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Behind the Headlines: Concerns raised on ITV Wales regarding call categorisation

You may have seen a story being run by ITV Wales today alleging that the Welsh Ambulance Service’s response times are being manipulated in order to meet targets.

The allegations, which have been made by three anonymous members of staff - both current and former - suggest that 999 calls are being upgraded and downgraded in order to make our performance appear better than it is.

We would like to take this opportunity to set the record straight.

Richard Lee, the Trust's Director of Operations and a Paramedic, said: “We take all issues raised by our staff seriously and are naturally concerned by the comments made by those interviewed, but we must be absolutely clear that our response times are not being manipulated in order to meet targets.

“We scrutinise the integrity of our data regularly, at the end of each call, each shift, each day and each month and there is no evidence to support the allegations that have been made.”

The technical part

When emergency calls are first made to the Trust’s three Clinical Contact Centres, they are automatically coded by the Medical Priority Dispatch system, which is used in almost 3,000 communication centres worldwide, processing approximately 65 million calls.

There are two different circumstances under which the initial call categorisation can be changed, which are based on a patient's clinical needs and have no impact on achieving response targets, as the clock starts from the point the patient’s primary symptom is identified.

Richard said: “The priority of a call is not determined by the Trust but rather by the information given by the caller in response to a set of scripted questions, which is then triaged by the MPDS system.

“There are only two occasions where the priority of a call will be changed; when new information from the caller is assessed via the MPDS system, or where a nurse or paramedic has gathered further information about the patient’s condition over the phone.

“In these instances calls are both upgraded and downgraded based on the clinical needs of the patient. This allows us to send resources to the sickest patient first.”

New Clinical Response Model has placed greater focus on clinical outcomes

Since the Trust's new clinical response model was introduced our performance for RED calls has become much more consistent across Wales, including previously challenging areas such as Powys and Ceredigion.

These are patients whose life is in immediate danger such as those who are in cardiac arrest and receiving CPR or choking or with ineffective breathing.

Richard said: “Our new model has allowed us to move away from crude time-based targets and placed a much greater focus on patient experience and clinical outcomes, inspiring the 11 NHS ambulance services in England and Scotland to follow suit. 

“We are proud of the improvements we have delivered for patients in life-threatening emergencies thanks to the hard work of our staff and volunteers, and continue to improve our response to AMBER calls for patients where an immediate attendance is not lifesaving but urgent treatment is required.  

“We have provided regular opportunities for staff to provide honest feedback about how the model is working in practice, but if any of our colleagues have concerns or would like to understand more about this then I would encourage them to come forward.” 

8 Aug 2017 17:13

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