ABSTRACT

The Welsh Ambulance Service NHS Trust (WAST) manages more than 500,000 calls every year, with its emergency ambulance staff attending more than 250,000 of these calls. WAST currently uses the Medical Priority Dispatch System to process its 999 emergency calls and is an accredited centre of excellence. WAST employs experienced nurses and paramedics to undertake 999 secondary telephone triages of 1) low acuity patients, 2) patients awaiting an ambulance response, and 3) patients whose condition may be managed effectively by an alternative to an ambulance. In 2019/2020, WAST 999 telephone triage nurses and paramedics cared for 6.3% of emergency callers without needing to dispatch an emergency ambulance response; through onward referral, advice, support, and the provision of telephone-based treatment options. WAST Nurses and Paramedic are currently supported somewhat in their telephone triage practice by a limited number of PDF-based triage charts that are not digitally integrated into any primary systems and provide no data. Audit remains a very manual process. WAST has identified an opportunity to improve the care it provides to its patients, improve the support it provides to its nurses and paramedics undertaking this practice, and improve the digital integration with the wider health economy. This paper presents a proposal for WAST, to the International Academies of Emergency Dispatch, for the implementation of the Emergency Communication Nurse System, for use by its 999 call centres by nurses and UK paramedics. It outlines the possible benefits of using ECNS in the UK ambulance context, how its early use can be measured in terms of quality, safety of care, and meeting the needs of thepopulation. It outlines the justification for the proposed novel approach of allowing UK registered paramedics to use ECNS and how this might be implemented.