East Midlands Ambulance Service shares measures to reduce patient waiting times

An ambulance chief has shared the new measures being put in place to reduce waiting times for patients during another tough winter - but she is asking the public to only dial 999 in an emergency.

East Midlands Ambulance Service (Emas) - like many parts of the NHS - is already experiencing extreme pressure due to a high demand for its services.

Emas divisional director for Lincolnshire Sue Cousland says a number of initiatives have been put in place to reduce waiting times, such as clinical navigators at hospitals and a new way of dealing with falls to save patients waiting for hours on a cold floor.

Ms Cousland said: “We are well aware this winter is going to be different to previous winters but we have had a tough two years certainly in the health and ambulance services.

“But we’re taking a number of different steps to to try and improve the experience not only for our patients, but our staff.

“We are all conscious that we don’t know what this winter is bringing, or what covid or flu is going to be like. The last couple of years we have had very low numbers of influenza cases.

“All I can say is that we are mindful of all the things that could occur. We have put in a lot of initiatives to help that and I really do have a lot of hope and confidence they will help minimise delays.

“ There may still be delays but we are hoping for as little time as possible.”

One problem which is affecting the system is holdups in ambulances handing over patients to hospitals due to a number of reasons, including a lack of social care to speed up discharges.

In August Emas estimates it lost 13,000 ‘resource hours’ in the East Midlands due to hospital handover delays.

The trust is hoping to alleviate delays by introducing ‘clinical navigators’ at Boston and Lincoln hospitals to work 12 hour shifts, seven days a week.

Ms Cousland said: “We have clinical navigators to act as an interface between the ambulance arriving at hospital and emergency department staff to find the best route for patients so we are trying to reduce the length of time that they have to wait in a queue.”

Some patients do not need help from the emergency department but do need a scan or are simply transferred to a ward.

This is where the clinical navigator steps in to help save needless waits for patients and to get ambulances back out onto the road as soon as possible.

Ms Cousland said: “For example if a patient had a suspected stroke, they would be identified by the clinical navigator who would get a quick assessment and work with nurses in the department to arrange for the patient to be taken to a CT scan.

“We are trying to reduce the wait as much as possible.”

Closer collaboration between different arms of the NHS is also being seen and it is hoped that this will help provide relief for older and vulnerable patients who have fallen.

National ambulance standards do not place these patients as a priority which can leave people on cold floors for a long time.

Ms Cousland said: “We do have a lot of calls to falls and the patients are usually vulnerable and elderly.

“If someone has been on the floor for a long time it can be distressing for everyone concerned.

“We are working with our community nursing colleagues who will offer a two hour rapid response service, and we are working with colleagues in Lives to put together a rapid response to reduce the time people are on the cold hard floor.

“It is all about having ‘eyes on the patient’. Whoever is there first on the scene can give an accurate, up-to-date assessment of what the situation is and what level of support is needed.

“Not everyone who falls injuries themselves so they might be shaken but not injured.”

Two ‘pathway leads’ are also being recruited to work with the wider system to find alternative treatment routes for patients rather than A&E.

Community teams are also looking at providing intravenous antibiotics to help prevent a hospital visit for some patients.

There are also moves to prevent care home residents from having the distress of being taken to hospital where possible, with senior clinicians assessing people over the phone or via video calls.

GPs and clinicians from Lives will also be based in the Lincoln and Nottingham control rooms to provide help.

The trust has also purchased 110 new ambulances to be rolled out across the region, along with recruiting 60 new call handlers for the control room.

It is also sending out welfare vehicles to hospitals to provide staff with a place to have a hot drink and a snack, along with piloting a new scheme which aims to help staff finish on time.

Ms Cousland said: “We have staff from the next shift coming in to release colleagues so they can finish as near to their time as possible.

“Staff can work 15 to 16 hour days.”

Ms Cousland is asking the public to support the service by using urgent treatment centres and pharmacists, after the service has received calls for sore throats and stomach issues.

Ms Cousland said: “Monday is a very busy day for us. Whether it is because people don’t have access to a GP over the weekend I’m not sure, but it can be quite a significant amount of work for us.

“For example, a person with a three week history of constant pain in their knee but can get around can get themselves to an urgent treatment centre.

“We’ve had calls for sore throats, coughs and colds. Gastro problems are really short-lived and while they can be distressing, are usually something which can be dealt with by a visit to a pharmacist.

“Help us to ensure that the resources we have get to the people that need them most.”

People are being urged to call the NHS 111 service, which is available for 24 hours a day, for help and advice on minor injuries and ailments rather than dialling 999.

Paramedics, emergency care assistants, call handlers and other staff at East Midlands Ambulance Service will be striking on December 21 and December 28, the GMB has announced.