1. Developing Urgent and Emergency Care Using Digital Technology
Chief Information Officer – Ross Fullerton
Chief Clinical Information Officer – Stuart Crichton
January 2019

2. Technology is changing the NHS
LAS Strategy
National Ambulance Digital Strategy
Lord Carter Report: Digital Implications
NHS Tech Vision
NHS 10 Year Plan
LAS Digital, Data & Technology Strategy

3. Increasing complexity
Ambulance Trusts are under pressure to respond to increased demand while meeting changing patient expectations
Increasing demand
Increasing complexity
Changing expectation
Efficiency
Opportunities
Challenges
Transformation support and funding
National initiatives for standardisation, new functionality and solutions
Funding and partnership opportunities
Guidance and thought leadership
Digital collaboration
Synergy effects
Sharing of learning experiences
Workforce considerations
Retention
Training
Rostering
Commissioning alignment
Targets & Ambulance Quality Indicators
Penalties
Variations: number of STPs and ICS within a geographical region
Digital alignment
Clarity on business / clinical strategy to align digital solutions
Communications & stakeholder engagement
Supplier management
Disruptive service models
Alternative commissioning arrangements
Potential disruption from new entrants

4. The national strategy is grounded in the new NHSE commissioning framework
Before the contact
Handle the contact
Provide the right care
Respond to my needs
Direct me to the right place
Strategic Demand Management
Public Education and Condition-Management Campaigns
Frequent Callers
Telemedicine
Modern Telephony
Multi-Channel Contact - Patients
Multi-Channel Contact – Devices and Sensors
Multi-Channel Contact – Partner Organisations
Call Automation
Call Handovers
Virtual EOC
Enhanced Triage
Computer Aided Dispatch
First Responder Notifications
Unmanned Vehicles (Drones)
Connecting Clinicians (“Digital Ambulance”)
Clinical Hub (“Virtual Ambulance”)
On-Scene Decision Support
Pre and Post Call Communications
Workforce Management
Vehicle and Asset Management
Medicines Management
Directory of Service
Access to Records
Electronic Patient Record
Emergency Department Handover
Wider System Referrals
Electronic Prescribing
Outcomes Feedback
Resilience and Cyber Information Governance Access for All

5. Chief Clinical Information Officer Connecting the LAS, London and the country. Creating personalised urgent and emergency care.
CCIO
What is the role?
Who am I?
What motivates me?

6. What are we doing now…. 999 – face to face ePCR 111 – Hear and treat
Coordinate my care access
MiDOS – Pathways access
Digital JRCALC
iPads at the patients side
ePCR
Electronic patient care records
"say it once"
"type it once"
111 – Hear and treat
Adastra
Clinical records
Coordinate my care records
Summary care record
National record locator service
One London
iCat
integrated clinical assessment and triage

7. What does this mean for Patients?
Burt (77) has suffered a cardiac arrest at home and has been successfully resuscitated by the LAS team at home. He is well known to his local acute and has previously had stents fitted. Alice (17) has a stab wound to her chest. She has extensive allergies that were discovered in her childhood.

8. What does this mean for staff?
Gareth is dispatched to a 30yom with a rash. After a face to face examination he decides the best course of action is to refer into the iCAT team to organise a GP appointment.
Gareth has come to this decision by using his iPad to securely access the following clinical information.
SCRa
NRLS
Previous ePCR entries
CMC

9. Patient flow 999 CAD ePCR See and Treat Patient Refer / Pathway
Hear and Treat
Adastra
Patient flow

10. Data 999 CAD ePCR See and Treat NHS Spine MiDOS SCRa CMC NRLS Patient
Refer / Pathway
Hear and Treat
Adastra
Data

11. Data flow 999 CAD ePCR See and Treat NHS Spine MiDOS SCRa CMC NRLS
Patient
Refer / Pathway
Hear and Treat
Adastra
Data flow

12. Data flow 999 CAD ePCR See and Treat NHS Spine LAS Data MiDOS SCRa
NRLS
CMC
Patient
Refer / Pathway
Fleet
Drug
Staff
Hear and Treat
Adastra
Data flow