Urgent & Emergency Care Review: response of the Association of Ambulance Chief Executives

06 December 2013
Opinion
02 December 2013
Volume 5 · Issue 12

Abstract

Following the publication of Sir Bruce Keogh's end-of-phase-1 report of the Urgent and Emergency Care Review on 13 November 2013, Martin Flaherty provides a response on behalf of the Association of Ambulance Chief Executives.

The Association of Ambulance Chief Executives (AACE) participated in the preparation of High Quality Care for All, Now and for Future Generations: Transforming Urgent and Emergency Care Services in England, the end-of-phase-1 report of the Urgent and Emergency Care Review, which was published on 13 November 2013 (nhS England, 2013). NHS ambulance services have warmly welcomed the report, which offers exciting opportunities for ambulance services to play a central part in delivering appropriate urgent and emergency care.

The end-of-phase-1 report identifies problems with the current emergency care system:

  • Demand is growing and the system is under severe pressure
  • It is confusing, with several ways of accessing the system by phone, and several names for places that treatment is provided
  • Too many seriously ill or injured patients are not getting the most expert care: A&E departments vary widely in levels of service and staffing.

    • The report recommends:

  • Supporting self-care, through improved care-planning, better information sharing and better information about self-treatment options
  • Right-place, first time treatment through enhancement of 111 so that it becomes the smart choice—aware of patients' clinical records, giving access to a wide range of professionals, able to make appointments, and to send an emergency response if needed
  • Improved urgent care provision outside hospital through better, and better-coordinated, primary care, out-of-hours and community response to urgent care needs, including better use of community pharmacists; co-locating community-based urgent care services in Urgent Care Centres—accessible by ambulance crews; and developing 999 ambulance services to become mobile urgent treatment services. Around half of 999 calls could be managed at scene, given extended training for paramedics and improved access to GPs and specialists
  • Better care for seriously ill and injured patients through introducing two levels of emergency centre: the first level with the full range of treatment for most conditions, staffed and equipped to assess patients for onward transfer if necessary; the second—major emergency centres—providing the full range of care, with ambulance crews able to take patients directly to them.

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