We Want Your Views On Our Proposed Clinical Response Model

30th November 2018

The Northern Ireland Ambulance Service are currently undertaking a public consultation on the way in which they respond to emergency calls. In our blog this week Brian McNeill, Director of Operations at NIAS, tells us how these proposed changes will be the most radical development in the way they deliver services in the last 20 years – and why they need to hear your views…

At the Northern Ireland Ambulance Service we aim to provide safe, effective, high-quality, patient-focused pre-hospital care and services to improve health and wellbeing by preserving life, preventing deterioration and promoting recovery.The proposed changes on how we respond to emergencies will be the most radical development in the way we deliver our services for 20 years.

So why do we need to change?  First of all, our current emergency response model is no longer sustainable or fit for purpose.  It was introduced in the mid-1970s, a time when healthcare was very different from today.Demand for our services significantly exceeds capacity, with the number of ambulance responses dispatched to calls increasing by 50% over the last five years.  This has resulted in many people having to wait longer for ambulances, with response times increasing year on year, and falling well below the targets set for us.

The current operating model results in the rapid dispatch of multiple resources to a large number of patients whose clinical condition may not warrant that level of response.  About 30% of our patients are categorised as requiring an 8 minute response, when emergent evidence demonstrates that fewer than 7% require a response that quickly.

The proposed new clinical response model is about making sure the best, high quality, most appropriate response is provided for each patient first time.  Patients with the most serious life-threatening conditions will get the most immediate response, while those whose condition is less urgent will benefit from a response appropriate to their needs.  This will enable us to direct our resources in the most clinically appropriate way to best meet the needs of all patients.  The outcome will be a clinical response model in which we provide an 8 minute response to the patients whose clinical condition actually requires that level of response.

It is important to point out that this is a clinically safe model that has been ‘tried and tested’ in NHS England with over 14million 999 calls having gone through this new way of working.

The Ambulance Service story has been one of constant evolution and improvement. When I joined, we were, in essence, a first aid and transport service. During my time here I have worked in a range of frontline and management roles and throughout   the service we provide has grown, adapting to advances in medical technology, an increase in demand and changes in our service users’ expectations.  We were tested to the extreme during the Troubles, introduced paramedics in the late 1980s, and became a regional service in the mid-1990s.  We have reviewed and modernised our service over the years, introducing new radio and mobile data technology in 2000 and, more recently, we have introduced a series of pathways which mean that we can refer patients to the most appropriate source of care, along with piloting paramedics working in rural communities. I very much believe that the proposed new clinical response model will build on these foundations and provide us with an Ambulance Service fit for the 21st century.

So far during the consultation, we have engaged with a range of individuals and organisations with an interest in the services we provide, including meetings with Local Commissioning Groups, but it is important that we hear your views.The consultation document and details about how you can respond are on our website at: http://www.nias.hscni.net/nias-launch-12-week-consultation-on-new-clinical-response-model/

I hope you will take the opportunity to let us know what you think about the proposals.

Brian McNeill
Director of Operations
Northern Ireland Ambulance Service Health and Social Care Trust