• Number of unnecessary Emergency Department attendances reduced during pilot scheme
• Advanced Clinical Practitioners work with Paramedics to review if care can be delivered in community
• During 20 day pilot 45% of ambulance conveyances were deflected from the Emergency Department by linking with other services

The number of people coming to Royal Bolton Hospital’s Emergency Department by ambulance has been reduced during a new pilot scheme with North West Ambulance Service (NWAS).

‘Call Before Convey’ sees Bolton NHS Foundation Trust’s Advanced Clinical Practitioners (ACPs) work closely with ambulance crews to assess calls and determine whether a patient would be better suited to receive care in the community.

The scheme aims to:

• Provide the right care, in the right place
• Reduce attendances to the Emergency Department.
• Safely help more people in the place they call home.
• Free up North West Ambulance Service resource to attend to other emergencies.
• Reduce ambulance handover times.
• Educate NWAS clinicians on available pathways within community services in Bolton, such as frailty virtual wards and Urgent Community Response (UCR).

Avoiding unnecessary attendances to the Emergency Department is a key element of the Trust’s ongoing work to improve urgent care services.

The first part of the pilot in December focussed on over 65s living in care homes, before continuing with people over 75 years old who were frail in January.

So far, the pilot has seen promising results:

• Across the 20 day pilot in December and January, 45% of admissions were deflected to community services.
• People avoided hospital by linking in with other services, such as virtual wards, Urgent Community Response and GPs.
• Additional capacity was created for ambulances as less are arriving at the Emergency Department.

Mike Chew, Divisional Director of Operations for Integrated Community Services at Bolton NHS Foundation Trust, said:

Call Before Convey reinforces our message to think ‘community first’ and provide the right care, in the right place, at the right time.

“We’re really proud of what we have been able to achieve with our Trust and NWAS teams to improve what our patients experience and ease pressure on our urgent care services.

“We’re now working more collaboratively with NWAS by proactively engaging with their calls before patients come to the Emergency Department. We’re also improving awareness and knowledge around what community services can support with out of hospital and supporting NWAS crews to leave patients safely in the place they call home with support from other services.

The pilot is continuing to be reviewed to understand how any improvements can be implemented long-term.

Donna Hooley, Sector Manager at North West Ambulance Service, said:

NWAS is delighted to be working with Royal Bolton Hospital, to help our crews access services which allow patients to receive safe care in the right place, first time.

“This puts our patients needs first and can help to improve health outcomes and patient experience. A collaborative approach to clinical decision making can also help to reduce unnecessary Emergency Department attendances, allowing NWAS to respond more effectively to patients in the community.

For more information about urgent care services at Bolton NHS Foundation Trust, please visit our website.