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NHS County Durham & Darlington. Ambulance evaluation research: Key insights (March 2013). June 2013. Presented by Joanne Loughlin-Ridley. Introduction.
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NHS County Durham & Darlington Ambulance evaluation research: Key insights (March 2013) June 2013 Presented by Joanne Loughlin-Ridley
Introduction • Explain was commissioned by NHS County Durham & Darlington in 2012 to deliver a comprehensive research programme that would independently evaluate the evidence based model of ambulance provision that was operating in the Durham Dales at that time. 8 Teesdale, 5 Weardale 216 Teesdale, 150 Weardale 14 Teesdale, 12 Weardale Opt-in sample Random selection Nominated sample 12 emergency care / 3 primary care Mix of demographic profiles Included operational and strategic roles • Fieldwork was completed between mid-January and mid-March 2013, with insight delivered at the end of March 2013.
Model • Below is an outline of the model of provision in the Dales which was central to the research:
Key insight: satisfaction • Patients that discussed positive experiences identified key contributors:
Key insight: reputation • Patients discussed how valued the local ambulance crew are in the Dales: • “Everybody is positive about them...round here there’s only praise as far as I know for the ambulance service here. Oh God, I couldn’t do without them. Honestly, we could not do without them. This would be disastrous, where we are in Romaldkirk. You need a fast response to here. And there’s some quite elderly people in the village, so you would rely on them”(Teesdale – stomach pains)
Key insight: reviewing the model • Patients that discussed positive experiences identified key contributors:
Key insight: weaknesses of the model Perception is that the service model is not working in practice
Key insight: paralleled perspectives • Control staff did not echo the concerns of other professionals about the model not delivering sufficient coverage in the Dales, holding a paralleled perspective that the model exceeded requirements and could be reduced in the future: “I don't think it requires any more than any other ambulance, one paramedic and one other... they've got four vehicles operating, during the day, and two vehicles operating through the night, and for the demand they've been treated very generously,… you could probably take one vehicle out of that equation… I don’t have this much cover in Durham city centre… they are getting above and beyond… It’ll be more efficient by not having the Middleton vehicle at all without hurting the service, I could use that vehicle somewhere else, much more efficiently” (Ambulance control staff) “People’s lives will be put in danger, and I know that's quite a strong thing to say, in fact I’ll say it even stronger, people will die if we don't have a 24-hour proper crewing system here in the Dale. We are so remote, we have an aged population, and definitive care for a number of different things, for example, heart attacks, and trauma, are a long way away...if we don't have 24-hour cover, and someone has to come into the Dale to do that, then that's a long way to go”(Paramedic)
Key insight: improvements • Be transparent about performance so areas for improvement are evidenced and clear for all involved • A number of other areas were discussed also: • Importance of 2 paramedics per vehicle due to the distance from hospitals • Training required to deliver valuable primary care to the Dales communities to tackle (re)admissions • 4x4 vehicle being needed all year long in Weardale • Ambulance station at St John’s Chapel being in need of attention / review • Retention of paramedics in the Dales and wider NEAS patch
Key insight: communication • Evidence of ongoing frustrations were found in regards to some of the professionals relationship and communication with the NHS and with NEAS specifically:
