Managing calls from healthcare professionals
There are two new national frameworks to manage calls from GPs and other healthcare professionals (HCPs) requesting an ambulance for patients who need urgent or emergency transportation to hospital or between hospital sites.
The National Framework for Inter-facility Transfers and National Framework for Healthcare Professional Ambulance Responses have been designed by the Association of Ambulance Chief Executives in collaboration with commissioners, NHS England, NHS Improvement and other key stakeholders.
The frameworks have been trialled in three ambulance services already - North West Ambulance Service, West Midlands Ambulance Service and North East Ambulance Service – and have shown benefits including:
- equity of access for all seriously ill and injured patients, supporting patients’ clinical needs
- consistent definitions for high acuity responses mapped to the equivalent 999 response priorities
- opportunity for local innovation and acknowledgement of different contractual and commissioning arrangements for lower acuity incidents (Level 3 and 4)
- reporting of HCP and IFT incidents separately to other 999 activity, and in a way that allows comparison and assures transparency.
Following national evaluation, it was decided that the frameworks would be implemented in all English ambulance services. EMAS went live with the processes on 1 October 2019.
Below are guidance documents for GPs and HCPs on the two processes.
Specialist Critical Care Transport
EMAS is currently commissioned to provide Specialist Critical Care Transport to patients requiring specialist transfers between hospitals for specialist investigation or treatment.
EMAS works with the three critical care networks and the associated critical care units operating within the East Midlands to ensure patients are transferred in a safe and timely way.
The transport is booked by healthcare professionals at the referring hospital when a baby, child or adult requires the specific care. The ambulance vehicle used to transport the patient is designed to include specialist critical care equipment that allows the ambulance crew and hospital clinicians who also travel with the patient, to ensure quality treatment and specialist care continues throughout the journey.
One example of the type of Specialist Critical Care journeys we undertake is Extra Corporeal Membrane Oxygenation (ECMO) transfers, this is used when a patient has a critical condition which prevents the lungs or heart from working normally.
An ECMO machine is similar to heart and lung machines used during open-heart surgery. It is a supportive measure that uses an artificial lung (the membrane) to oxygenate the blood outside the body (extracorporeal). When a patient has been accepted by the hospital for ECMO they need transporting to the hospital by a dedicated team and, unless a helicopter is required due to the distance to travel, EMAS provides the transport.
During the journey, the intensive care environment is replicated as far as possible and patients are maintained on a ventilator (breathing machine) and have continuous monitoring of their vital signs by the hospital team until they reach the destination facility.