More patients set to benefit as vital response service expands

Date: 19 September 2018

Waveney EIV

An innovative scheme which sees the region’s ambulance service and healthcare partners in Great Yarmouth and Waveney keep patients at home following a 999 call is expanding to operate seven days a week.

The Early Intervention Vehicle (EIV) will start running between 7am and 7pm, 365 days a year, in October thanks to an investment of more than half a million pounds.

It follows a successful trial during which it operated for four days a week. The expansion will allow crews to help even more patients by putting the right help and support in place so that they can remain at home rather than be taken to an acute hospital.

The EIV is staffed by an East of England Ambulance Service NHS Trust (EEAST) senior emergency medical technician, together with a physio or occupational therapist from East Coast Community Healthcare (ECCH), the James Paget University Hospital (JPUH) or Norfolk or Suffolk County Council. Wherever possible, they provide a one-stop service, assessing the patient, reviewing their medication, making onward referrals for additional health and social support where necessary and providing equipment to help them stay safe, such as walking aids, slippers or alarms.

During a seven-month trial, the EIV attended 256 people who had suffered falls, went to 51 category 1 calls and gave advice and guidance to other crews on 158 occasions.

Less than a quarter had to be taken to hospital following a visit from the EIV, compared with three in every four treated by an ambulance crew. As a result, the EIV is estimated to have saved 370 ambulance attendances, 285 conveyances to hospital, 255 emergency department attendances, 78 unplanned admissions to an acute hospital and 708 bed days.

Terry Hicks, EEAST Sector Head for Norfolk and Waveney, said: “We are incredibly proud - it is a great example of partnership working which offers a gold standard of service to patients by putting in place all of the support they need to recover at home, where they feel most comfortable.

“The EIV has been a huge success. Data from the trial shows that it is having a significant impact on the health system by reducing the number of patients who are taken to hospital, while the feedback we have had from patients has been overwhelmingly positive.

“Evidence shows that spending 10 days in a hospital bed causes the equivalent of 10 years ageing in the muscles in people aged 80 and over, which could easily lead to a loss of independence which may mean they are never able to return home.

“Providing the right care and support to meet their needs at home at the time of that initial 999 call not only helps them get better more quickly and improves their experience of accessing care, but also reduces pressure on the NHS and make best use of its limited resources.”

The expansion was secured after NHS Great Yarmouth and Waveney Clinical Commissioning Group (CCG) agreed to fund the service permanently, investing £540,000 a year.

Cath Byford, Deputy Chief Officer/ Director of Commissioning with the CCG, said: “This important service has already made a real difference to hundreds of people. It is also helping to minimise unnecessary hospital admissions and emergency department attendances, in turn making sure that these vital resources remain available for those in the greatest clinical need.

“The EIV is a great example of different organisations working together to improve people’s qualities of life and we are really pleased it has had such a positive impact so far.”

ECCH’s Director of Operations Adele Madin said: “We have an aging population, many of whom feel socially isolated and may be living with long term conditions, so our physiotherapists and occupational therapists play an increasingly key role in helping people to stay mobile and maintain their independence at home.

“This service is a great example of how working in an integrated way with our NHS and social care colleagues means we can be more efficient and effective, and provide our patients with the best possible care when they need it most.”

Graham Wilde, Chief Operating Officer at JPU, said: “We are really pleased to be a part of this service and to see the benefits it has delivered to individuals by enabling them to stay in their own homes rather than being admitted to an acute hospital bed. It is a great example of partnership working.”

Early Intervention Vehicle – patient story

The EIV visited Mrs Jones* after she suffered a fall at home in Lowestoft. Her family were unable to get her up from the floor and were concerned her deterioration was linked to a recent diagnosis of brain cancer.

An emergency medical technician and therapist were on the scene in the EIV in just 23 minutes, compared with an average response time for category 3 calls of two hours. During a single visit, the team was able to:

  • Carry out immediate medical and therapy assessments to rule out conditions such as sepsis and stroke, which would need urgent hospital attention
  • Dress Mrs Jones’ wounds
  • Supply a commode and train family members to help Mrs Jones use it safely
  • Rearrange the furniture so that Mrs Jones could get to all areas of her home safely
  • Provide specialist equipment to reduce the chance of Mrs Jones developing pressure ulcers
  • Refer to social care so that family members could receive a carer’s assessment and any additional support they may need
  • Liaise with patient transport so that Mrs Jones could get to a planned neurology outpatient appointment the next day
  • Refer to the neuro rehab team for specialist follow up
  • Ask Mrs Jones’ GP to consider a referral to investigate difficulties with swallowing and communication
  • Provide an alarm and key safe to improve safety and allow health professionals to get into the house when the family are out
  • Carry out a variety of tests, such as a urine check, osteoporosis screen and nutrition assessment, so that further action could be taken where necessary

By working together, the EIV team was able to prevent an inappropriate hospital admission and put additional equipment and support in place to help Mrs Jones remain at home safely. Within a short space of time they also carried out multiple assessments which otherwise would have taken several weeks to complete, in turn improving Mrs Jones’ quality of life by allowing treatment or interventions to begin immediately.

* Mrs Jones’ name has been changed to protect her identity

  • Summary:

    An innovative scheme which sees the region’s ambulance service and healthcare partners in Great Yarmouth and Waveney keep patients at home following a 999 call is expanding to operate seven days a week.