What does a great responder service look like?

MD at Taking Care Steve Gates believes while the national ambulance crisis is unquestionably challenging, it also provides huge opportunities for collaboration and solutions for TEC, NHS & communities.

It was great to be able to meet face to face again at the ITEC 2022 conference in Birmingham back in March and we are deeply privileged to be a headline sponsor for TSA events this year. It was truly inspiring to hear about so many great initiatives and projects spearheaded by the TEC sector supporting our common goal of keeping our loved ones living healthier, safer, and happier independent lives.

Even though the dust may have settled slightly on Conference itself, I’m sure you will all agree there is much more we can do. None of us can avoid the shocking, almost daily, news reports of the escalating crisis with ambulance wait times across the country. Here at Taking Care we are seeing the challenges and effects of this impact across all our three Emergency Resolution Centres:

1. Longer call handling times: Our call handling times for a category 3 or 4 emergency that has been referred through to the ambulance service is getting longer and longer.
   
2. More outbound support calls. Longer ambulance wait times inevitably means we are making more outbound calls to the customer as part of the deterioration policy.
   
3. More calls in to check ambulance progress. More customers or their families are phoning us to find out progress on the ambulances.
   
4. Call length and call complexity is increasing. Post COVID we are seeing people starting to come and speak to us who already have a large accumulation of health problems.

The figures from NHS South Western Ambulance Service below indicate that they are outliers in terms of category 3 emergencies, and they are taking up to 24 hours before they are getting to see someone.

One of our objectives at Taking Care is to prevent avoidable hospital or crisis care attendances and admissions and to help people return home from hospital who need extra support. So, we are absolutely delighted to be working with Caroline Williams, Associate Director for Integrated Care at Warrington Borough Council and Warrington and Halton Hospitals NHS Foundation Trust, and the Warrington team in their pilot scheme for the nationwide initiative to support crisis care in the local community. The scheme is also unlocking how a public / private collaborative partnership can help solve the challenges in responder services and demonstrate the benefits of working together for our common goals of reducing the strain on NHS services and saving lives.

Case Study - London Borough of Bexley and St John Ambulance

So, what does a great responder service look like in practice? We currently have an excellent model in place with one of our corporate clients. We are working with the London Borough of Bexley with support from St John Ambulance to provide access to medically trained St John Ambulance staff as an alternative to blue light services for ARC operators in the Bexley area.

On attendance St John Ambulance staff use their Falls Pathway (based on iStumble post-fall assessment) and clinical observations using NEWS2 score. Full patient reporting is delivered to the control centre after the service user has been discharged and left at home. Where ambulance attendance is required a St John Ambulance staff member directly attends to assist. The results so far have been incredibly encouraging; for over 1,500 call outs:

• 68% were responded to within 20 minutes: 99% were responded to within 45 minutes
• 20% required post-visit referral for additional care and medical support
• Less than 10% required an ambulance: 81% would have resulted in deteriorating / more serious injury or fatality if St John Ambulance had not responded
• 100% of post-fall Welfare Visits were delivered within 48 hours
• 13 were referred to Safeguarding Teams

Always looking forward for positive change

We at Taking Care like to view history as a place of reference and not refuge, and while the national ambulance crisis is unquestionably a huge challenge for everyone, it also provides us at the sharp end with some huge opportunities.

In our opinion, collaboration is key. We need to work hard to find different routes, alternative routes, or new routes, and be clear in terms of bridging those gaps and focusing on the outcomes.We shouldn’t look over our shoulder at the way things worked before as a model; we’ve now increasingly got to look forward and to see how we can do things differently to make a significant impact to deliver exceptional care for our loved ones and their families.

Steve Gates is the Managing Director of Taking Care, part of AXA Health, the UK’s largest private provider of personal alarms to vulnerable and elderly customers. Steve has been part of Taking Care for the last three years. Prior to that Steve worked at BUPA and Denplan and was both a Vice-President of the Hampshire Chamber of Commerce and Chair of the local Chamber committee in Winchester for five years. Steve is a Chartered Director and is a previous holder of the Best Leader award from the “Sunday Times 100 Best Companies to Work For”.

READ > the 999 partnership between Warrington BC and the ICSs - Connecting TEC, UCR and Responder Services – the blueprint for integrated services

WATCH BACK > ITEC session when TSA shared the stage with Kath Evans (NHS England) and Caroline Williams (Warrington), Progress Lifeline and Taking Care