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 3 rd November

“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

Clinical Practice Professional Registration a pre-requisite Evidence Based ‘Selective’ Clinical Skills Guidelines for Clinical Judgement

N HS (Direct)

NHS Direct Walk-in Centres Capacity Management GP ‘Out of Hours’ Review On-line Services Web Cam Facilities

Millennium Ambulance Service

Bashed Clinical Practice Bashed BASMED JRCALC Bashed j Local Medical Steering Committee Individual Clinicians Faculty of pre - Hospital Care BAEMS Medical Directors BASICS NICE Bashed CHI

JRCALC A.S.A. Clinical Effectiveness Committee Ambulance Education and Training Committee Standard Protocols Clinical Leadership Evidence Based Practice Lead Advisory Body on all Clinical Issues Medicines Commission Medicines Control Agency

The NHS Plan 21 st 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/ Single Gateway Health Development Health Information Health Promotion Chronic Disease Management Nurse Triage Emergency Ambulance Sub-structure ‘electronically networked for home care diagnosis’ Full range of patient telematics Electronic Access

That’s all Folks