Building A Relationship With Primary Care Aim of our Presentation To engage with Primary Care as a key partner in delivering sustainable patient care To provide background information on our service and its transition to a clinically focussed organisation ID: 693639
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Slide1
Welsh Ambulance Services NHS Trust
Building A Relationship With Primary Care Slide2
Aim of our Presentation:
To engage with Primary Care, as a key partner in delivering sustainable patient care.
To provide background information on our service, and it’s transition to a clinically focussed organisation.To share key service issues for both Primary Care & WAST. To identify potential opportunities to work collaboratively with Primary Care colleagues.
IntroductionSlide3
BackgroundSlide4
Background – 3 Service Lines
Non Emergency Patient Care Service (NEPTS) - non emergency/elective patient
transport.
Emergency Medical Services (EMS) and Urgent Care Services (UCS) underpinned by our 5 Step Clinical
Model.
NHS
Direct Wales (NHSDW) - providing skilled nurse triage and health information 24/7 - 365 days a year.
1
2
3Slide5Slide6
Five Steps – Ambulance Care Pathway
Commissioned by the Emergency Ambulances Services Committee (EASC
).
New Response
Model –
commenced October
2015.
Independent review commissioned by WG – following 12 month
pilot, and now operational.
Slide7
Step 3 – Come to
see me: Response
CategoriesSlide8
Situation
(what is going on now)
WAST’s IMTP has a clear aim to develop our services in alignment with the needs of Primary Care. Public Health Wales’ evaluation of the Pacesetter Programme.
Health, Social Care & Sport Committee’s Inquiry into Primary care Slide9
Data Analysis – Specifically on Health Care Professional Calls (HCPs)
Health
Care Professionals (HCP) call volume
=
58,281 number of Verified Incidents during 2015/16 (1st Oct 2015 to 30th Sep 2016 - i.e. the timeline for the new clinical model
).
HCP's - highest presenting call volume (12.6% of all demand - 462,414):
0.01
% (3)
RED Calls
: Unscheduled demand & responded to as part of WAST's Emergency Medical Services
(
EMS - Blue lights
).
1.6
% (92)
AMBER Calls
:
Unscheduled demand & responded to as part of WAST's
EMS
- Blue
lights.
98.4
% (57,358)
GREEN Calls
: Predictable (or scheduled) demand for pre-arranged patient admissions, and do
not need EMS - Blue light responses .Slide10
HCP GREEN Calls – Predictable Call Demand
Peak Period is Monday to Friday
Peak Times are between 10:00 to 18:00 Hours
Height of demand is 13:00 hours Monday to Friday Slide11
Recommendations (what is our offer)
Welsh Ambulance Services NHS Trust
Community - based Paramedics
Advanced Paramedic Practitioners to be part of Multi-Disciplinary Teams (rotational posts)
Patient flow procedures for low acuity (predictable) admissions
Shared new estate / premises – WAST working directly with Primary Care
Patient Care Plans for Pre-hospital careSlide12
Example of an Improvement by Joint Working – The ‘Community Paramedic Scheme’:Slide13
Primary Care
17, 000 (283 hours) minutes of GP time saved
Secondary Care Only 36 patient admissions from
226 home visits (16%)
The Impact of this Testing and Illustration of Prudent Health Slide14
Immediate
Offer
:
Interim data of the Western Vale
Model has been positive, and due to workforce plans, WAST can offer this model to Primary Care in the first instance.
There have been expressions of interest, to date from: AB; ABM; CT; HD and Powys.
Next
Steps:
Agree
finances with
Primary Care (
key dependency
), and if feasible, put in place
an operational
model.
Full evaluation of the Advanced Paramedic
Scheme
in January 2018, in conjunction with the Bevan Commission, to determine opportunities for this level of clinician to work in other Primary Care
Services
, as well as home visiting (e.g. Primary Care Hubs).
WAST to align
the
development of the Community Paramedic Scheme to the College of Paramedics Career Framework.
Paramedic – home visits to assess and report back to the GP
Advanced Paramedic – home visits to assess, treat, refer / resolve.
Current trial in Western Vale
Current trial in St John’s Medical Practice.
Ongoing service with General Medical Services Team in Hywel DdaOut of Hours Services in CT & AB (
tbc)
WAST’s Second Request / Offer – ‘
Pacesetter (MDT working)’Slide15
Key Messages from our presentation:
We wish to develop services jointly through engagement with Primary Care.
We wish to address variation, and develop solutions for improved patient care / experiences collaboratively. We seek opportunities to work directly with Clusters via our Heads of Operations and Clinical Leads.We wish to retain staff, and develop joint contracts to enable colleagues to work in both Primary Care, and for WAST.
Summary Slide16
Thank You
Questions and Observations Welcome
Direct Contacts:
Dr. Brendan Lloyd, Executive Medical
Director -
Brendan.Lloyd2@wales.nhs.uk
Grayham Mclean, Unscheduled Care Lead –
Grayham.Mclean@wales.nhs.uk