Surge in ambulance demand in Shropshire prompts investigation
An action plan is being developed by Shropshire CCG to help address a surge in demand for ambulance services in the county.
A new ambulance demand and pathways group has carried out a 'deep dive' analysis of ambulance activity to determine the nature of the increase and the key drivers for it.
It was led by Shropshire Clinical Commissioning Group and included other local health organisations, as well as NHS regulators.
A report to Shropshire CCG's governing board, which meets today, says over the last 12 months Shropshire and Telford & Wrekin have recorded higher than expected increases in ambulance demand.
It says at this stage no direct causal link can be established between the increase in demand and any changes in service delivery locally.
Split
The review found the rise appears to be a continuation of a growth trend reported before the county's Shropdoc telephone service was replaced by NHS 111 last July.
According to the report, it changed the proportional split of ambulance demand by source, with an increase in dispositions from NHS 111 and a reduction from 999.
It says 70 per cent of the ambulance generated A&E growth was in the out of hours period and was the highest at Princess Royal Hospital in Telford.
The review found that a large number of patients conveyed to Shropshire's A&Es were discharged rather than admitted and there may be other potential ways to manage similar patients in the future.
The report says: "During the 15 months Oct 17 to Jan 19, there were 24,095 ambulances to Royal Shrewsbury Hospital and 26,477 ambulances to PRH.
Alternatives
"Almost half of these ambulance arrivals were discharged rather than admitted.
"Further review of A&E data suggests that 24 per cent of cases discharged from PRH and 13 per cent of cases discharged at RSH have no treatment/investigations or advice only.
"This indicates that there is potential for a proportion of these cases to be managed through alternative pathways to acute and the ambulance group is undertaking further work to determine if there are viable alternatives which could be put in place, where possible using the learning from other areas."
Changes to Shropshire's ambulance services also mean patients are no longer taken to the hospital closest to where they fall ill.
West Midlands Ambulance Service is now operating a system where it can look at how busy hospitals are and can choose to take patients to a hospital where they can be seen more quickly.
New figures show that there was a reduction in ambulances waiting more than an hour to hand over patients at PRH and RSH in March.
There were 188 delays of over an hour, compared with 308 in February.
The ambulance demand and pathways group is now developing an action plan from its findings.
