Changes to how the Welsh Ambulance Service responds to calls aims
to improve care for patients with strokes and other serious
conditions such as heart attacks.
A new "orange: time sensitive" category will prioritise fast
assessment, response, clinical care and transport, ensuring
patients quickly reach specialist care.
Currently, individuals suffering a stroke or STEMI, a type of
heart attack, are grouped with many other cases in the broad
"amber" category, which represents 70% of all 999 calls to the
ambulance service.
Under the new approach, "rapid clinical screening" undertaken by
nurses and paramedics in 999 clinical contact centres will help
identify time sensitive conditions more quickly and dispatch
skilled ambulance clinicians to provide the best clinical care in
vehicles capable of rapid transport to hospital. This will give
service users the best chance of a better outcome.
The changes replace the current categories with:
-
‘Orange: time sensitive' - for conditions
needing a fast response and care from ambulance clinicians
before transport to hospital for specialist care, such as a
stroke.
-
‘Yellow: assess and respond' - for conditions
which require further clinical assessment to determine the best
pathway of care, such as a person suffering from abdominal pain
who may be suitable to stay at home or may need further
investigations.
- ‘Green: planned response' - for conditions
such as a blocked catheter which may require community care or
planned transport to urgent care services.
The new categories, which replace the current amber category, are
scheduled to be implemented before Winter this year as part of a
new emergency ambulance performance framework.
Additional measures will track the clinical care provided by the
ambulance service and the duration from a 999 call to arrival at
the hospital for stroke and STEMI cases. Monitoring and reporting
will also include average and longest response times.
This follows the first phase of ambulance call improvements
introduced on 1 July, which created new categories for cardiac
and respiratory arrest and life-threatening emergencies.
Health Secretary said: "For people in
stroke, every minute counts if lives are to be saved and
disability reduced or prevented - with each minute that passes,
around two million brain cells are lost.
“That's why we're introducing a new orange category into the
system which will help our ambulance service identify time
sensitive complaints such as stroke quickly and get patients the
right specialist treatment faster.
"This will help ensure that people experiencing a stroke receive
the rapid, tailored response they need to survive, recover and
thrive following a stroke."
To support people with time sensitive complaints like stroke to
receive timely ambulance responses and access to the right care
quickly a Pre-hospital Video Triage approach is being piloted at
five Welsh stroke services with support of the ambulance service.
This sees real time communication between pre-hospital
clinicians, such as ambulance clinicians, and hospital stroke
specialists, to improve the assessment and diagnosis of stroke.
Early findings show it supports clinical decision making improves
pre-arrival information for hospital teams, speeding up access to
life saving and life changing treatments.
Health Boards also continue to develop a new model for stroke
care. From 1 July, the University Hospital of Wales has been
providing a daytime South Wales Thrombectomy service.
The new ‘orange: time sensitive' category, together with
Pre-hospital Video Triage, the introduction of artificial
intelligence to support faster diagnosis of stroke, and the new
daytime South Wales Regional Thrombectomy Service, are important
steps towards a transformed model for stroke care in Wales.
Andy Swinburn, Executive Director of Paramedicine at the
Welsh Ambulance Service, said: “We welcome this
announcement from Welsh Government on the creation of new
categories and the continued focus on patient outcomes, and not
solely on response times.
“The nature of how patients present to 999 has changed and it's
important to reflect this in the way we respond, first and
foremost to increase ambulance availability for those who truly
need it but also to ensure that patients who can be cared for
closer to home get that opportunity.
“This latest change, which builds upon those already introduced
for the most life-threatening calls, is another step towards
creating the framework to do this.”
Dr Shakeel Ahmad, national clinical lead for
stroke in Wales, said:
“When a patient is having a stroke urgent rapid treatment is
critical as every second counts in order to restore blood flow to
the brain for those patients eligible for treatments to remove or
disperse blood clots from the brain. The new orange: time
sensitive category will be able to prioritise stroke patients who
require this urgent treatment.
“The category changes are important steps towards a transformed
model for stroke care in Wales. This will enhance the stroke
pathway leading to greater number of patients receiving life
changing treatment in a timely fashion.”
