Paramedics from East Midlands Ambulance Trust are taking on a new role based in hospitals in Derbyshire to advise patients and ambulance crews on alternative pathways.
Three EMAS Clinical Navigators were introduced to the emergency departments at Royal Derby Hospital and Chesterfield Royal Hospital in December to ensure patients receive the right care in the right place.
When an ambulance crew arrives at A&E with a patient, the Clinical Navigator is there to support them with making sure the patient is receiving the right care.
If a crew doesn’t think a patient needs to go into hospital but is unsure of which pathway is most suitable to get the patient the help they need, they can also speak to the Clinical Navigators over the phone who will advise them on what is available in the area.
If the Clinical Navigators identify any gaps in treatment pathways, they are also able to work with the local commissioners to help shape new health and social services.
Tim Slater, Paramedic and Derbyshire General Manager at EMAS, said:
If our ambulance crews are able to get patients the medical care they need outside of hospital, this is beneficial to everyone.
It means that the patient receives the right care more quickly, they do not have to sit in a busy A&E department waiting to see a doctor or for treatment that can be provided elsewhere.
It also reduces the pressure in A&E so the staff can focus on treating the most poorly patients who really need emergency medical intervention.
The trial has been so successful in improving patient care and reducing hospital admissions that it has now been extended until the end of May, three more Clinical Navigators have joined the team and two are now based at the Clay Cross Hospital in Derbyshire, supporting primary care.
In the last month, there have been at least two occasions where ambulance crews have not needed to take a single patient to hospital during their 12 hour shift because they have been able to get them the care they need in the community.
Clinical Navigation in action: an example…
The EMAS crew attended an 80-year-old woman suffering with sciatica, who was in so much pain that she could not get up and walk around.
As she is a carer for her husband, it was important to her that she did not go into hospital as there would be no-one to look after him.
The ambulance crew called the Clinical Navigators to discuss the options, especially as the patient had not suffered a fall or a trauma, the hospital would not have done an x-ray.
The team instead managed to implement a care regime for the patient at home, and also arranged for a carer to come in to look after her husband while she was unwell.
If the patient had been taken to A&E, it would have caused her unnecessary anxiety about her husband, and she would not have received the care she needed.