The impact of an admission avoidance rapid response respiratory car in collaboration with the Northwest Ambulance Service

Abstract

Background: Respiratory disease affects one in five people in England and is ranked the third biggest cause of death, with mortality rates higher in disadvantaged groups and areas of social deprivation (NHS Long term plan, 2019). This is associated with increased smoking prevalence, high levels of air pollution and poor housing conditions. Health inequalities in respiratory conditions present challenges to clinicians, particularly those based within emergency care and the ambulance service. Such services play a vital part in improving patient experience and reducing the strain on the system, especially within the emergency departments nationally (The National Ambulance Commissioners Network (NACN), 2015).

Aims: To provide ‘hospital expertise’ within the patient’s own home. Operational 10 hours per day, 7 days per week, between October 2019 and March 2020. The service aimed to review all 999/111 calls which generated a category 2/3/4 response from NWAS which was coded as a ‘respiratory’ call, including shortness of breath.

Methods: A retrospective population study using statistical data was undertaken, whilst the respiratory car was in operation.

Results: In total, 542 contacts were made. This resulted in 231 admissions avoided, 177 of which were respiratory in nature. With the average cost per admission being approximately £1000, it can be assumed a significant saving of £231,000 was achieved.

Conclusion: We are taking ‘hospital expertise’ into the patient’s home. Partnership working can promote improved services for patients with respiratory disease and prevent unnecessary hospital admissions.