Joint Royal Colleges Ambulance Service

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Joint Royal Colleges Ambulance Service Liaison
Committee (JRCALC) Conference
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What does the Ambulance Service need from JRCALC
in the New Millennium?
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A.S.A. Video
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The Ambulance Service Map
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As at 1200Hrs 3rd November 2000
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Where does the Ambulance Service see its Future
Strategic Direction?
How can we Help?
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Towards Perfect Vision 2010
Strategic review undertaken by The School of
Health and Related Research, Sheffield
University. Draft Report scheduled - December
2000
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Public Safety
Public Health
or
Health Care Arm of the Emergency Services
Emergency Arm of the Health Care Service
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Current Issues

• Role (scope of practice, disasters ? home care
  is ambulance service a good name)
• Organisation (links, mergers, networks, etc)
• The ASA and the NHS confederation
• Demand and demand management, targeting and
  prioritisation
• Management staff (NHS / AS)
• Operational staff (lay, drivers,EMTs, paramedics,
  PECS, nurses and doctors, control room staff)
• Operational Technologies (IT, vehicles, AVL, GIS,
  EMD, digital radio)

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Current Issues

• Therapeutics (telemetry, drugs, thrombolysis,
  etc)
• Variations in practice and protocols (audit)
  Evidence based practice (research)
• Protocols (therapeutics, timings, treat and
  leave, by passing, etc)
• Clinical Skills (education and training,
  maintaining skills, rotation)
• Performance standards (time,clinical
  practice,c-calls, outcomes)
• Non-emergency work (PTS, NHS Direct, etc)
• Voluntary sector (St. Johns / Red Cross)
• Funding (economic viability funding levels
  local contracting)
• Legal and regulatory framework (clinical
  governance ..)

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Options for the Future

• The Organisation of Ambulance Services
• Links, Mergers and Networks
• The Emergency Health Care Trust

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The Journey To-Date
Clinical Role of Ambulance Services
1970/80 Millar Ambulance Personnel
1990 Paramedics Emergency Medical Technicians
2000 State Registered Paramedics
2005? Practitioners in Emergency Care
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• Professional Registration a pre-requisite
• Evidence Based
• Selective Clinical Skills
• Guidelines for Clinical Judgement

Clinical Practice
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0845 46 47
0845 4N HS
(Direct)
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• NHS Direct
• Walk-in Centres
• Capacity Management
• GP Out of Hours Review
• On-line Services
• Web Cam Facilities

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Millennium Ambulance Service
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JRCALC
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Bashed
Local Medical Steering Committee
CHI
Bashed
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Individual Clinicians
NICE
Clinical Practice
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Faculty of pre - Hospital Care
BASMED
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Medical Directors
BAEMS
j
BASICS
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Medicines Commission Medicines Control Agency
A.S.A.
JRCALC
Ambulance Education and Training Committee
Clinical Effectiveness Committee

• Standard Protocols
• Clinical Leadership
• Evidence Based Practice
• Lead Advisory Body on all Clinical Issues

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The NHS Plan
21st Century Service for the needs of the Public
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The Millennium Ambulance Service will -

• Develop its capability and potential for an
  enhanced integrated role within the primary care
  setting
• Maximise the advantages to be gained from the
  developments in clinical treatments and
  telemedicine technology
• Provide the emergency communications gateway for
  the National Health Service
• Stronger medical influence through the
  appointment of Medical Directors

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The Millennium Ambulance Service will -

• Audit and Evaluation (in partnership with Primary
  and Secondary Care providers)
• Clinical outcomes determining future practice
• Enhanced interventions within the community
  (Practitioners in Emergency Care)
• Community programmes of education in CPR and
  automatic defibrillation

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The Millennium Ambulance Service will -

• Integrated and seamless pathways of care
• Single gateway for emergency access
• Enhanced response performance (90) for life
  threatening conditions
• Application of digital technology and
  telemedicine leading to the introduction of
  mobile health care

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999/112/08 45 46 47
Single Gateway

• Health Development
• Health Information
• Health Promotion
• Chronic Disease
• Management

Emergency Ambulance
Nurse Triage
Sub-structure electronically networked for home
care diagnosis
Full range of patient telematics
Electronic Access
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Thats all Folks