Paramedics told to treat patients at home to keep wards clear
Now wounds, infections and breathing problems ‘may NOT warrant hospital’...
AMBULANCE crews have been ordered to treat more patients in their own homes under new plans to cut attendance at A&E.
Amid fears that Covid-19 will pile pressure on the usual winter demands and leave the NHS ‘stretched like never before’, paramedics are being urged to keep people out of casualty departments whenever possible.
Instead of being taken to hospital, patients will receive treatment such as wound-dressing, or the administration of oxygen or intravenous fluids, in their own homes.
Specially trained ‘advanced paramedic practitioners’ will deliver more medical treatments than standard 999 staff.
Meanwhile, A&E doctors will be available over video link to help with diagnoses and treatment plans.
Patients with various physical injuries and wounds, infections, respiratory problems, mental health concerns and pain caused by a range of different conditions will, when possible, be treated ‘in a homely setting to reduce unnecessary A&E conveyance’.
Health bosses say the controversial move, outlined in the Scottish Government’s Winter Preparedness Plan, will reduce pressure on hospitals and safeguard vulnerable groups.
The Scottish Ambulance Service (SAS) has been allocated up to £10.5 million in extra funding to put extra resources in place, but opposition politicians have cautioned against putting added pressure on already overstretched paramedics.
The 2020-21 winter strategy, published at the end of last month, warns that the country is set to experience ‘further peaks’ of coronavirus and hospitals have been ordered to repurpose 3,000 acute beds for Covid patients.
It states that ‘continued access to urgent and emergency services will continue to be a priority’ for the
NHS throughout the pandemic.
But it lists a number of ‘outcomes’ to reduce hospital footfall, including ‘more care at home’.
A new ‘urgent care pathway’ has been put in place, it states, to ensure that people are seen in the ‘most appropriate healthcare setting for their clinical need’ with ‘as early access as possible to a senior clinical decision-maker, as close to home as possible’.
This will ‘reduce the need for attendance at A&E services and, where possible, avoid emergency admissions, keeping patients and staff safe from the risk of crowding in busy waiting areas’.
An SAS spokesman said: ‘Patients who, following clinical assessment, do not require immediate hospital care are often suitable for care and support at home by communitybased services.
‘Guidance and training has been developed, aimed at working with patients and carers to agree the best outcomes for patients and delivering the necessary support.
‘Our aim is to increase our support to patients in community settings where this is the right thing to do.’
The spokesman insisted that the most serious emergency cases will always still go to hospital.
Ambulance staff have welcomed the move towards home care.
David O’Connor, regional organiser of the Unison union, said: ‘Ambulance crews have been heroes through this pandemic. They have been struggling with the increased demands caused by Covid-19 and now that we have a second wave, the demands are increasing.
‘Despite improved PPE, the number of Covid-19 cases within the service continues to rise, putting more pressure on the workforce.
‘Paramedics are working carefully with the Scottish Ambulance Service and health boards to deliver more care and assistance at home and reduce unnecessary trips to accident and emergency.
‘This is beneficial for patients and frees up capacity.
‘Crews have a direct link to doctors and A&E departments, which allows them to discuss the patient’s condition and best way in which to treat them. If a patient requires hospital treatment, or there is any question over whether they need to go to hospital, then they are taken to hospital. There has been no change in the criteria for taking someone to hospital during the pandemic.’
While A&E visits fell by more than half at the start of lockdown, 999 callouts have remained high throughout the pandemic.
Scottish Tory health spokesman Donald Cameron said: ‘Ambulance workers have been on the front line of the fight against Covid-19 from the beginning. They are already under considerable stress. They cannot be expected to go further than they already are, unless the Government is prepared to increase staffing levels and provide more training as a matter of urgency.
‘We need the Government to provide clarity on what exactly they’re asking paramedics and ambulance technicians to do.’
A Scottish Government spokesman said: ‘We are committed to supporting the ambulance service’s intention to provide healthcare at home or in a community setting wherever possible and when this is in the patient’s best interests.
‘Decisions on whether a patient requires to be taken to hospital will be made by clinically trained staff. Safety is always the priority.’
‘Crews have been heroes through this pandemic’