Summary
Ambulance services are assessing how they respond to the small number of people who frequently phone 999 (more than five times a month or 12 times in three months), but often without a medical problem requiring immediate treatment. Some services have introduced local “case management” initiatives, with referrals to a team from different agencies (social services; primary care (GP); community mental health services; Emergency Departments; ambulance service) that devises individualised ‘treatment plans’, aiming to reduce callers’ contact with emergency services.
We will study: the characteristics of people who call frequently; what is currently being done for them; what helps them to stay well and not need to call 999 or other emergency services; and assess how well case management helps them. Using routinely collected NHS data for ambulance services, we will: see if frequent callers have fewer emergency episodes when “case management” is available; gauge the safety of this approach; and determine associated costs and savings. We will work with four ambulance services that have introduced a new case management approach in some parts of its catchment area, but still operate the standard 999 service in other parts.
We expect to recruit 316 high users per service (n=1264), allowing us to detect a change in rate of further emergency events/death of 10% with 90% power and 95% confidence.
We will also interview: 32 patients treated through case management to explore how they feel about this service; and 36 health, social care and other professionals involved in case management initiatives to identify operational issues in providing such services.
Contact Details
Trial Manager / Lead Contact: Dr Rabeea'h Aslam
Phone: 01792 606464
Email: r.w.aslam@swansea.ac.uk
IRAS ID: 262419;