Trust Developments & Joint Working Joint cardiac initiative with Merseyside Fire & Rescue Service A new cardiac initiative is being launched across Merseyside that will see Merseyside Fire and Rescue Service and ambulance crews working together to treat cardiac arrests. The scheme, launched on 29 February 2016, will see both services dispatched to an incident and whoever reaches the casualty first will provide the life-saving treatment needed. In the event that the fire service arrive first, care will be handed over to the ambulance crew once on scene. Under the new scheme, Merseyside Fire and Rescue Service will be contacted when a suspected cardiac arrest is reported near to a fire station. One of the advantages is that fire crews are able to respond on blue lights which will enable them to arrive on scene quickly, which is vital in a cardiac arrest situation. Similar schemes have already proved successful in Lancashire and Manchester. NWAS Delivers Remote Telehealth Monitoring To Patients We are currently implementing an exciting new project to provide remote tele-healthcare for patients across the North West. A primary aim of the initiative is to test the effectiveness of telehealth monitoring and health coaching, for patients with long term conditions, to support improved management of their condition in their own home, or within a residential care setting. It will also aim to improve co-ordination of care for patients recently discharged from hospital, in order to reduce risk of re-admission whilst improving patient outcomes and experiences. Working in partnership with Closercare, part of MSD Healthcare Services, this telehealth project is a first for an ambulance services in England and Wales and will run for a six month period until June 2016. Up to 120 patients will be recruited and will be split into a mixture of short term (1-2 weeks) and long term (up to 90 days) telehealth monitoring. Our network of Community Specialist Paramedics (CSP) will manage and co-ordinate delivery of the project, working collaboratively with local GP practices and other primary, community and acute care providers. The CSP will be supported by our Urgent Care Desk, which will provide 24/7 remote monitoring and support for patients, as and when required. Patients will take their observations in the morning each day and answer some simple questions about how they are feeling. These will be uploaded to a monitoring system where alerts will be generated if the patient’s observations or answers fall outside the agreed parameters set by their GP or consultant. Our Urgent Care Desk will contact patients who generate an alert to complete a more in depth assessment and then follow an agreed care plan set by the GP or consultant. The project will deliver a range of benefits for patients including early intervention and improved co-ordination of care, closer to home, improved care outcomes and experience and improved self-care/management of long term conditions. Patients who are being monitored will have their addresses flagged so that ambulance clinicians can be made aware if they are requested to attend. Joint Working with Police Emergency Services in the North West are facing an unprecedented challenge to maintain quality services with restricted finances, whilst the complexity and quantity of cases continue to increase. Ambulance services traditionally respond to police requests for an ambulance with a physical response. Recent discussions between a number of UK ambulance services and local police forces have highlighted a mutual willingness to reduce inappropriate requests for ambulance responses. To achieve this, we will work collaboratively with Cheshire, Merseyside and recently Lancashire Police, to provide a response to ambulance requests in a timely manner, whether this is a physical response or a ‘Hear and Treat’ assessment via telephone triage by specialist clinicians. A team of specialist ambulance clinicians are now based at the Joint Control Centre (JCC) in the force control room with the aim to clinically manage ambulance requests from Cheshire and Mersey Police and improve the efficiency of joint working. Based amongst the police dispatchers at the JCC, the specialist clinicians are able to target police requests for an ambulance in order to clinically determine the most appropriate pathway of care for patients. Pathways include, but are not limited to, referring patients to GP in or out of hours, minor injury units, walk in centres and urgent care services/providers as well asking patients to make their own way to the Emergency Department by family, friends or taxi. Clinicians are also able to discharge patients on scene by telephone triage and giving the appropriate self-care and worsening advice. As well as referring patients to alternative care pathways and delivering self-care advice, specialist clinicians can also escalate some calls for a quicker response depending on the outcome of the telephone consultation. New Diabetes Referral Scheme goes live in Liverpool From 11 January, 2016, ambulance clinicians now have access to a new diabetes referral scheme, for Liverpool patients. When attending a patient, who has experienced a hypoglycaemic episode, either in their own home or in a public place, clinicians can make a referral to the local Diabetes Referral Scheme, via our Support Centre. This type of referral scheme encourages patients to remain independent, with improved wellbeing and confidence. By making a referral, clinicians are ensuring that recent episodes are flagged, and that the patient’s ongoing care can be reviewed and possibly changed, in line with their immediate care needs. New Rapid Clinical Assessment Team Available for Widnes Patients A new initiative has recently been launched by Halton CCG aimed at service users aged 75 and above and who are not critically ill. The new Rapid Clinical Assessment Team (RCAT) will offer an enhanced rapid clinical assessment, including access to associated diagnostics, providing appropriate treatment to patients in their own home. The team will have input from a Care of the Elderly Consultant and within two hours of receiving the referral, the consultant-led team will attend the patient’s home (own home/residential home/nursing home/sheltered accommodation) to undertake a physical examination and perform basic diagnostic tests, including bloods. Should it be appropriate for the patient to undergo further tests, these will be conducted within the Halton Urgent Care Centre. Following receipt of the results, the consultant-led team will return to the patient’s home to review the patient, confirm the diagnosis and formulate the treatment/management plan. A review of patients will be conducted, following interventions, on, at least, a daily basis. Patients who respond to treatment and improve will be discharged back to the responsibility of their own GP. It is anticipated that the service will expand to include Runcorn at some point in the future. Care Plan Update - Southport and Formby patients and their carers Community matrons within Southport and Formby are actively undertaking care planning and care plan production. The care plans are being developed for patients who have long term conditions such as COPD, or patients who have fallen for example. The community matrons are also taking into account the needs of primary carers, in order to avoid unnecessary conveyance of patients who may be left without any care provision from their carer. Single Point of Access (SPA) Pathways available in Warrington Ambulance clinicians and crews can refer appropriate patients to specific, specialist teams via Single Point of Access (SPA) in order to enhance patient outcomes, reduce unnecessary hospital admissions and improve clinical effectiveness. SPA can offer 51 care pathways for patients including catheter care, cardiac nurse, Parkinson’s nurse and a community respiratory team. Warrington crews can refer patients to SPA, via the local GP/Acute Visiting Service (AVS) referral schemes. Wirral Rapid Response Admission Prevention Team The Wirral Rapid Response Admission Prevention team is happy to receive referrals for patients with minor lacerations/skin tears and any patient that requires further support. The Rapid Response team can arrange short-term emergency care/support and can refer patients to the Integrated Care Co-ordination Team (for multi-factorial health and social care assessment), Community physio and OT (able to meet highly complex needs), Intermediate Care and the Falls Prevention Service.