Funding axed for ambulance IT system

Urgent talks are underway to save a computerised capacity and activity monitoring system (CAMS) used to direct ambulances to hospitals best placed to deal with patients after PCTs in the East of England SHA withdrew their funding.

The East Anglian Ambulance Trust and acute trusts across Norfolk, Suffolk and Cambridgeshire are in last minute talks with East of England (EoE) SHA to prevent the screens going blank on 7 March 2007.

The crisis comes as EoE SHA tries to reign in a projected overspend of £175m.

In November 2006 executive directors at the SHA asked PCTs to consider whether to recommission CAMS, which helps direct ambulances to hospitals best placed to deal with emergencies.

They decided to withdraw their funding, which is thought to amount to £175,000 a year. The service will end officially on 31 March 2007 although it may be withdrawn as early as 7 March, sources indicated.

CAMS is an NHS-owned system. It was developed by the ambulance service in Surrey and is currently in use or being developed in all SHA areas except EoE. Nationally CAMS employs one manager.

The web-based system allows acute hospital managers to input information about their capacity including the number of empty beds and the current waiting times in A&E. Nurses usually do this two-hourly but can update as often as they like.

This information is then sent out to ambulances via on-board screens where crew members can view information in near-real time.

At its most basic, CAMS is used by ambulance staff when they are equidistant between hospitals to decide where to take patients. But with 15 modules, it can be used in a much more sophisticated way to prevent emergency admissions by directing patients to more appropriate services.

The system reduces administration time for staff and makes best use of capacity within the system, typically diverting five per cent of patients. Evaluation of projects across the UK indicate that it can deliver significant savings.

The system had been running as a pilot in Norfolk, Suffolk and Cambridgeshire since 2004. It had cost £500,000 to implement and was about to move into the next stage of development.

A formal evaluation was about to get underway in January when the decision to withdraw funding was finalised. This has now been cancelled.

EoE SHA head of service development Kate Gill said the decision to pull PCT funding was made because it would be too expensive to roll out CAMS across the entire region.

The system was not in place in Essex or Bedfordshire and Hertfordshire – the two SHAs that merged with NSC to create the new EoE SHA in July last year.

The full potential of the system had yet to be demonstrated, she said.

She added: ‘PCTs felt they were funding something that benefited the acute side and we had some sympathy with that.’

An East Anglian Ambulance trust spokesman said talks were under way about the future of the system with the hope it could be saved. ‘It’s a valuable service and we would be very disappointed to see it go,’ he said.

Losing CAMS is unlikely to endanger patients, sources told EHI, as hospitals have a duty to treat patients in an emergency. But it will mean the ambulances and trusts revert to pen and paper.

Judi Davis, director of the Norfolk, Suffolk and Cambridgeshire emergency care network, which has also been decommissioned by PCTs and was in charge of the CAMS project, said the project had been hard to evaluate. It had achieved consistency in the escalation process across the region, she said, but had proved time consuming.

She said: "It’s a shame because the project was just getting to the point where it was integral to practice. It was also about to support the commissioners who were paying for it. The operational mangers will see it as a loss."

Operational lead for the monitoring system Christine Ames said: "They have pulled the rug from capacity management.

"If money is not found then on 31 March the screens will go blank and we will be back to pen and paper. We will see crazy things happen along the borders [of neighbouring ambulance trusts]."