How we provide the best care for patients: An update from CEO Robert Morton

Robert Morton ambulance OPT

The majority of people seeking healthcare generally access it through their local GP (also called primary care), 999, 111 or the Emergency Department (ED). We also know from feedback from both our own service and partners providing healthcare, that some patients call us or go to an ED because they are not aware of, or are confused about, what the best option for them is and when and where this might be available.

So we need to think across the healthcare sector about how we can better guide patients to the right option for their needs at the time they need it – this could be some kind of portal through which the public can access a range of healthcare options, one of which might be an emergency ambulance. EEAST has the potential to become this portal to urgent and emergency care as recently highlighted in the Sir Bruce Keogh’s review, helping patients get the right care from the right providers closest to home.

In my previous message dated the 5th November 2015, I indicated that our new strategy and plan, would need to expand on our models of care, including:

  • Hear and Treat
  • See and treat
  • See, treat and convey

I want to talk about hear and treat this week, which includes referring patients to the right service for their needs. We know that our clinicians already perform this within the EOC environment. At this stage, clinicians successfully and safely manage approximately 5% of our 999 call volume in this manner. However, when benchmarked against some of the best performing ambulance services, we know that up to 10% is easily possible if we could expand our capacity to undertake more in depth clinical triage over the phone. Ideally, we would also be able to re-triage 111 calls, however this is currently not allowed under NHS regulations which is why we are working closely with our clinical commissioning groups and 111 providers to encourage them to ensure any 999 call that is passed to us has first been triaged by a clinician.

EOC currently has a range of clinical staff undertaking some form of telephone triage including Paramedics, Nurses and a GP and since last week our CSD is fully staffed. All these professionals make complex clinical decisions about options and priorities for patients with a wide range of clinical conditions. Patients, at both ends of the clinical spectrum, benefit from these services that are safe and effective. Since last week, our CSD capacity is now fully staffed. An example of how we might be able to bring our EOC clinical capacity to bear is to consider triaging all Green 4 calls through PSIAM before we automatically send a physical response, which we know at this stage can often tie up a resource inappropriately for prolonged periods of time when a better pathway or healthcare option could have been chosen and used.

However, becoming such a portal is not just about clinical triage. It is also about being an accessible repository of comprehensive and accurate information which reflects the full Directory of Services that may be available to patients and to which we can refer them locally. Additionally, it is about being an advocacy service that actively works to navigate “systems” so that patients can be connected with the option that best meets their needs. In short helping the patient get the right care, when they need it locally.

In this regard, our relationship with the newly formed Urgent Care Networks will be key to ensuring we are positioned to participate in discussions about the development and expansion of such referral options. Developing our EOC, increasing our clinical capacity and securing 111 contracts in the future will be a critical success factor if EEAST is to be capable of delivering on these new models of care and become the hub within the urgent and emergency care system.

With best wishes,


Published 10th December, 2015

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