Joint Royal Colleges Ambulance Service

Liaison Committee

(JRCALC) Conference

“What does the Ambulance Service

need from JRCALC in the New Millennium?”

A.S.A. Video

The Ambulance Service Map

As at 12:00Hrs 3rd November 2000

32

“Where does the Ambulance Service see its Future Strategic Direction?”

How can we Help?

Towards Perfect Vision 2010

Strategic review undertaken by The School of Health and Related Research, Sheffield

University.

Draft Report scheduled - December 2000

Public Safety

Health Care Arm of the Emergency

Services

or

Public Health

Emergency Arm of the Health Care

Service

Current Issues

•Role (scope of practice, disasters home care; is ‘ambulance service a good name)

•Organisation (links, mergers, networks, etc)

•The ASA and the NHS confederation

•Demand and demand management, targeting and prioritisation

•Management staff (NHS / AS)

•Operational staff (lay, drivers,EMTs, paramedics, PECS, nurses and doctors, control room staff)

•Operational Technologies (IT, vehicles, AVL, GIS, EMD, digital radio)

Current Issues

•Therapeutics (telemetry, drugs,

thrombolysis, etc)•Variations in practice and protocols (audit) Evidence based practice (research)•Protocols (therapeutics, timings, treat and leave, by passing, etc)•Clinical Skills (education and training, maintaining skills, rotation)•Performance standards (time,clinical practice,c-calls, outcomes)•Non-emergency work (PTS, NHS Direct, etc)•Voluntary sector (St. Johns / Red Cross)•Funding (economic viability; funding levels; local contracting)•Legal and regulatory framework (clinical governance ..)

Options for the Future

•The Organisation of Ambulance Services

•Links, Mergers and Networks

•The Emergency Health Care Trust

The Journey To-Date

Clinical Role of Ambulance Services

1970/80

Millar

Ambulance

Personnel

1990

Paramedics

&

Emergency

Medical

Technicians

2000

State

Registered

Paramedics

2005

Practitioners

in

Emergency

Care

ClinicalPractice

•Professional Registration a pre-requisite

•Evidence Based

•‘Selective’ Clinical Skills

•Guidelines for Clinical Judgement

0845 46 47

0845 4N HS(Direct)

•NHS Direct

•Walk-in Centres

•Capacity Management

•GP ‘Out of Hours’ Review

•On-line Services

•Web Cam Facilities

National Emergency Number999/112

Ambulance ServiceEmergency Control Centre

------------------------->-------------------------------------------------<-------------------------- NHS Direct

Call centre

Prioritisation Nurse Triage

Cat A Cat B Cat C AmbulanceService

Response

Self Care CommunityServices

VoluntaryAgencies

SocialServices

GP Contact A & E

ParamedicResponse

Paramedic/TechnicianResponse

Advice TechnicianResponse

NHSDirect

NursingPaediatrics

DentalMental Health

Pharmacy

HomeVisit

Practice

Triage/Treatment

Triage/Treatment

AppropriateReferral Unit

Home AppropriateReferral

Unit

GP Contact

Millennium Ambulance Service

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Clinical

Practice

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BASMED

JRCALC

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Local MedicalSteering

Committee

IndividualClinicians

Faculty ofpre - Hospital

Care

BAEMSMedicalDirectors

BASICS

NICE

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JRCALC A.S.A.

ClinicalEffectivenessCommittee

AmbulanceEducation and

TrainingCommittee

•Standard Protocols•Clinical Leadership•Evidence Based Practice•Lead Advisory Body on all Clinical Issues

Medicines CommissionMedicines

Control Agency

The NHS Plan

21st Century Service

for the needs of the Public

• Develop its capability and potential for an enhanced integrated role within the primary care setting

• Maximise the advantages to be gained from the developments in clinical treatments and telemedicine technology

• Provide the emergency communications gateway for the National Health Service

• Stronger medical influence through the appointment of Medical Directors

The Millennium Ambulance Service will :-

• Audit and Evaluation (in partnership with Primary and Secondary Care providers)

• Clinical outcomes determining future practice

• Enhanced interventions within the community (Practitioners in Emergency Care)

• Community programmes of education in CPR and automatic defibrillation

The Millennium Ambulance Service will :-

•Integrated and seamless pathways of care

•Single gateway for emergency access

•Enhanced response performance (90%) for life threatening conditions

•Application of digital technology and telemedicine leading to the introduction of mobile health care

The Millennium Ambulance Service will :-

999/112/08 45 46 47

Single Gateway

Health Development•Health Information•Health Promotion•Chronic Disease Management

Nurse Triage

Emergency Ambulance

Sub-structure‘electronically networkedfor home care diagnosis’

Full range of patienttelematics

Electronic Access

That’s all Folks