Feb 2019 - Your questions answered: requesting urgent or emergency ambulance transport

In December, North West Ambulance Service (NWAS) started a pilot of new national frameworks for handling healthcare professional (HCP) requests for urgent or emergency ambulance transport to hospital or between hospital sites. This included a new telephone number for HCPs to use and a new cohort of NWAS staff dedicated to answering these calls.

Further to the communication with HCPs in November and December, and in response to some queries, a list of ‘frequently asked questions’ is available online, with key points highlighted below.

Who should use this number?

The new healthcare professional line: 0345 140 0144, is for use by all HCPs including: GPs and clinicians working in hospitals, the community, mental health units, out of hours providers, midwife-led units, etc.

It is important that the patient’s clinician makes the telephone call because clinical questions about the person’s condition will be asked.

Where this is not possible, e.g. for a single point of access, the person making the call must have certain information, which can be found in the booking checklist available to download at www.nwas.nhs.uk/professionals.

When should I use this number?

This number should be used any time there is a clinical need for a patient to have urgent or emergency transport to hospital or between hospital sites.

The level of ambulance response is determined by the information you provide about the patient’s clinical condition and corresponds with the national Ambulance Response Programme (ARP) standards which were introduced in August 2017. You can read more about ARP here: https://www.england.nhs.uk/urgent-emergency-care/arp/

Call categories

999 is still available to HCPs but should only be used if the situation is immediately life-threatening and requires additional clinical support on scene as soon as possible to deliver life-saving support (e.g. a ‘Category 1’ incident).

For all other urgent and emergency incidents, including those given above as Category 2 examples, the 0345 number should be used. Through this route, HCPs will be asked relevant questions regarding their clinical assessment of the patient to allow the correct response to be determined as quickly as possible. The response will be prioritised based on clinical need and calls from HCPs will be treated equally to calls from the public that come through 999.

The process for booking through the Patient Transport Service (PTS) remains unchanged. PTS is operated by NWAS in Cumbria, Lancashire, Greater Manchester and Merseyside, and is for non-emergency transport to routine appointments for those who meet the eligibility criteria. 

Why am I being asked for NEWS2?

NEWS2 is a ‘National Early Warning Score’ used by clinicians across the country to quickly determine the degree of illness of a patient. HCPs requesting an emergency ambulance for all patients who are aged 16 years or over and not pregnant will be asked for NEWS2. 

A patient safety alert issued by NHS Improvement, NHS England and the Royal College of Physicians mandated that NEWS2 should be adopted by all ambulance and acute trusts in 2019. More information about this, along with a NEWS2 clinical resource pack, can be viewed here: https://improvement.nhs.uk/news-alerts/safe-adoption-of-NEWS2/ and a free-of-charge NEWS2 training module is available to NHS employees here: https://news.ocbmedia.com/

Where HCPs are unable to give NEWS2, they will be asked to provide a clinical reason for the emergency response. 

Why have these changes been introduced?

The improvements to the national frameworks have been led by the Association of Ambulance Chief Executives (AACE) and NHS England in response to HCP concerns about the previous system and developed with their input. We are one of 4 ambulance services piloting the new frameworks.

We will be finessing the pilot as it is rolled out to continuously make improvements. We appreciate the new number and process is a change for many HCPs but we would like to reassure colleagues that the new frameworks will lead to benefits for them and their patients, including:

  • An equitable response for patients who are with HCPs and members of the public dialling 999
  • A smoother process, with most calls answered by a team dedicated to handling HCP requests
  • Patients receiving the right response, at the right time – by working with HCP colleagues we can ensure ambulance resources are used appropriately, keeping vehicles and crews free to respond quickly to the most serious incidents.

 Please note:

  • This will replace the various previous local telephone numbers for professional use. These numbers will automatically divert to the new number during the pilot to ensure patient safety.
  • The healthcare professional line is not for use by members of the public.

A project team at NWAS is available to support HCPs and can be contacted at ift.hcp@nwas.nhs.uk with any general queries or feedback. More information, including a downloadable resource pack, is available at www.nwas.nhs.uk/professionals.

HCPs are asked to support us by taking some time to read the guidance available, begin to use the new 0345 line for requests, and use emergency ambulances responsibly. This includes considering whether it is appropriate for the patient to make their own way (e.g. private transport) or to book via PTS if they meet the eligibility criteria.  Thank you for your support.

Dr David Ratcliffe