Innovative thinking leads to new, collaborative approach to A&E admissions

New thinking has led to a collaboration between South Central Ambulance Service, Portsmouth Hospital Trust and South Hampshire GP Alliance to ensure only the appropriate patients are conveyed to A&E.

The pilot, offering a live video connection between paramedics and GPs, is going from strength to strength. The secure video consultation service provided by Sesui is helping make vital connections and significantly reducing the number of unnecessary conveyances to PHT by SCAS.

With Covid 19 bringing a host of logistical challenges for all their operations, and for the services of the organisations they collaborate with and rely upon, Southern Hampshire Primary Care Alliance (SHPCA) knew that decisive, effective action needed to be taken as early as possible during the pandemic.

Recognising that a significant factor in delivering services would be early intervention in order to direct patients to the correct clinician, the alliance believed that the South Central Ambulance Service (SCAS) could be key. If paramedics were able to access expert advice at the point of contact, they would be far better placed to direct those patients to the most appropriate care. Not only would this be beneficial to patients, but it would crucially avoid unnecessary admissions to A&E – already a long term goal for all health trusts, but even more vital during the Coronavirus crisis.

Although paramedics at SCAS had previously been able to call patients’ GP practices for guidance on treatment, it was often difficult for them to access doctors or even get through to the surgery. This is where Sesui came in. By providing a single point of access, on a single phone number, to a dedicated paramedic liaison GP, Sesui allowed ambulance crews to immediately access expert advice. This so-called “hot transfer” allowed for telephone triage which could easily be upgraded to a video consultation, without the barriers of switchboards and surgery timetables.

SHPCA’s Clinical Operations Manager, Aisa Fraser has been impressed with the fast solution Sesui offered:

We told Sesui what we wanted to put in place and within a week they had tailored a bespoke service to meet all our needs. Their customer service was excellent – they really listened to what our priorities were – a super reliable secure system, with the option of good quality video, which would be easy for our staff to use. Within two weeks we had good evidence of the hours of paramedic time that had already been saved, and the number of unnecessary hospital admissions avoided.

A month into the pilot scheme, not only is this new service benefiting patients and paramedics, but it is also providing a much better case setting for the GP working on the service. Having undertaken a shift in the “hot transfer” role, GP and Director at SHPCA Dr Raj Laly experienced it first hand:

Whereas in the past GPs were expected to take paramedic calls during their busy surgeries, this new system allows doctors to work a dedicated shift, focusing purely on the “hot transfer” calls and cases. GPs fulfilling this role have access to full medical histories, live video to help ensure a better clinical picture, and crucially, the time to concentrate on the patient. This is infinitely better than phone triaging for paramedics whilst in a busy surgery setting, and allows consistent and reliable collaboration with the ambulance service.

The successful collaboration with Sesui has led to SHPCA being brought into the 111 First pilot being run in the Portsmouth area. Using a similar model to the paramedic service, 111 callers can be assessed by the SHPCA CAS team working at remote sites – with the ability to up-scale to a video consultation when a visual diagnosis is required.

The adoption of this new way of working is a great testament to the willingness of health providers to adopt new practices and fully utilize technology like that offered by Sesui.

And whilst the patient, paramedic and consulting GP are obvious beneficiaries of these new services, one of the most significant outcomes could be for Portsmouth Hospitals Trust – with fewer unnecessary A&E admissions a perennial target throughout the NHS.

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