Summary
Strategies To Manage Emergency Ambulance Telephone Callers With Sustained High Needs – An Evaluation Using Linked Data
Funder: NIHR HSDR
Background and aims
Over recent years, more people are phoning 999 but ambulance services cannot see everyone promptly when they are very busy. A small number of people phone 999 a lot – more than five times a month or 12 times in three months. But they don’t always have a medical problem which will cause death or disability if not treated immediately. If someone’s life is not in danger, the time the ambulance crew spends seeing them may mean paramedics cannot see someone else who might die without immediate help. It may be better for people with less urgent needs to get the right help without having to phone 999. One possible way of getting the right help for these people is called ‘case management’. This approach means the person is referred to a team from different agencies – including social services, primary care (GP), community mental health and the Emergency Department who work together with the ambulance service to consider what the caller may need. These professionals and the person agree what will happen and how – this is called a treatment plan. The aim is to help such people so they don’t need to contact emergency services again.
UK ambulance services are trying out new ways of responding to people who call 999 frequently, with local case management initiatives in place in some areas. In this research, we want to understand the characteristics of people who call frequently, what is currently being done for this group and what helps them to stay well and not need to call 999 or other emergency services. We want to look at how well case management helps people who phone 999 a lot
• Do they have fewer emergency episodes if a ‘case management’ service is available?
• Is this help safe?
• How much does case management cost to deliver and what costs if any are saved? • How do people feel about this help?
• How easy or difficult is it for services to give this kind of help?
How will we do this?
We will work with four ambulance services where the new case management approach has been introduced in partnership with local agencies, and in other areas where the standard 999 service is still in operation. We will then be able to see what difference the new partnership approach makes. We expect to include 1200 people who have been classified by the service as a ‘frequent caller’ – 600 in areas where case management is in place and 600 where it is not.
We will use NHS information which is automatically collected to find out whether case management reduces further emergency calls. We will interview some patients who are treated through case management (and who have agreed to be contacted), to hear about their experiences and how they feel about the care offered to them, whether it has helped – or not. We will interview health, social care and other professionals who are involved in case management initiatives so that we can understand what helps or hinders service delivery.
Involving people who phone 999 in our research
People who call 999 and who also have illnesses of the mind are included in our research team. Two people will come to our meetings, representing a wider group, and be involved in running this study by giving their views and sharing in decision-making.
Telling people about what we learn
We will print what we learn in the magazines that experts read. We will go to meetings with people who plan and run health services, meet with people who phone 999 and with people who work in ambulances to talk about what we find.
Contact Details
Trial Manager / Lead Contact: Dr Rabeea'h Aslam
Phone: 01792 606464
Email: r.w.aslam@swansea.ac.uk
IRAS ID: 262419;