Ambulance staff helping to reduce hospital admissions


nias_logo_hscniThe Northern Ireland Ambulance Service (NIAS) is central to the on-going reform programme enabling the Health and Social Care system to deliver new models of care.

The Ambulance Service have been working closely with Trusts and other providers to develop new ways of working, called ‘Alternative Care Pathways’, which will enable paramedics to provide assessment and treatment at the scene and only transport those patients to hospital who require further or more specialist assessment and treatment.

Photograph of an ambulance.One such new care pathway has been developed for falls patients.

The Northern Ireland Ambulance Service (NIAS) attends to approximately 20,000 patients every year who have fallen.

Many of these patients are not injured and do not require hospital admission. However, it is known that those who do fall are at an increased risk of falling again with nearly 82,000 patients per year sustaining a hip fracture as a result of a fall across the UK.

NIAS have worked in collaboration with the Health and Social Care Trusts to develop a new referral pathway for patients over the age of 65 who fall but do not require assessment at a hospital.

The new referral pathway now means that paramedics refer suitable patients to the Falls Teams in local Trusts instead of being transferred to a hospital.  Since the initiative begin in June, over 150 referrals have been made enabling patients to be treated appropriately in the comfort of their own home rather than a period in hospital.

Here you can read about a couple of real life examples of how the NIAS have helped patients avoid hospital admissions:

  • The NIAS responded to a 97-year-old female who had a fall in a residential care home in mid-August 2015.   After assessment by the paramedic, the patient did not actually require attendance at an Emergency Department, where she could have encountered a lengthy delay before being sent home.  Instead, the attending paramedic referred the patient to the local Trust’s Falls Team. The Team contacted the staff at the residential home by phone the following day and a priority appointment was arranged for assessment at a rapid access clinic.  A full multidisciplinary assessment by a team consisting of consultant geriatrician; physiotherapist; occupational therapist and nurse was carried out. Falls risks were identified and recommendations were made to the residential home on the same day. The lady was then reviewed by the consultant geriatrician.
  • Early June 2015, NIAS attended to an 87-year-old male who had fallen at home. The patient did not actually require attendance at an Emergency Department and the paramedic judged that referral to the local falls team in his local Trust would again be a more appropriate way of helping the patient. The paramedic made a referral before leaving the patient’s home.

Photograph of a paramedic, with ambulance in the background.The Trust’s Falls Team then contacted the patient on the same day and carried out an initial telephone consultation.  Following this consultation, the patient was referred to the Domiciliary Physiotherapy Team for assessment of his mobility. A Physiotherapist and Occupational Therapist attended to the patient in his own home and identified falls risks in the home and reviewed his walking aids. The physiotherapist visited this gentleman at home again a couple of weeks later to ensure that he had followed their advice and that there had been no further falls.

In addition, NIAS have introduced Alterative Care Pathways for Palliative Care, Diabetes and Minor Injuries patients. Information about the roll out of these pathways and the development of new pathways in relation to Asthma, Epilepsy/Seizures and Mental Health  can be viewed in future editions of this eZine.

For all the latest news from NIAS visit the NIAS website.

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