need] to make this a reality.

“Ambulance trusts should also be able to access scheduling systems so that response hubs can be fully effective with the staff able to see which appropriate clinicians are available to visit the patient in question and agree that with the clinician and patient.”

In a section on using technology to improve efficiency, the review cites the example of Hereford and Worcester Ambulance Service NHS Trust’s adoption of a digital radio network infrastructure which transfers data from an ambulance via the control room to hospital.

The system generates an electronic record automatically which can be accessed by any of the three hospitals in the area. The system has been used with 150 patients including one who received treatment within 16 minutes of calling the ambulance.

Links

Taking healthcare to the patient: transforming ambulance services