Benefits to Ambulance trusts

NHS Pathways supports ‘hear and treat' by enabling referral to primary care on the first point of contact, thus avoiding the need for a separate queue of Category C calls, waiting to be re-triaged by clinicians using a separate system.

The link to the integrated Directory of Services offers real time information on all the clinical skills available within any given area; each entry on the directory is maintained by the primary or acute care service.

This means the Ambulance Trust can see and access up-to-date data at any given point, without the need to employ staff to gather and maintain an in-house directory. This enables greater integration of the ambulance service in the local health community within which it works.

There is also evidence that NHS Pathways can offer more appropriate sorting of 999 calls. Independent academic evaluation identified that NHS Pathways offered sorting levels to Category A calls around 10% lower than the national average.
The Ambulance Services have more choice over how they answer 999 calls.

The first pilot at the North East Ambulance Service is currently avoiding approximately 2000 inappropriate ambulance journeys each month, through the use of NHS Pathways and Directory of Services to triage 999 calls.

Data from the use of NHS Pathways and Directory of Services within the ambulance service offers commissioners real time data on the actual services required by a population; providing the ambulance service with evidence to support discussions on performance, operations and funding.

The ability to redirect callers to an appropriate primary care service when they call 999 is currently avoiding 2000 inappropriate ambulance journeys a month in the North East.

Benefits to commissioners

NHS Pathways provides commissioners with an option to enable consistent clinical assessment, no matter where callers choose to ring. Coupled with the integrated Directory of Services, this ensures all callers are directed to an appropriate level of care as close to home as possible.

This ensures best use of services, minimises inappropriate use of higher cost services, and allows demand to be moved around the system. At any given point call handlers can, if commissioners choose to use this functionality, see the relative capacity displayed in a simple colour format (Red/Amber/Green) of any given service. If necessary they can refer patients away from those experiencing pressure to those services with capacity, as well as the skills to meet the needs of the patient.

The use of NHS Pathways and its integrated Directory of Services allows generation of data for commissioners on the gaps in their service provision e.g. data on the clinical skills required, by time of day or night, by postcode and in particular, the skills required for which no primary care service was available.

This will enable commissioners to identify the changes required to commissioned services and maximises the use of available resources.

All primary care services can be added to the Directory of Services and commissioners have the option to choose opening times, clinical skill sets and capacity available at each service.

Commissioners can receive detailed data showing actual clinical skills needed in the area, by time of day and postcode.

Benefits to patients

After a comprehensive review, the Department of Health licensed NHS Pathways for use in 999 control rooms, bringing a number of benefits to patients.

These include:

• More patients go to the right place, first time.
• Reduced delay in accessing appropriate care.
• Improved patient experience – they may feel less anxious than when waiting for a call back.
• Reduced re-triage – there is less need to repeat information to different people on the phone whilst trying to get access to the right care.
• For callers who ring an urgent care line, not 999, NHS Pathways offers the ability to dispatch ambulances for the very ill in no more time than if they had called 999 directly – this means, no delay and no re-triage.

System benefits

NHS Pathways is a suite of clinical assessment content, for triaging telephone calls from the public, based on the symptoms they report when they call. Structured symptom based flows determine the clinical skills required, and the timeframe in which they must be accessed.

In summary:

• As an assessment progresses, the system collects ‘markers' that identify if a particular clinical skill will be required to treat the patient. These markers map seamlessly against a record of clinical skills in primary care services, local to the patient using the integrated Directory of Services. This enables the call handler to offer the caller details of a service local to the patient, open and with capacity to provide the clinical skills needed.
• NHS Pathways offers the NHS the means to achieve the ultimate strategic aim of national clinical assessment and referral to a specific local service – all on first point of contact.
• NHS Pathways can be integrated with existing systems and technology.
• NHS Pathways provides one common clinical assessment.