Brand new ambulances, additional 999 call handlers and staff welfare vehicles to provide hot drinks to frontline crews are just some of the steps being taken by EMAS to make sure we are ready for winter.
The winter months are traditionally one of the busiest times of year for the NHS due to increases in flu cases and cold weather-related illnesses such as trips and falls.
For the ambulance service it can also become more challenging to reach patients in need due to adverse weather and subsequent poor road conditions.
David Williams, Deputy Director of Operations at EMAS, explained that winter planning in the NHS begins almost as soon as the previous winter has ended, so that we can capture best practice and learning and then make the required changes for the next winter.
He said: “There are three key focusses for us at EMAS this winter – the welfare of our staff, ensuring we have as many frontline colleagues available to respond as possible to help keep our patients safe, and reducing any unnecessary demand on our emergency service.
“This means working with both our senior EMAS clinicians and healthcare colleagues so that only patients who genuinely need an ambulance receive one, and all other patients are suitably signposted to the medical help that they need.
“We also continue to work daily with our NHS system partners to respond to the challenges relating to hospital handover delays so that our highly-trained ambulance crews can be back out responding to the next patient in the community who needs our help.
“The public can help us by practising self-care and utilising their local pharmacies, GP surgery, NHS111 online or Urgent Treatment Centres when they have a medical issue, and only calling us in genuinely life-threatening emergencies, so that we can be there for people when they really do need us.”
Multiple steps have been taken in many areas of our organisation to prepare for the busy winter months, including:
- 110 brand new, high-spec ambulances are being rolled out across EMAS to replace older vehicles being retired from service.
- Throughout the year we have worked hard to recruit and train new frontline ambulance crews including Newly Qualified Paramedics, Newly Qualified Technicians and Ambulance Support Crews to maximise the number of ambulance crews available to respond to patients in the community.
- Recruitment of additional 999 call handlers has continued throughout the year, with an expected total workforce of 210 by Christmas this year (an increase of 60 call handlers).
- As a result, our two EMAS control rooms continue to have the best response times in the country, with an average call pick-up rate of just seven seconds.
- Additional Specialist Practitioners continue to be recruited to EMAS to support with senior clinical triage of patients both in person and over the phone, to help patients access the right care at the right time.
- GP and Air Ambulance doctors continue to do shifts in our control rooms to provide support to our highly-skilled frontline ambulance crews when they need a second opinion about their patient who has a complex medical issue, but it’s not immediately life-threatening.
- From early December, staff welfare vehicles will be stationed at hospital emergency departments in the region to help ensure the wellbeing of our ambulance crews. They will offer our staff hot drinks and a safe place to have a quick break during their shift.
- In addition, we are piloting new processes to help staff finish on time to protect their wellbeing, and have a wide range of health and wellbeing services available for them to access should they need them.
- During periods of intense demand, we receive additional support from local Private Ambulance Service providers.
Division-specific winter activities
Additional steps have also been taken at a local level in the following divisions:
Lincolnshire
- Recruiting six permanent Clinical Navigators to be based at Lincoln County Hospital and Boston Pilgrim Hospital, seven days a week or 12-hour shift encompassing peak times. These roles will work in partnership with clinicians and nurses in the emergency departments to prioritise patients waiting to be seen and supporting ambulance crews to access more appropriate alternative services where possible.
- Recruiting two pathway leads to work closely with the wider Lincolnshire health service to ensure the availability and suitability of alternative clinical pathways to help patients avoid attending the emergency departments.
- Working with LIVES to deploy additional senior clinicians into the Lincolnshire 999 control room or remotely during periods of peak demand to work alongside Specialist Practitioners in identifying identify patients waiting for an ambulance who would benefit from receiving care from a different and more appropriate pathway, and ensuring they get the medical support they need.
- Working with the healthcare system on the provision of IV antibiotics by community services to prevent the patient from needing an ambulance or attending hospital.
- Providing two welfare vehicles for our staff.
Leicestershire and Rutland
- Working with the healthcare system in the Urgent Care Co-ordinating Hub, which works to identify patients waiting for an ambulance who would benefit from receiving care from a different and more appropriate pathway, and ensuring they get the medical support they need. This is helping to reduce the number of waiting calls and allows ambulances to attend life-saving emergencies.
- Assigning colleagues to emergency departments during periods of intense pressure to cohort patients to allow the ambulance crew to return to responding to patients in our communities, and supporting our staff with finishing their shifts on time.
- Providing welfare vehicles for our staff.
- Dedicated ambulance service access to Consultant Geriatricians and GPs to support with the discharge on scene of over 65s or referral to community beds to help prevent older patients from needing to attend the emergency departments.
- Working with our 999 control room to utilise the falls response team for patients where appropriate.
Nottinghamshire
- Working with St John Ambulance on their bespoke vehicle to support with the increased night time economy in Nottingham city centre throughout the festive period.
- Exploring joint responding with Nottinghamshire Police in the city centre.
- Agreed escalation processes now in place with system partners such as the hospitals and local mental health providers.
- Providing two welfare vehicles for our staff. We are also exploring with Bassetlaw Hospital how we can provide refreshments to our ambulance crews there too.
- Assigning colleagues to emergency departments during periods of intense pressure to cohort patients to allow the ambulance crew to return to responding to patients in our communities, and supporting our staff with finishing their long shifts on time.
- Working to ensure every staff member has some respite over the festive period, and developing winter rotas to support better work/life balance especially throughout the longer nights.
Derbyshire
- Provision of additional tactical commanders throughout the winter months who are available to support both staff and patients.
- Additional training for ambulance crews to support patients experiencing mental health distress to help patients access the right care for them.
- Continuation of the Community Paramedic for Rough Sleepers role which works to ensure homeless individuals receive their flu jabs and COVID-19 boosters, as well as signposting people to support services and helping them access housing.
- Assigning colleagues to emergency departments during periods of intense pressure to cohort patients to allow the ambulance crew to return to responding to patients in our communities and supporting our staff with finishing their long shifts on time.
- Non-conveyance lead working to reduce the number of patients needing to be taken by ambulance to hospital emergency departments by working with the Derbyshire healthcare system to ensure alternative services are available to patients when required.
- Providing two welfare vehicles for our staff.
Northamptonshire
- Specialist Practitioner (SP) Triage Hub which enables SPs trained in telephone triage to call back, assess and appropriately manage calls as they come to the ambulance service from either 999 or 111, directing the patient to an alternative pathway where appropriate. The SPs can also attend the patient to carry out an in-person where required. This is helping to reduce the number of waiting calls, allows ambulances to attend life-saving emergencies, and helps the patient access the right help in the right place at the right time.
- Providing two welfare vehicles for our staff.