An innovative service wide response to patients who contact the Yorkshire Ambulance Service (YAS) Yorkshire Ambulance Service NHS Trust

The Yorkshire Ambulance Service NHS Trust (YAS) receives a high number of calls about falls, representing approximately 11% of overall demand. Quickly attending patients who have non-injurious falls is challenging, due to finite resources. However, the longer a patient is on the floor following a fall the poorer their experience and outcome. This project aimed to reduce or prevent long lie times to improve patient outcomes and reduce hospital admissions.

The project developed, piloted and evaluated responses to patients who had fallen, ensuring they received appropriate care, as clinically governed by the YAS. Responses included using a bespoke telephone triage assessment tool when speaking to the patient or carer and remote contact between expert clinicians at the control centre and a trained non-clinical responding team at the patient’s side. The intervention allowed safe, informed and appropriate onward care decisions to be made, and freed paramedics to respond to life-threatening emergencies.

YAS implemented the project across nine West Yorkshire Clinical Commissioning Groups, analysing 5,995 patients over 119 days from December 2016 to April 2017. The project achieved improved patient outcomes with measurable quality benefits to staff and patients (albeit not on the scale predicted), including:

• fewer patients conveyed to the emergency department
• freeing paramedic resources to attend other patients
• reducing the time patients had to wait on the floor for someone to come to them.

The project focused on quality and safety, and an economic benefit was not included as an objective. The difficulty of demonstrating clear economic benefit for the site contributed to implementation and sustainability challenges.

Key enablers were a dedicated and engaged project team, and having an external evaluator on the project. The team is confident that the intervention can be sustained with changes to scope and practices.

Contact information

For more information about this project, please contact Thomas Heywood, Clinical Manager – Pathways, Yorkshire Ambulance Service NHS.