Around 20 per cent of our calls are Category C (non-urgent). No one wants a needless trip to hospital if it can be avoided and many of these non-urgent callers just needed telephone advice, treatment at their home or referral to a GP.
WMAS responds to almost 65,000 Category C calls each year. In September 2004 we started work to ensure we would be able to offer telephone assessment and advice for calls triaged as Category C once local NHS organisations were given the responsibility for managing and monitoring their response to non-urgent 999 (Category C) calls (from 1 October 2004).
We developed a system where calls initially assessed as Category C are then further assessed by paramedics, working as part of the Emergency Operations Centre (EOC) team. Using pre-prepared 'Call Scripts' the paramedics can offer telephone advice, make a referral to a GP or arrange for an ambulance service response. This may be a traditional ambulance emergency response, a non-emergency ambulance response or a single individual may be sent to make a face-to-face assessment or urgent response to a designated timeframe.
We found that only 15 per cent of calls assessed by telephone triage resulted in an emergency ambulance response (the response all Category C calls automatically received prior to the scheme), and 56 per cent of the triaged calls resulted in a non-emergency ambulance response.
A total of 28.5 per cent of calls did not require any ambulance response at all - the patients simply needed telephone advice or referral to other parts of the NHS.
So far the scheme has only run between 10am and 8pm. However the success of the pilot means that in the very near future it will run 24 hours a day. Eventually we should able to provide telephone advice to almost 15,000 callers each year.
A further 40,000 callers would receive a non-emergency ambulance response or be referred to other services. This will free more ambulances for life-threatening emergencies and avoid needless trips to hospital for patients who could be treated just as well without a trip to A&E.
It is still early days for the scheme but I think the potential is exciting for patients and ambulance staff. It offers a significant expansion of the role of ambulance personnel and most importantly a better service for all those who contact WMAS - whether they have a life-threatening emergency or just need advice or reassurance.
