References
Reducing frequent caller use of ambulance services: a review of effective strategies
Abstract
Background:
Frequent callers are known to place significant stress on ambulance services through decreased system efficiency and increased costs. Frequent callers often have interconnected and complex physical, mental and social needs, which bring them into contact with ambulance services.
Aims:
This review synthesised evidence on strategies to mitigate frequent caller impact on ambulance services while meeting callers' individual needs.
Methods:
Major databases were systematically searched for relevant studies and critically appraised. Main themes were analysed and reported on.
Findings:
Preliminary evidence indicates that mass-distribution letters, case-management and caller-management systems may reduce frequent caller impact. Ambulance services require clear definitions and identification systems; information should be shared between services and multi-component strategies explored. Understanding the reasons behind calls can enable more personalised, effective care.
Conclusion:
Initial evidence points to promising frequent caller reduction strategies but further high quality research is urgently needed to confirm their effectiveness and support implementation.
In recent years, the increased demand for ambulance services has drawn attention to the phenomenon of frequent callers who, although making up a small subset of service users, account for a disproportionately high volume of calls (Scott et al, 2014a; 2023; Aslam et al, 2022).
Frequent callers often request ambulance services for non-emergency reasons, resulting in increased costs, reduced availability of ambulances for other people and, therefore, a lower quality of care for those needing emergency care (Snooks et al, 2019). The consequences of frequent callers highlight the importance of effective strategies that can be introduced to reduce such calls.
The definition of frequent callers to ambulance services has previously varied across the evidence base (Smith and McNally, 2014; Edwards et al, 2015). Variability in definitions can significantly impact research findings and real-world applications (Middleton et al, 2014; Scott et al, 2023). Therefore, the Frequent Caller National Network (FreCaNN), established in 2013, defined a frequent caller as one who generates five or more calls in 1 month or 12 calls in a 3-month period (FreCaNN, 2022). Although this definition has been criticised for limiting the definition to those who call themselves and omitting other calls (Harring et al, 2024), the FreCaNN definition aims to provide consistency to help healthcare services share best practice and inform local and national policy on the standardised management of frequent ambulance callers.
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