Best Practice at East of England Ambulance Service NHS Trust
The Early Intervention Vehicle (EIV)
In partnership with our community Teams EEAST has designed and trialled Early Intervention Vehicles to target specific groups of patients who would benefit from integrated care. These cars manned by Ambulance clinicians and community practitioners have reduced the 999 responses to elderly fall patients, reduced emergency admissions and repeat fallers are falling less.
In addition, our community partners have received a positive response from patients and carers as they have received rapid referrals for extra or enhanced packages of care and social care where required.
The staff on the vehicle can provide services like community health care assessments, occupational/physiotherapy attendance, social service access, equipment provision and advice on medication. We are proud of the improvements we have made to the services delivered to this rapidly growing group of patients.
The EIV is staffed by an East of England Ambulance Service NHS Trust (EEAST) senior emergency medical technician, together with a physio or occupational therapist from East Coast Community Healthcare (ECCH), the James Paget University Hospital (JPUH) or Norfolk or Suffolk County Council.
Wherever possible, they provide a one-stop service, assessing the patient, reviewing their medication, making onward referrals for additional health and social support where necessary and providing equipment to help them stay safe, such as walking aids, slippers or alarms.
During a seven-month trial, the EIV attended 256 people who had suffered falls, went to 51 category 1 calls and gave advice and guidance to other crews on 158 occasions.
Less than a quarter had to be taken to hospital following a visit from the EIV, compared with three in every four treated by an ambulance crew. As a result, the EIV is estimated to have saved 370 ambulance attendances, 285 conveyances to hospital, 255 emergency department attendances, 78 unplanned admissions to an acute hospital and 708 bed days.
Terry Hicks, EEAST Sector Head for Norfolk and Waveney, said:
We are incredibly proud – it is a great example of partnership working which offers a gold standard of service to patients by putting in place all of the support they need to recover at home, where they feel most comfortable.
The EIV has been a huge success. Data from the trial shows that it is having a significant impact on the health system by reducing the number of patients who are taken to hospital, while the feedback we have had from patients has been overwhelmingly positive.
Evidence shows that spending 10 days in a hospital bed causes the equivalent of 10 years ageing in the muscles in people aged 80 and over, which could easily lead to a loss of independence which may mean they are never able to return home.
Providing the right care and support to meet their needs at home at the time of that initial 999 call not only helps them get better more quickly and improves their experience of accessing care, but also reduces pressure on the NHS and make best use of its limited resources.
Early schemes evidenced that 60% of patients seen did not require transport to hospital following the excellent care they were provided at home. These schemes are now being used in other regions of the organisation.