London Ambulance ServiceNHS Trust

What are the alternatives for patients who are not life threatened?

• Clinical Telephone Advice• Walk in Centres• Minor Injuries Units• Intermediate Care• Falls teams• District nurses• Mental Health Crisis Intervention Teams• Primary care• Social services• NHS Direct

London Ambulance ServiceNHS Trust

Requires us to change:

• Provide telephone advice to callers with non-serious conditions

• Develop referral pathways

• Send a professional who is trained in the recognition and treatment of non-life threatened, but often complex, patients

London Ambulance ServiceNHS Trust

N urse

M inor Illness

Applied Pharm acology

D iplom a - Em ergency C are P ractitioner

Chronic Conditions Param edic M odule if neededOr Choice

M inor Injury Paediatric

GO LIVE

Clin ical Decision

Physical Assessm ent

Level 1 APELShort Essay, applicant profile

and d iagnostic in terv iew

Param edicor EM T w ith 4 years A & E experience

O T or Physio

Education for Emergency Care Practitioners

St Georges Medical School/Kingston University

London Ambulance ServiceNHS Trust

Around the Country

Merseyside – relatively clear care pathways

West Country – strong educational package & some extensions in practice

Warwickshire – v. competent practitioners,open access routes to role, clerking into acute sector

Staffordshire – clear location in demand patches, CPOs senior role in service, patient focused ethos

Sheffield – rotation through control & MIUs, also focus on older peoples needs

East Anglia – strong links with GPs non escalation of cases unless necessary = basic principle, extended practice