Rapid clinical screening to improve outcomes for 999 callers

13.12.24

THE Welsh Ambulance Service has introduced a new process to improve outcomes for 999 callers and deliver a safer service.

Paramedics and nurses in the Trust’s control room will now undertake a rapid clinical review of most 999 calls to ensure patients get the most appropriate help. 

Those whose condition is immediately life-threatening will continue to be sent an emergency ambulance on lights and sirens as quickly as possible so that highly skilled clinicians can deliver life-saving interventions at the scene.

Callers whose condition is not as time-sensitive will be further triaged by control room clinicians, who will identify the most appropriate response for their needs. 

Thirty clinical navigators have been appointed to run the new service and are based from the Trust’s clinical contact centres in St Asaph, Carmarthen and Cwmbran.

Pete Brown, the Trust’s Assistant Director of Operations, said: “Winter is a busy time for the NHS with seasonal illnesses and cold weather putting more pressure on an already over-stretched system.

“This means a poor patient experience, not to mention frustration for our people, who are not able to help the community as quickly as they would like.

“Rapid clinical screening enables highly skilled paramedics and nurses to apply their critical thinking in a control room environment in a brand new ‘clinical navigator’ role, ensuring that those in most urgent need of help, get it.”

Greg Lloyd, Assistant Director of Clinical Delivery, added: “After the initial interaction with a non-clinical 999 call handler, getting an experienced clinician involved in the decision-making process is the most effective way of ensuring patients get the right care according to their needs.

“This may include sending an emergency ambulance, paramedic or advanced paramedic practitioner, or it may include a remote assessment with a clinician to gather further information to inform the next steps in the care and advice we provide.

“Clinical navigators can also observe and listen into 999 calls in real-time, prompting call handlers to ask additional questions to elicit more information and will stay on the call until a safe decision is made.

“This continuous assessment will lead to better patient outcomes, as well as a much safer service, and all with a view to ensuring patients get the right care or advice, in the right place, first time.”

The Welsh Ambulance Service is testing a number of new approaches over winter to improve patient safety and quality of care.

The Trust’s dedicated Mental Health Response Vehicle in south Wales is better supporting people in a mental health crisis and reducing avoidable hospital admissions.

Meanwhile, Community Welfare Responders are being trained to attend appropriate 999 calls in their community and take a set of observations from the patient to help clinicians in the ambulance control room determine the appropriate next steps.

Rachel Marsh, the Trust’s Executive Director of Strategy, Planning and Performance, said: “At the end of winter, we’ll look at how these changes have gone.

“Key to the evolution of our response model will be feedback from patients, staff and other stakeholders, and we’ll be listening to feedback in earnest to ensure our services better meet the needs of the people of Wales, now and in the future.”