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Intelligent Conveyance Trial

Ambulance on motorway

The trial is taking place from 16th August – 20th August 2021 in:

Cambridgeshire and Peterborough

Hertfordshire and West Essex

Bedfordshire, Luton and Milton Keynes (BLMK)

EEAST has a responsibility to work with system partners to achieve an effective and timely clinical handover of patients at Emergency Departments (ED) to ensure an effective response to patients waiting in the community. 

Delays seriously impact ambulance service capacity, the ability to respond to patients in the community and can lead to patient safety concerns, including serious harm.

EEAST is currently working in partnership with NHS England and NHS Improvement (NHSE/I) to move forward with a live trial to progress the joint Intelligent Conveyance project. The aim of this project  is to provide each patient with the timeliest treatment on arrival at an acute A&E department.

Currently, EEAST Tactical Commanders may enact load levelling at any point to reduce system pressures and to reduce the risk to patient safety in the community, especially for those who are without any on-scene clinical support.

When load levelling is enacted, patients are diverted from one acute to another when the original receiving hospital is experiencing delays in offloading patients from ambulances.

Intelligent Conveyance seeks to pre-empt, and potentially prevent, hospital offload delays by monitoring demand and performance for both EEAST AND acute hospitals.This is brought about by utilising live information from systems to make informed decisions based upon patient safety, minimising risk and providing the best patient experience.

Trials began in localised areas, and we are now expanding to C&P and BLMK.  Any learning from this trial will be implemented with a plan to expand Trust wide.

What will this mean to our crews?

Patients falling within pre-determined criteria, who require conveyance to an acute emergency department, may be conveyed to an alternative receiving acute ED.

Crews will be notified if their patient is being considered for Intelligent Conveyance and advised as to the new receiving acute ED

As an example of this principle, a patient being conveyed to their local acute ED, 15 minutes away, may have to wait an hour and a half to be handed over into hospital care. Alternatively, a 25-minute journey to an alternate acute ED, may have a handover time within 15 minutes (mandated as a National Quality Requirement (schedule 4b) within the NHS standard contract.)

Transporting the patient to an alternative acute ED could assist crews in becoming available to respond to outstanding calls in the community within a shorter time frame and to potentially reduce late finish times whilst waiting to offload patients at busy hospitals.

 

The impact of Intelligent Conveyance on Trust resources, trigger points and exclusion criteria are being constantly reviewed. Current exclusion criteria include, but is not necessarily limited to:-

  • Patients being transported under an acute specialty pathway (including but not limited to maternity, PPCI, stroke, trauma, critical care)
  • Patients who require an ambulance response in a community setting and transport to an acute hospital following clinical assessment by a healthcare professional (HCP) but with a pre-agreed specified receiving team outside of ED.
  • Patients being transported under the National Framework for Inter Facility Transfers (patient transfers between facilities defined as healthcare facilities that provide inpatient services, noting that local inclusions can be urgent treatment centres or other type 3 and 4 services with direct admitting rights to inpatient services)
  • Pre-alerted patients
  • Patients currently receiving specialist treatment at a receiving hospital (e.g. sickle cell)
  • Patients with learning difficulties/disabilities (including autism) who are familiar with their local hospital
  • Formal hospital diverts where required in addition (actioned under the existing NHSE &I Divert Protocol)

 Further details, including other trial dates and trial areas, will follow. Frontline staff and managers will be made aware when the Intelligent Conveyance project trial is in operation with their area.

 

Published 10th August 2021