Table 1 A summary of responses to a UK wide survey of ambulance service current policies and practice in relation to the management of the care of people who make frequent emergency calls
Service | Service-wide policy | Local policies/pathways | Call volume | Audit/ Evaluation |
|---|---|---|---|---|
1 | Service wide policy in place National definitions for ‘Frequent Caller’ used Aim – to discourage people from calling | One area of service has an initiative which started in 2015 Aim – to identify triggers which lead to the patient making the call e.g. adverse childhood events, mental health, drug and alcohol dependency | Not reported | No audit or evaluation reported; Frequent Caller lead reviews cases on four monthly basis |
2 | Service wide policy updated 2017 National Definitions for ‘Frequent Caller’ used Aim – to reduce further calls to emergency ambulance service | One area of ambulance service has initiative started in 2017. Aim – to work together to ascertain any unmet needs with a view to reducing demand | 346 patients on active management plans at time of response | Auditing at individual case level, in process of developing evaluation process on larger scale |
3 | Service wide policy in place National definitions for Frequent Caller used Aim – to close cases (take the person off the frequent caller list) and reduce calls | Several areas participate in MDT meetings. No specific aim given | 600 patients a month, team involved with 50 callers per month | None reported |
4 | Service wide policy in place National definitions for ‘Frequent Caller’ used Aim- to reduce or prevent people from calling | In several areas cross service initiatives are in place. Aim – to work as a multi-agency team to reduce demand and provide the patient with the most appropriate care to meet their complex needs | 900 people per month are classified as ‘Frequent Caller’ | No audit or evaluation undertaken |
5 | Service wide developed policy developed in 2017 National definitions for Frequent Caller used No specific aim reported | In one area cross-service initiative started in 2017 No specific aim reported | 200 calls per month | No audit or evaluation reported |
6 | Service wide policy in place since 2013, currently being updated National definitions for ‘Frequent Caller’ used No specific aim reported | Additional programme in one area targeted at patients with mental health problems – started in 2016 No specific aim reported | No data provided | No audit or evaluation reported |
7 | Service wide policy in place National definitions for ‘Frequent Caller’ used Aim – to reduce calls and address reasons for calling Actions for callers meeting defined threshold | No variations reported by area | 2500 people classified as Frequent Caller per year | No audit or evaluation reported |
8 | Service wide policy since 2007 National definitions for ‘Frequent Caller’ used No explicit aim given | Several areas have cross service initiatives in place Aim – to ensure that patients have access to the most appropriate care pathway. Usually callers have an exacerbation of an underlying chronic illness over a short period of time and do not know which service to access; or they have recently left hospital (geriatric) or prison; have a mental health condition; have recently experienced a bereavement or have a drug or alcohol problem | No data given | No audit or evaluation reported |
9 | Service wide policy since 2013 National definitions for ‘Frequent Caller’ used No specific aim given | In one area a service has been set up which uses the GP neighbourhood model Aim – to identify why patients are calling and see what support can be put in place to support them | No figures given | No audit or evaluation reported |
10 | Service wide policy since 2009 National definitions for ‘Frequent Caller’ used Aim – to reduce calls and ED attendance | One area has a new pilot service which started in 2017 Aim – to reduce calls and reduce ED attendance | 700 calls per month | Pilot schemes audited on monthly basis |
11 | No response | |||
12, 13 | Services responded that the survey was not applicable, little was done and service 12 stated that no letters were sent to patients | |||