Date

Roving Admission Avoidance Car

Type sub heading here and author name

East of England Ambulance ServiceNHS Trust

Date

East of England Ambulance ServiceNHS Trust

Type sub heading here and author name if required

RAAC • The role of RAAC is designed to

complement existing clinical teams.• The RAAC clinicians should ultimately

be in a position to make autonomous clinical. decisions within their scope of practice

• The RAAC works across all traditional boundaries of emergency care.

• The RAAC role should aim to have an impact on the pathway and through out the patient journey.• Reduce A&E attendance’s by treating patients at the scene• Reduce waiting times in A&E and acute care as only those patients needing treatment in this environment would attend hospital

Date

East of England Ambulance ServiceNHS TrustRAAC

HEOC Referrals: The HEOC are to pass all information relating to the referral to the clinician including the

clinical information gleamed through the triage. Operational Referrals:

When RAAC accepts an operational referral, the RAAC clinician is to advise the HEOC that they are mobile to the call (This is to ensure clinician safety and wellbeing).

EEAST Call handler (Non Clinician) processes call and call is coded using the

MPDS software

HEOC refers the case to RAAC.

RAAC to report outcome to HEOC upon completion. RAAC clinicians are to contact patients GP and or OOH where clinically appropriate

Low acuity agreed codes are passed to the Clinical Support Desk G3 & G4 calls

Referral from EEAST operational staff who have attended patient deemed

clinically suitable for RAAC criteria for advice or visit. Crews to contact the

RAAC clinician to complete a clinician to clinician referral.

Local schemes may receive referrals from EAU consultant or senior community

nurse/APS

CSD Clinician acquires further information and re-triages the call using

(PSiam support software). The clinical outcomes could be

alternative pathway referrals, self help advise, ambulance dispatch or a referral

to the local RAAC scheme.

RAAC clinician is to provide face-to-face assessment. Assess, treat, refer, review or provide welfare checks.

(RAAC will not telephone triage calls once referred by HEOC but may prioritise the order

they see patients based on clinical need)

If RAAC unable to accept due to workload (following discussion with

HEOC) the call will be passed to dispatch for a conventional response in

accordance MPDS coding and triage. RAAC will aim to see patients within 2

hours of referral

Some high acuity calls will be passed to the ECT desk and re-triaged to ensure appropriate

resource/response. The clinical outcomes could be an ambulance response or the

call referred to the Clinical Support Desk

999 Call Received by EEAST

Appendix 1

RAAC referral process

Version Number: 1 Owner: Teresa Church

Operational From:

14th October 2014

Review Date: 31st May 2014

Applicable to:

A/E Operations & HEOC

Distribution:

North Sector Staff, In Touch, Need to Know and group email

Introduction The North Sector is working with the clinical commissioning groups within health and social care to reduce the total number of unplanned hospital admissions and ambulance conveyances to hospital. One of the key building blocks of the new urgent care pathway is to improve access to specialist community services. Underpinning this ambition is the need to improve the existing delivery of care to people at risk of admission and to provide care alternatives to the acute settings. The CCG’s and EEAST are committed to managing urgent care demand by commissioning a model of urgent care that integrates the health and care system to deliver –

“The Right treatment at the right time in the right place” The service goal is to reduce unnecessary conveyances to hospital through a bespoke see and treat service. This instruction will explain the process and framework of operation. Scope Within the North Sector there is currently one RAAC scheme which is being staffed by Specialist Paramedics. The area they are working in is East Suffolk in collaboration with I&ESCCG. Area Call Sign Hours of Operation* RAAC Contact numbers Suffolk East NRAC01 0700 – 0100 x 7 07740 256051 Suffolk West NRA642 1100 – 2300 Mon/Fri

1100 – 2300 Sat/Sun 07753 722830

*Please note hours of operation may vary, please contact the HEOC to confirm if the RAAC car is booked on duty. The RAAC will work flexibly within the North Sector in their commissioned areas of East and West Suffolk. The service will provide a responsive (aiming to attend to a patient within 2 hours), high quality, safe and appropriate service in a patients’ home. This service is intended for patients with immediate primary care needs who require early assessment and work up with dedicated clinician time. Skill sets on each RAAC may vary however the resource should be approached to see if they can assist.

Operational Instruction (OI) 135 Roving Admission Avoidance Car – North Sector

• RAAC operates 0700-0100 Sun-Thurs 0700-0300 Fri-Sat

• East Suffolk catchment area• Contactable: 07740256051• ‘See & Treat’ service• Aim to see patients within 2 hours• Skilled in primary care• PGD’s allow to administer a range of primary care drugs & TTA’s• ‘Right treatment, right place at the right

time’• Respond to R1 calls (life threatening)• Reduce number of ambulance

conveyances• Reduce front door activity at hospital• Support frontline staff with decision

making• Work alongside APS