In Summer 2005, Health Minister Lord Warner announced improvements to England's ambulance service. The changes are set to revolutionise the way in which ambulances deliver care across the country and build on the significant advances already made over recent years.
A number of changes that patients can expect to see over the next five years were outlined:
Faster response times to save more lives - Improved technology and information, re-organisation of ambulance trusts and call-centres, and streamlining of response time targets and call categories will mean that ambulances can concentrate on reaching the most urgent cases where every second counts. This will save more lives. The Category A response time for life threatening conditions will be measured from when the call is connected to avoid differences in measurement.
Better advice over the phone - non-urgent callers to 999 will be offered more advice over the phone and provided with the most appropriate local service that best meets their needs. This could be a referral to GP services, in or out of hours, or an emergency nurse service. This will give patients the best care for their condition and help them avoid an unnecessary visit to A&E. Ambulance services will work with other NHS services to ensure the right action in the right time.
More care in the home - Ambulance staff will be trained and equipped to carry out and interpret more diagnostic tests and undertake basic procedures in the home. They will also be able to refer patients to social care services, directly admit patients to specialist units, and prescribe a wider range of medications. This will be of particular benefit to patients in rural areas or with mobility problems.
More treatment at the scene - More patients with urgent, but not life-threatening, conditions will be treated at home rather than being taken to hospital. This could benefit, for example, older people who have had a fall and suffered cuts, bruises or other minor injuries and would prefer not to leave their home for treatment. At least one million people currently taken to A&E every year could be treated at the scene.
Home visits for better health - Ambulance staff will undertake routine assessments of patients with long-term conditions in their homes, in partnership with GP and nursing teams. This will help people with such conditions better manage their own health and avoid unnecessary visits to hospital.
Assisting all of these changes is an increase in the number of Emergency Care Practitioners (ECPs) across the country. ECPs are a new type of health professional, largely but not exclusively paramedics with extended training. They have greater assessment and examination skills and more training for the treatment of minor injuries and illnesses. ECPs are also trained in the management of long-term conditions.
There are currently more than 600 ECPs working in England. The Department of Health will work with Strategic Health Authorities and ambulance trusts to significantly increase the number of ECPs to help deliver these changes. It will also ensure that the training and education of other ambulance clinicians is reviewed to ensure that they can best meet patient needs.
The review outlines the potential for efficiency savings that could be made to free-up resources for greater investment in the training and recruitment of front-line and control room staff.