Half a year on from the permanent implementation of ‘call before convey’ in NHS Lanarkshire, the pathway is becoming more and more embedded into every-day ways of working for ambulance clinicians. ‘Call before convey’ enables Scottish Ambulance Service clinicians to use Consultant Connect to contact local ED colleagues within the Flow Navigation Centre when seeing patients with non-life-threatening conditions. This allows patients to be directed to the most suitable place for their care, often bypassing ED, and therefore relieving pressure on ED departments, or receiving self-care advice with the appropriate community management.
All activity via Consultant Connect is recorded within a secure cloud for medico-legal reasons. This means that clinicians can access recordings they have made or received at any time for training and monitoring purposes, or to talk through and revisit cases to improve the service. The data reports show how quickly calls are answered and the outcome of each call, exemplifying the benefits to those contacting the service and the impact on patients.
Advanced paramedic practitioner Sharleen Anderson answers ‘call before convey’ queries in the Flow Navigation Centre and recalls a recent example of how the pathway improved the patient’s journey:
‘An ambulance crew attended to a patient following a call from their GP. The GP had seen the patient and was concerned about his observations which were slightly abnormal. It was communicated that the patient regularly attends hospitals under multiple specialties/departments for various ongoing medical conditions, but he has never been treated holistically, and therefore, his episodes of care have never resulted in a complete resolution.
‘On scene, the patient’s family was keen for him to remain at home and not go through the long-winded process of attending hospital again. The ambulance crew phoned us at the Flow Navigation Centre via Consultant Connect, and we agreed that his condition sounded appropriate for the Hospital at Home pathway.
‘The Hospital at Home Team visited the patient, and, on this occasion, they decided that he required a level of care that could only be provided within hospital. Although the patient ended up needing a hospital conveyance, being admitted following a visit from the Hospital at Home Team benefited him greatly: the team carried out additional observations, tests, and created a referral, allowing him to be a direct admission, rather than waiting hours in the back of an ambulance.
‘Furthermore, when the ambulance crew attended to the patient earlier that day, due to the busyness of the ED, there’s a good chance the patient would have waited outside the department for several hours before even being assessed. A hospital conveyance with the ambulance crew would have created a lengthy patient journey, whereas this alternative pathway resulted in the patient receiving a bed on the most appropriate ward but in a shorter time frame. He was able to remain in the comfort of his own home, albeit for one night, and come in as a direct admission which was a more expedited route.
‘The Hospital at Home Team’s interventions created a bigger picture for the hospital medics, showing what the patient needed and where he needed to be. Providing that joined-up care provides better patient experiences, and frees up ambulance crews to see more patients in a timely manner.’
– Sharleen Anderson, Advanced Paramedic Practitioner.
Since launch*, more than 950 calls have been answered within three seconds, on average, with a first-time connection rate of 99%. 40% of calls received resulted in patients requiring admission, ensuring patients receive the right care in the right place the first time.
* Stats from November 2023 – May 2024.
If you have any questions or would like more information, call us on 01865 261467 or email hello@consultantconnect.org.uk.
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