In June 2022, a pilot project was launched whereby ambulance clinicians at an Ambulance Trust in England could use Consultant Connect to seek rapid Telephone Advice & Guidance from out-of-area NHS consultants regarding frail patients, as there is no local service available.
The project was initiated for ambulance clinicians who cover a small area where there is no local frailty service available, to discuss patient care. The project utilises out-of-area NHS consultants from the National Consultant Network (NCN) who answer calls for advice from ambulance clinicians. In December 2022, 6 months after launch, the project was renewed as a result of its success.
Examples of how the service has been helping reduce unnecessary patient conveyances were shared.
On one occasion, ambulance clinicians were called to a residential home where a patient with severe dementia presented with recurrent left-sided arm weakness. Although all the patient’s symptoms resolved during assessment, the patient became distressed, which caused them to resist further investigations. The ambulance clinicians used Consultant Connect to call a frailty consultant on the NCN to discuss the suitability of the patient attending ED. As a result, it was decided that the patient should remain in the residential home with a treatment plan of 75mg aspirin for a month with an accompanying GP referral for awareness and a medication review.
Similarly, another example of the use of this line was shown when ambulance clinicians arrived on scene for a 93-year-old patient who had fallen out of bed and had been on the floor for 7 hours. Although the patient had been able to move, reported no injuries and was mobilising well during this time, the crew were concerned regarding the patient’s level of frailty and wanted a discussion regarding blood requirement. After speaking with a frailty consultant on the NCN, it was agreed that the patient should not be conveyed to ED and instead referred to their GP for urgent bloodwork that same day.
Since the launch of the project, access to specialist advice in this way has helped avoid unnecessary patient conveyance, meaning that patients are treated in the most appropriate place for their care, and unwarranted pressures on Secondary Care are reduced, all whilst ambulance clinicians are able to receive rapid specialised advice.
Of all calls made to frailty consultants on the NCN via Consultant Connect since the set-up of this project, 88% have resulted in a patient avoiding conveyance or admission to hospital*.
* where an outcome was recorded.
‘I’m pleased that we’ve been able to progress this pilot into a project. The team’s willingness to spend time reviewing the service has meant we were able to ensure the project is successful, and have been able to keep implementing improvements to ensure it meets the team’s needs.’
– Dan Brown, Account Manager at Consultant Connect.
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