VAN
Research type
Research Study
Full title
Understanding variation in rates of ambulance service ‘non-conveyance of patients to an emergency department’
IRAS ID
160559
Contact name
Alica O'Cathain
Contact email
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Ambulance services are experiencing increasing demand for response to emergency calls. In response, they have increased the proportion of patients not conveyed to an emergency department (ED) in order to help manage demand, provide a clinically appropriate service for patients and contribute to reducing unnecessary use of EDs and emergency beds. Alternatives to transporting patients to an ED include the provision of telephone advice rather than dispatching a vehicle (‘hear and treat’), treatment at the scene (‘see and treat’) and transport to other facilities such as a walk in center (‘see and convey elsewhere’). There is considerable variation in the rates of different types of non-conveyance, and in non-conveyance overall, between the 11 ambulance services in England.
We will explore variation in the three different types of non-conveyance in four work packages (WP):
WP1 will identify determinants of non-conveyance in all ambulance services. Undertaking interviews with ambulance service staff and commissioners we will identify potential factors that may explain the variation at a patient, crew and organisational level.
WP2 will undertake a multilevel analysis for each of the three types of non-conveyance using one month of routine ambulance data to test factors identified in WP1.
WP3 will identify the determinants of potentially inappropriate non-conveyance by focusing on re-contacts with the ambulance services for the three types of non-conveyance.
WP4 will address evidence gaps. First using non participant observation, variation in the provision of ‘hear and treat’ will be explored. Second, we will pay specific attention to respiratory problems and non-conveyance in WP1-3.
The main benefits of this study will be to provide guidance for policy makers, health care commissioners and ambulance services about the actions they can take to increase non-conveyance rates while minimising re-contact rates.
The project is funded by NIHR and will last for 24 months.REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
14/NW/1388
Date of REC Opinion
14 Nov 2014
REC opinion
Favourable Opinion