Health Service Journal
ENGLAND — Commissioners have criticised ambulance trusts for not delivering appropriate patients to urgent care centres instead of A&E departments in some parts of the country.
At a conference on avoiding hospital admissions in London last week, speakers said risk aversion by ambulance trusts was a factor in the low attendance at urgent care centres.
I have never met such a risk averse organisation as the North West Ambulance Service. It is slowly starting to change but it is about culture
Dr Hugh Reeve, chair of the West Morland Primary Care Collaborative social enterprise, criticised the North West Ambulance Service in particular.
He said: “I have never met such a risk averse organisation as the North West Ambulance Service. It is slowly starting to change but it is about culture. It is apparently different in the South West.”
He went on to describe ambulance crews in his part of south Cumbria sometimes having to spend half a day taking a patient to an acute hospital in Lancaster with a level of injury that an urgent care centre could deal with.
A director at one Midlands primary care trust, also attending the conference, agreed, saying his organisation was struggling to direct paramedics away from A&E to the urgent care centre.
But NHS Confederation’s Ambulance Services Network director Jo Webber said there was an expectation among patients that paramedics would deliver them to an A&E, and that the trusts had their own triage measures in place.
She said: “The bottom line is people expect an ambulance to turn up and for them to be taken to A&E. One man’s risk aversion is someone else’s doing what the patient would want them to do.”
North West Ambulance Service medical director Kevin Mackway-Jones said it was improving staff training so “more complex disposition decisions to be made in the difficult pre-hospital arena”.
He said: “We will continue working with acute and community providers to safely extend the options that our staff can access for the benefit of patients.”
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