1. SCOTTISH AMBULANCE SERVICE Managing demand across Scheduled and Unscheduled Care Peter Ripley Director of Service Delivery

2. Background The Service employs 4,300 staff Responds to 600,000 unscheduled care calls per year Undertakes 1.6 million scheduled care patient journeys per year Staff based at over 170 locations

3. There are three Emergency Medical Dispatch Centres (Glasgow, Edinburgh and Inverness) 3 Special Operations Response Team’s Four Air Ambulances

4. Generally the Service coped really well despite the challenges Comprehensive planning With good communications We improved response times for life threatening calls across Scotland to an average of 6.9 minutes versus 7.2 minutes the previous year – this is world class! Introduced the new Resource Escalatory Plan Overview

5. Preparation for Winter Demand & Capacity Planning – Nationally & Divisionally Strategic Coordinating Centre Winter Event Planning Pandemic Flu arrangements Resource Escalatory Action Plan (REAP)

6. Strategic Coordinating Centre SCC operating 24/7 during key periods (REAP Level 4 +) Regular briefing reports to managers, health boards and to the Scottish Government Support from voluntary agencies in the SCC Co-ordination of four wheel drive capability Provision of specialist vehicles

7. REAP REAP Level 6Potential Service Failure REAP Level 5Critical REAP Level 4Severe Pressure REAP Level 3Moderate Pressure REAP Level 2Concern REAP Level 1Normal Service

8. Positive attitude of staff and managers Staff and staff side worked with the organisation Huge effort made by staff to get to work Sickness levels reduced Excellent support from PTS staff, both in and out of normal working hours ‘Buddy’ system with other ambulance services Staff support

9. Partnership working with NHS organisations Regular communication with health boards & NHS 24 to agree local priorities With hospitals for patient admissions, transfers and discharges With hospitals for Scheduled Care Liaison with GPs and local hospitals BASIC’s

10. Partnership working with other agencies Support from voluntary agencies, providing staff and vehicles NHS24 support at times of peak demand SAS managers triaging calls in police control rooms Liaison with other UK ambulance services Local authorities Met Office

11. Communications with the general public Communicated key messages through the media from October onwards Emphasised the increased demand over the winter period Focussed on not drinking to much alcohol Signposting patients to other suitable alternatives e.g. NHS 24

12. Key Learning More effective engagement and involvement in planning with Local Authorities Improved demand and capacity planning REAP triggers and understanding Call handling capacity for clinical triage Better planning for accessing renal patients Tactical use of 4 x 4 assets National co-ordination but meeting local need

13. Key Learning Work with Acute Hospitals looking at elective planning Involvement where wards are being closed to new admissions Treating patients nearer home to reduce inter hospital transfers Managing the impact of reduced medical cover at rural hospitals Need to use Met Office services e.g. they have tools to predict changes in demand by condition as weather changes

14. Thank you