Joint Royal Colleges Ambulance Service Liaison Committee JRCALC

Joint Royal Colleges Ambulance Service Liaison Committee (JRCALC) Conference

“What does the Ambulance Service need from JRCALC in the New Millennium? ”

A. S. A. Video

The Ambulance Service Map 32 As at 12: 00 Hrs 3 rd November 2000

“Where does the Ambulance Service see its Future Strategic Direction? ” How can we Help?

Towards Perfect Vision 2010 Strategic review undertaken by The School of Health and Related Research, Sheffield University. Draft Report scheduled - December 2000

Public Safety Public Health or Health Care Arm of the Emergency Services Emergency Arm of the Health Care Service

Current Issues • Role (scope of practice, disasters home care; is ‘ambulance service a good name) • Organisation (links, mergers, networks, etc) • The ASA and the NHS confederation • Demand demand management, targeting and prioritisation • Management staff (NHS / AS) • Operational staff (lay, drivers, EMTs, paramedics, PECS, nurses and doctors, control room staff) • Operational Technologies (IT, vehicles, AVL, GIS, EMD, digital radio)

Current Issues • Therapeutics (telemetry, drugs, thrombolysis, etc) • Variations in practice and protocols (audit) Evidence based practice (research) • Protocols (therapeutics, timings, treat and leave, by passing, etc) • Clinical Skills (education and training, maintaining skills, rotation) • Performance standards (time, clinical practice, c-calls, outcomes) • Non-emergency work (PTS, NHS Direct, etc) • Voluntary sector (St. Johns / Red Cross) • Funding (economic viability; funding levels; local contracting) • Legal and regulatory framework (clinical governance. . )

Options for the Future • The Organisation of Ambulance Services • Links, Mergers and Networks • The Emergency Health Care Trust

The Journey To-Date Clinical Role of Ambulance Services 1970/80 1990 2005 Millar Paramedics State Practitioners Ambulance & Registered in Personnel Emergency Paramedics Emergency Medical Technicians Care

• Professional Registration a pre-requisite • Evidence Based • ‘Selective’ Clinical Skills Clinical Practice • Guidelines for Clinical Judgement

0845 46 47 0845 4 N HS (Direct)

• NHS Direct • Walk-in Centres • Capacity Management • GP ‘Out of Hours’ Review • On-line Services • Web Cam Facilities

Millennium Ambulance Service

JRCALC Bashed Local Medical Bashed Steering Committee CHI Bashed NICE BASMED Bashed Individual Bashed Clinicians Clinical Practice Medical Directors Faculty of pre. Bashed - Hospital Care BAEMS Bashed j BASICS

Medicines Commission Medicines Control Agency A. S. A. JRCALC • Standard Protocols • Clinical Leadership • Evidence Based Practice • Lead Advisory Body on all Clinical Issues Clinical Effectiveness Committee Ambulance Education and Training Committee

The NHS Plan 21 st Century Service for the needs of the Public

The Millennium Ambulance Service will : • Develop its capability and potential for an enhanced integrated role within the primary care setting • Maximise the advantages to be gained from the developments in clinical treatments and telemedicine technology • Provide the emergency communications gateway for the National Health Service • Stronger medical influence through the appointment of Medical Directors

The Millennium Ambulance Service will : • Audit and Evaluation (in partnership with Primary and Secondary Care providers) • Clinical outcomes determining future practice • Enhanced interventions within the community (Practitioners in Emergency Care) • Community programmes of education in CPR and automatic defibrillation

The Millennium Ambulance Service will : • Integrated • Single and seamless pathways of care gateway for emergency access • Enhanced response performance (90%) for life threatening conditions • Application of digital technology and telemedicine leading to the introduction of mobile health care

999/112/08 45 46 47 Single Gateway Health Development • Health Information • Health Promotion • Chronic Disease Management Electronic Access Emergency Ambulance Nurse Triage Sub-structure ‘electronically networked for home care diagnosis’ Full range of patient telematics

That’s all Folks