EMERGENCY CAR E
Connecting emergency services with technology
With Integrated Care Boards (ICB) having moved onto statutory footing, it is time to use digital connectivity to join up services – starting with emergency care, argues Mike Farrar, former chief executive of the NHS Confederation and North-West England Strategic Health Authorities.
The NHS is facing huge challenges in the post-COVID lockdown period, with emergency services and primary care under the greatest pressure. NHS England funding needs to grow by 4.3% each year to maintain existing standards. This means we need to get better at treating more patients with the same resources. Technology offers a great opportunity for the NHS to find better ways to provide services, especially in an emergency. By reducing the number of patients in urgent care, the NHS can allocate more beds to clear the elective care backlog. The NHS is already adopting digital technologies for emergency care, such as smart ambulances, and patients are being discharged from hospital with remote support – for example, ‘virtual wards’ with remote monitoring using apps, wearables, and medical devices (including pulse oximeters for COVID-19 discharge). However, these technologies are being adopted in a piecemeal fashion. To meet the challenges of the future, technology needs to be joined up in a holistic way.
Connecting for productivity Digital solutions adopted by the NHS have too often been commissioned independently by Clinical Commissioning Groups (CCGs), social care, care homes and other organisations. This has led to duplication in technology, or incompatibility between software – creating waste and reducing the quality of patient experience. NHS organisations too often work independently of each other. Ambulance services, for example, traditionally operate separately from out-of-hours GP and mental healthcare. Patients can end up being taken to A&E by default – taking up valuable resources for emergencies, such as heart attack or stroke.
Non-NHS emergency responders, such JANUARY 2023
as firefighters, are disconnected from NHS clinicians and may lack the confidence to deal with a medical emergency without calling an ambulance. Paramedics do not always have remote access to specialist clinical support, which leads to lengthy handovers at the hospital.
Promoting integrated care On 1 July, integrated care boards (ICB) became legal entities with access to NHS funding. They are the first structure established in the NHS to use funds for integrated working between health and social care. This is a massive opportunity to commission joined-up technologies. In order to achieve this, ICBs need to aspire to join up organisations over time and think about the technological solutions. Primary, acute, and social care should have a vision for connecting the technologies they need to meet productivity challenges – rather than leaping for a fragmented solution. At a Visionable emergency services that I chaired, we discussed
roundtable1
how ambulance services and fire officers could be trained together to provide a
coordinated emergency response. Joining together emergency care will require not only creativity around training but also technological solutions which work in a joined-up way.
Integrating with technology As we move forward, ICBs must adopt best-in-class technologies that join existing systems together, allowing services to work more efficiently. Remote monitoring systems to help older people live independently, for example, need to be connected to the local ambulance service – ensuring that an older person who has a fall can be quickly taken to hospital.
On-scene paramedics can be connected by video link to clinical specialists and mental health professionals, allowing for remote triage, speedier hospital handover, and a 360-degree view of patient health. For example, video conferencing telemedicine apps can be used effectively to link paramedics directly to specialist stroke consultants via tablets. These can then also be used to enable paramedics to access a patient’s medical record, enabling further
WWW.CLINICALSERVICESJOURNAL.COM l 57
▲
All images in this article are © Visonable.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68
