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 3rd November 2000
32
“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
ClinicalPractice
•Professional Registration a pre-requisite
•Evidence Based
•‘Selective’ Clinical Skills
•Guidelines for Clinical Judgement
0845 46 47
0845 4N HS(Direct)
•NHS Direct
•Walk-in Centres
•Capacity Management
•GP ‘Out of Hours’ Review
•On-line Services
•Web Cam Facilities
National Emergency Number999/112
Ambulance ServiceEmergency Control Centre
------------------------->-------------------------------------------------<-------------------------- NHS Direct
Call centre
Prioritisation Nurse Triage
Cat A Cat B Cat C AmbulanceService
Response
Self Care CommunityServices
VoluntaryAgencies
SocialServices
GP Contact A & E
ParamedicResponse
Paramedic/TechnicianResponse
Advice TechnicianResponse
NHSDirect
NursingPaediatrics
DentalMental Health
Pharmacy
HomeVisit
Practice
Triage/Treatment
Triage/Treatment
AppropriateReferral Unit
Home AppropriateReferral
Unit
GP Contact
Millennium Ambulance Service
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Clinical
Practice
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BASMED
JRCALC
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Local MedicalSteering
Committee
IndividualClinicians
Faculty ofpre - Hospital
Care
BAEMSMedicalDirectors
BASICS
NICE
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JRCALC A.S.A.
ClinicalEffectivenessCommittee
AmbulanceEducation and
TrainingCommittee
•Standard Protocols•Clinical Leadership•Evidence Based Practice•Lead Advisory Body on all Clinical Issues
Medicines CommissionMedicines
Control Agency
The NHS Plan
21st 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 :-
999/112/08 45 46 47
Single Gateway
Health Development•Health Information•Health Promotion•Chronic Disease Management
Nurse Triage
Emergency Ambulance
Sub-structure‘electronically networkedfor home care diagnosis’
Full range of patienttelematics
Electronic Access
That’s all Folks