SCOTTISH AMBULANCE SERVICE

Managing demand across Scheduled and Unscheduled Care

Peter RipleyDirector of Service Delivery

Background

• The Service employs 4,300 staff

• Responds to 600,000 unscheduled care calls per year

• Undertakes 1.6 million scheduled care patient journeys per year• Staff based at over 170 locations

• There are three Emergency Medical Dispatch Centres (Glasgow, Edinburgh and Inverness)

• 3 Special Operations Response Team’s

• Four Air Ambulances

• Generally the Service coped really well despite the challenges

• Comprehensive planning• With good communications• We improved response times for life

threatening calls across Scotland to an average of 6.9 minutes versus 7.2 minutes the previous year – this is world class!

• Introduced the new Resource Escalatory Plan

Overview

Preparation for Winter

• Demand & Capacity Planning – Nationally & Divisionally

• Strategic Coordinating Centre

• Winter Event Planning

• Pandemic Flu arrangements

• Resource Escalatory Action Plan (REAP)

Strategic Coordinating Centre

• SCC operating 24/7 during key periods (REAP Level 4 +)

• Regular briefing reports to managers, health boards and to the Scottish Government

• Support from voluntary agencies in the SCC

• Co-ordination of four wheel drive capability

• Provision of specialist vehicles

REAP

REAP Level 6 Potential Service Failure

REAP Level 5 Critical

REAP Level 4 Severe Pressure

REAP Level 3 Moderate Pressure

REAP Level 2 Concern

REAP Level 1 Normal Service

• Positive attitude of staff and managers

• Staff and staff side worked with the organisation

• Huge effort made by staff to get to work

• Sickness levels reduced

• Excellent support from PTS staff, both in and out of normal working hours

• ‘Buddy’ system with other ambulance services

Staff support

Partnership working with NHS organisations

• Regular communication with health boards & NHS 24 to agree local priorities

• With hospitals for patient admissions, transfers and discharges

• With hospitals for Scheduled Care

• Liaison with GPs and local hospitals

• BASIC’s

Partnership working with other agencies

• Support from voluntary agencies, providing staff and vehicles

• NHS24 support at times of peak demand • SAS managers triaging calls in police control rooms

• Liaison with other UK ambulance services

• Local authorities • Met Office

Communications with the general public

• Communicated key messages through the media from October onwards

• Emphasised the increased demand over the winter period

• Focussed on not drinking to much alcohol

• Signposting patients to other suitable alternatives e.g. NHS 24

Key Learning

• More effective engagement and involvement in planning with Local Authorities

• Improved demand and capacity planning

• REAP triggers and understanding

• Call handling capacity for clinical triage

• Better planning for accessing renal patients

• Tactical use of 4 x 4 assets • National co-ordination but meeting local need

Key Learning

• Work with Acute Hospitals looking at elective planning

• Involvement where wards are being closed to new admissions

• Treating patients nearer home to reduce inter hospital transfers

• Managing the impact of reduced medical cover at rural hospitals

• Need to use Met Office services e.g. they have tools to predict changes in demand by condition as weather changes

Thank you