NHS Pathways & CMS DOS Vision Delivering the right patient care, in the right place, at the right time, through a skilled and committed workforce, in partnership with local health economies Vision Delivering the right patient care, in the right place, at the right time, through a skilled and committed workforce, in partnership with local health economies Strategic Objectives Achieve Quality and Excellence Accurately assess patient need and direct resources appropriately Establish market position as an Emergency Healthcare Provider Work in Partnership Service Delivery Objectives Deliver Service Improvement Increase Efficiency Develop our Workforce Transform our Technology Infrastructure Values World Class Service Patient Centred Dignity and Respect for All Skilled Workforce Teamwork Effective Communication Values World Class Service Patient Centred Dignity and Respect for All Skilled Workforce Teamwork Effective Communication

NHS Pathways & CMS DOS WMAS Ambulance Responses - Projected 5 Year Activity 2010/2011

NHS Pathways & CMS DOS The Previous Position Within WMAS 999 Triage Process CSD NHSD 4% 96% Response R1,R2 G1,G2 G3,G4 68% To Hospital

NHS Pathways & CMS DOS How Did We Change This?....NHS Pathways & CMS DOS

NHS Pathways & CMS DOS CMS DOS (Multiple Presentations Shown) via NHS Pathways (999)

NHS Pathways & CMS DOS The Pathways Solution Within WMAS 999 Pathways Red Flag Further Assessment CSD DOS HCRT/REFS A&E MIU GP in hrs GP OOH DN WiC MidwifePharmacy NHS DirectOther services Immediate 72 Hours

NHS Pathways & CMS DOS CMS Directory of Services (DOS) Location Module collects Clinical markers (Algorithms) based on ‘ruling out’ DOS CSD Pathways Modules Clinical Need TimeCapacity

NHS Pathways & CMS DOS The Importance of an Integrated NHS Pathways & CMS DOS Key System Benefits : Patients go to the ‘Right Place, First Time, All of the Time’ Improved patient journey and experience Better use of available services Cost base for assessment and referral to care much reduced Inappropriate ambulance journeys avoided Reduction in 999 conveyances and A&E attendances Gives commissioners world class data on what services are needed

NHS Pathways & CMS DOS Clinical Safety & Clinical Support Extensive piloting – over 1.3 million patient calls safely assessed across 4 different sites– No adverse incidents Academic evaluation by 3 universities – ‘safe and appropriate’ Ministerial license for use granted February 2009 BMA and Royal Colleges – overt support National Clinical Governance Group chaired by RCGP

NHS Pathways & CMS DOS

WMAS CMS DOS User Guide

NHS Pathways & CMS DOS WMAS CMS DOS Health Economy Leaflet

NHS Pathways & CMS DOS Staffordshire, Coventry & Warwickshire Experience – July 2011 (11 weeks) Ambulance Response Community Healthcare Service 56 Dentist 14 Early Exit 306 ED Referral 942 Health Information service 11 Home Management 268 No Value (attend Inc) 1639 Other Emergency Services 30 PARA Triage 324 Referred to GP 1586 Specialist Healthcare Service 13 Vehicle Arrived Before Coding Complete 3063 Emergency Calls Emergency Incidents Hear & Treat Alt Pathways 2.9% Hear & Treat Count CSD 3.5%

NHS Pathways & CMS DOS Birmingham, Black Country & West Mercia Experience – September 2011 (1 week) Ambulance Response 8856 Community Healthcare Service 2 Dentist 6 Early Exit 98 ED Referral 211 Health Information service 1 Home Management 45 No Value (attend Inc) 119 Other Emergency Services 7 PARA Triage 100 Referred to GP 376 Specialist Healthcare Service 5 Vehicle Arrived Before Coding Complete 727 Emergency Calls Emergency Incidents Hear & Treat Alt Pathways 3.3% Hear & Treat Count CSD 3.3%

NHS Pathways & CMS DOS Any Questions