Most United Kingdom (UK) ambulance services undertake remote clinical consultation of 999 emergency calls, often using computerised decision support systems, such as the Emergency Communication Nurse System (ECNS). In 2021 the Welsh Ambulance Services NHS Trust implemented ECNS in a novel way. Both nurses and paramedics used the tool to assess the full range of Advanced Medical Priority Dispatch System (AMPDS) codes and acuities. This study reports the ECNS outcomes of the full range of AMPDS codes, aiming to inform future discussion, protocol evolution, and clinical models internationally.

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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...

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