1. Paramedics & Ambulance Transport
South East Coast Clinical Senate Defining the clinical co-dependencies of acute hospital services Wednesday 10th September 2014
Andy Collen
DipHE MSc MCPara
Clinical Development Manager, South East Coast Ambulance Service
Medicines and Prescribing Project Lead, College of Paramedics
Paramedics
&
Ambulance Transport

2. Areas for discussion “Cross cutting theme” in Co-dependencies matrix
Four key themes;
Ambulance and transport issues: Paramedic Practice & Patient Flow
Ambulance and transport issues: Inbound transport (inc. secondary, tertiary and community facilities)
Ambulance and transport issues: Interfacility Transport
Ambulance and transport issues: Outbound transport (supporting patient flow and discharge planning)
Impact on ambulance services with increase co-location of specialist services – experience of previous changes to services

3. Ambulance and transport issues: Paramedic Practice & Patient Flow
Medical and Surgical take: Direct admissions - Reducing ED pressures
Pre-hospital critical care: CCPs and enhanced journey to appropriate facility
Pre-hospital emergency care: Enhanced pre-hospital care for cardiac arrest patients accessing causal therapy
Direct referral for admission for known patients with primary or comorbid issue
Enhanced obstetric and neonatal training for paramedics. - Consideration for mobilising support (revisit flying squad model for highly complex issues)"

4. Ambulance and transport issues: Inbound transport (inc
Ambulance and transport issues: Inbound transport (inc. secondary, tertiary and community facilities)
999 callers – disposition from scene: more complex?
Improved "booking" opportunities to accepted patients (RAMU model)
Enhanced MTC decision support
Direct access emergency pathways: ?Cold limb pathways - AAA pathways - General vascular emergency pathways"
Reduced conveyance for normal births (even in unplanned home confinement)

5. Ambulance and transport issues: Interfacility Transport
Step up to MTC - Step down to TU/LEC
Critical Care Network support with use of improved transfer training - Enhanced method of selecting ambulance crew to minimise delay (i.e. need for paramedic)
Supporting step up from DGH to Acute Stroke Unit (time standards)
Neonatal transfer services

6. Ambulance and transport issues: Outbound transport (supporting patient flow and discharge planning)
Supporting four hour target - Admission avoidance"
Discharge planning to rehab centres - enhanced care in transit for recently disabled patients"

7. Thank you
Any questions….