Transforming Welsh Ambulance Service

41 Pages·2017·6.61 MB·English

by  Brendan Lloyd

Transforming Welsh
Ambulance Service:
scrapping times,
supporting patients!
Dr Brendan Lloyd
Medical Director Welsh Ambulance Services Trust
Founding Senior Fellow FMLM
Dr John Kotter: “Leading Change”
8-stage process to creating major change

Our ‘Burning Platform’ - 2013 Operating Context
• Increasing demand and acuity
• Financial constraint / resourcing gap
• Deteriorating performance
• Flawed operating / performance model
• Frequent senior management turnover
• Weaknesses in corporate governance
• Challenging industrial relations climate
• Talented but disengaged workforce
• Intense political and media scrutiny
• Repeated review and re-organisation
• Doubt about the organisation’s future
The Problem: Contacts 2013/14
• 999 – 420,000 calls
CALL TYPE CATEGORY & CODE (MPDS)
RED 1 (~3%)
• 40% or 166,000 RED 1&2
≤ 8 min
(Echo and high end Delta codes)
CATEGORY
• 86,000 HCP – 25,000 RED A RED 2 (~35%)
≤ 8 min
• RED: multiple dispatches
(Delta and high end Charlie codes)
GREEN 1 & 2*(~40%)
• 317,000 NHS Direct
Face to Face≤ 20 min
(Charlie & Bravo codes)
CATEGORY
• 3m website hits
C GREEN 3 (~22%)
Call Back CTA≤ 10 min or
Face to Face ≤ 30 min
• 1m PCS Journeys (Alpha & Omega codes)
Designing ambulance into unscheduled care
Conditions for Change – Health Policy
Clinical Response Model
CATEGORY RESPONSE MODE DEPLOYMENT MEASURES
Blue lights Multiple Resources 65% within 8 minutes
RED
≤ 8 minutes
( 60-70 calls per Ideal/Suitable
day out of 1300)
Blue lights Right clinician/resource Clinical Interventions
AMBER
Ideal/Suitable in a timely manner, based Patient Outcomes
(65%) on clinical need.
Hear and Treat Planned non-emergency Clinical Outcomes
GREEN
Normal Road Speed transport (ambulance/taxi): Patient Satisfaction
(30%) Telephone advice / clinical
assessment
SIMPLE …… CLINICALLY FOCUSED…... PRUDENT …… SAFE