QIPP, Efficiency & Savings

07.12.12

‘Zero tolerance’ for ambulance handovers

A collaborative approach could significantly reduce delays in ambulance turnaround times, a new report from the NHS Confederation shows.

Delayed turnaround times can cause extended waits for treatment, and are expensive and inefficient, the report states.

Currently, 80% of turnarounds take place within 15 minutes, but the NHS Confederation is calling for a “zero tolerance” approach from ambulance services, acute trusts, primary care providers and commissioners working together.

The report details ten recommendations, including seeing turnovers as a whole system issue, monitoring and recording processes, and for representatives at each part of the system to work together at a local level to address handover issues.

NHS Confederation interim director of policy Jo Webber said: “The vast majority of patient handovers between ambulance crews and hospital staff take place within minutes, but with nearly 5 million emergency ambulance journeys each year, and nine out of ten of these resulting in patients transported to an emergency department, it is right that the whole service looks at ways it can improve in this area. Now is the time for the NHS as a whole to take a zero tolerance approach on this.

“But this is not a problem just for ambulance services and acute hospitals. Getting the right solutions in place is a job which needs input from all health and care service components, including commissioners and the primary care sector to work out what the issues are at local level and how they can be tackled effectively.”

Health Minister Lord Howe added: “Everyone should be seen quickly when they arrive at hospital, even more so when they arrive in an ambulance. It is unacceptable for patients to be left waiting in ambulances outside hospitals.

“We want hospitals, ambulance trusts and commissioners to look closely at this report and work together to reduce long delays getting patients into A&E.

“The NHS needs to ensure it has proper plans in place to deal with high demand and we are doing everything we can to support the service in treating patients as swiftly as it can.”

Tell us what you think – have your say below, or email us directly at [email protected]

Comments

Rupert Fawdry   10/12/2012 at 13:57

My 99 year old mother has made many trips to hospital by ambulance, and it is extremely frustrating and infuriating to see (a) how many separate sets of care records she has and (b) how little use is made of them by the hospital staff even when the ambulance personnel bring them along with her. This results in crucial medical and personal details being missed or lost and the same data having to be recorded several times. A similar situation used to occur when hospital maternity staff frequently ignored the small hand-held GP maternity co-op card. That has been largely resolved by the introduction of the hand-held antenatal notes where the pregnant woman holds the master record of care. This has resulted in much greater interoperability throughout the UK in maternity care than in any other area of healthcare. There is a general delusion that eventually all health and social care electronic databases will "talk" to each other. But if Santander has had to give up its bid to take over many RBS bank branches because of the cost of reconciling two comparatively simple banking systems, what possible hope is there of paying the trillions of pounds which would be required to reconcile all the hundreds of NHS and Social Care electronic database silos? Don’t kid yourselves. It will never happen. I am currently working on the concept of what I am calling the WISDAM unified patient held core record (W.I.S.D.A.M. = With Individual - Social, Demographic And Medical record). See http://wisdam.info for further details. Although such a concept would not necessarily improve A&E efficiency and reliability of the handovers for every patient, there is no doubt in my mind that such a revolution would help significantly in the care of every mainly housebound or institutionalised patient in the UK (and even internationally), especially if such patient-held paper records contained: a) sticky labels of the patient’s basic medical details which could be used by ambulance crews to reduce time spent on filling in forms about such things as the name of the next of kin, long term medical problems and handicaps, and the name of the patient’s Primary Health Centre etc b) if the same information were also printed as QR codes which can be read by any smart phone - in time, software could be written to allow the data to be easily transferred to any hospital computer anywhere in the world without someone having to key in all the same information over and over and over again. Such an innovation would save a great deal of the time currently spent both by paramedics and by A&E staff entering the same information on multiple different forms and into many incompatible computer systems.

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