What are emergency ambulance services doing to meet the needs of people who call frequently? A national survey of current practice in the United Kingdom.

Autor: Snooks HA; Swansea University Medical School, Singleton Park, Swansea, SA1 8PP, UK., Khanom A; Swansea University Medical School, Singleton Park, Swansea, SA1 8PP, UK. a.khanom@swansea.ac.uk., Cole R; West Midlands Ambulance Service, Trust Headquarters, Millennium Point, Waterfront Business Park, Waterfront Way, Brierley Hill, West Midlands, DY5 1LX, UK., Edwards A; Division of Population Medicine School of Medicine, Cardiff University, Cardiff, CF10 3AT, UK., Edwards BM; Swansea University Medical School, Singleton Park, Swansea, SA1 8PP, UK., Evans BA; Swansea University Medical School, Singleton Park, Swansea, SA1 8PP, UK., Foster T; East of England Ambulance Service, Bury St Edmunds, Suffolk, UK., Fothergill RT; London Ambulance Service, 220 Waterloo Rd, Lambeth, London, SE1 8SD, UK., Gripper CP; Swansea University Medical School, Singleton Park, Swansea, SA1 8PP, UK., Hampton C; Swansea University Medical School, Singleton Park, Swansea, SA1 8PP, UK., John A; Swansea University Medical School, Singleton Park, Swansea, SA1 8PP, UK., Petterson R; Welsh Ambulance Services NHS Trust Headquarters, Ty Elwy, Unit 7, Ffordd Richard Davies, St Asaph Business Park, St Asaph, Denbighshire, LL17 0LJ, UK., Porter A; Swansea University Medical School, Singleton Park, Swansea, SA1 8PP, UK., Rosser A; West Midlands Ambulance Service, Trust Headquarters, Millennium Point, Waterfront Business Park, Waterfront Way, Brierley Hill, West Midlands, DY5 1LX, UK., Scott J; Northumbria University, Sutherland Building, Newcastle-upon-Tyne, NE1 8ST, England.
Jazyk: angličtina
Zdroj: BMC emergency medicine [BMC Emerg Med] 2019 Dec 28; Vol. 19 (1), pp. 82. Date of Electronic Publication: 2019 Dec 28.
DOI: 10.1186/s12873-019-0297-3
Abstrakt: Background: Emergency ambulance services are integral to providing a service for those with unplanned urgent and life-threatening health conditions. However, high use of the service by a small minority of patients is a concern. Our objectives were to describe: service-wide and local policies or pathways for people classified as Frequent Caller; call volume; and results of any audit or evaluation.
Method: We conducted a national survey of current practice in ambulance services in relation to the management of people who call the emergency ambulance service frequently using a structured questionnaire for completion by email and telephone interview. We analysed responses using a descriptive and thematic approach.
Results: Twelve of 13 UK ambulance services responded. Most services used nationally agreed definitions for 'Frequent Caller', with 600-900 people meeting this classification each month. Service-wide policies were in place, with local variations. Models of care varied from within-service care where calls are flagged in the call centre; contact made with callers; and their General Practitioner (GP) with an aim of discouraging further calls, to case management through cross-service, multi-disciplinary team meetings aiming to resolve callers' needs. Although data were available related to volume of calls and number of callers meeting the threshold for definition as Frequent Caller, no formal audits or evaluations were reported.
Conclusions: Ambulance services are under pressure to meet challenging response times for high acuity patients. Tensions are apparent in the provision of care to patients who have complex needs and call frequently. Multi-disciplinary case management approaches may help to provide appropriate care, and reduce demand on emergency services. However, there is currently inadequate evidence to inform commissioning, policy or practice development.
Databáze: MEDLINE
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