Do unscheduled care coordination hubs reduce avoidable ambulance journeys?

Aim

Evaluating the use of Unscheduled Care Coordination Hubs to reduce pressure in the emergency department and use of ambulance services

Background

Alternatives to ambulance transportation to the emergency department for patients who are not seriously ill are urgently required, to reduce pressure on emergency services and reduce avoidable harm to patients. A high percentage of patients using ambulances for transportation to hospital could be safely cared for in the community. However, there is a lack of rapid access to community services. Unscheduled Care Coordination Hubs allow patients using ambulance services to access a community hub in real time and, where appropriate, transfer patients to a skilled community team with access to a full range of immediate and follow up care. This frees up the ambulance service for other patients.

Outline of our project

In collaboration with NHS England’s Emergency Care Improvement & Support Team (ECIST), our Urgent and Emergency Care theme is evaluating Unscheduled Care Coordination Hubs nationally. We will be assessing the impact of 4 different hub models, focusing on the following:

• 999 call engagement and how hubs are used
• Outcomes of 999 calls into the hub, including reduced journeys to hospital

Findings

• 8633 patients were transferred to the Staffordshire hub (on average around 40 patients a day) and of those, 2841 were transferred by the ambulance service over 7 months. Of patients with a known outcome, only 3.6% required transfer to hospital by ambulance.
• In Leicester, over a single week 169 emergency ambulance journeys were avoided, which equates to 507 hours of staff time released back into the system to respond to emergency calls.