SCOTTISH AMBULANCE SERVICE
Managing demand across
Scheduled and Unscheduled Care
Peter Ripley
Director of Service Delivery
Background
• The Service employs 4,300 staff
• Responds to 600,000 unscheduled care calls per year
• Undertakes 1.6 million scheduled care patient journeys
per year
• Staff based at over 170 locations
• There are three Emergency Medical
Dispatch Centres (Glasgow, Edinburgh
and Inverness)
• 3 Special Operations Response
Team’s
• Four Air Ambulances
Overview
•
Generally the Service coped really well
despite the challenges
•
Comprehensive planning
•
•
With good communications
We improved response times for life
threatening calls across Scotland to an
average of 6.9 minutes versus 7.2 minutes the
previous year – this is world class!
Introduced the new Resource Escalatory Plan
•
Preparation for Winter
• Demand & Capacity Planning – Nationally & Divisionally
• Strategic Coordinating Centre
• Winter Event Planning
• Pandemic Flu arrangements
• Resource Escalatory Action Plan (REAP)
Strategic Coordinating Centre
• SCC operating 24/7 during key periods (REAP Level 4 +)
• Regular briefing reports to managers, health boards and to the
Scottish Government
• Support from voluntary agencies in the SCC
• Co-ordination of four wheel drive capability
• Provision of specialist vehicles
REAP
REAP Level 6 Potential Service
Failure
REAP Level 5 Critical
REAP Level 4 Severe Pressure
REAP Level 3 Moderate Pressure
REAP Level 2 Concern
REAP Level 1 Normal Service
Staff support
• Positive attitude of staff and managers
• Staff and staff side worked with the organisation
• Huge effort made by staff to get to work
• Sickness levels reduced
• Excellent support from PTS staff, both in and out of normal working
hours
• ‘Buddy’ system with other ambulance services
Partnership working with NHS
organisations
• Regular communication with health boards & NHS 24 to
agree local priorities
• With hospitals for patient admissions, transfers and
discharges
• With hospitals for Scheduled Care
• Liaison with GPs and local hospitals
• BASIC’s
Partnership working with other agencies
• Support from voluntary agencies, providing staff and
vehicles
• NHS24 support at times of peak demand
• SAS managers triaging calls in police control rooms
• Liaison with other UK ambulance services
• Local authorities
• Met Office
Communications with the general
public
• Communicated key messages through the
media from October onwards
• Emphasised the increased demand over
the winter period
• Focussed on not drinking to much alcohol
• Signposting patients to other suitable
alternatives e.g. NHS 24
Key Learning
• More effective engagement and involvement in planning
with Local Authorities
• Improved demand and capacity planning
• REAP triggers and understanding
• Call handling capacity for clinical triage
• Better planning for accessing renal patients
• Tactical use of 4 x 4 assets
• National co-ordination but meeting local need
Key Learning
• Work with Acute Hospitals looking at elective planning
• Involvement where wards are being closed to new admissions
• Treating patients nearer home to reduce inter hospital transfers
• Managing the impact of reduced medical cover at rural hospitals
• Need to use Met Office services e.g. they have tools to predict
changes in demand by condition as weather changes
Thank you