North East Ambulance Service

NEAS operate across Northumberland, Tyne and Wear, County Durham, Darlington and Teesside. NEAS provide NHS 111 and 999 services to over 2.71 million people and employ more than 2500 staff, including volunteers.

They work closely with health and social care partners, commissioning bodies, emergency services and voluntary agencies. They are at the forefront of delivering new digital technologies and information sharing initiatives in England.

NEAS are one of only three ambulance service Global Digital Exemplars, internationally recognized NHS providers delivering improvements in the quality of care, through the world-class use of digital technologies and information in England.

They are also a member of the Great North Care Record, a new way of sharing medical information across the North East and North Cumbria.

NEAS were one of the first NHS foundation trusts to complete the migration to HSCN, moving over all their connectivity during October 2018. To ensure they took advantage of the benefits of HSCN connectivity as early as possible, NEAS launched their HSCN procurement back in December 2017.  

After a review of their estate and discussion with NHS Digital they chose to use the Crown Commercial Services (CCS) Network Services framework to invite bids from accredited HSCN suppliers. Following a competitive bidding process, with offers from multiple HSCN suppliers, NEAS awarded their contract for HSCN connectivity to BT in March 2018.

In addition to providing increased capacity at a competitive price, BT could also support NEAS to migrate their legacy IP addressing, including support with some historical N2 (the predecessor to N3) addresses. Working closely with BT meant all orders for new HSCN services were placed by June 2018.

Getting started early with their procurement and order placement meant the trust had time to plan and book in their HSCN migration slots at times that were most convenient to them. Migration of their connections took place in early October 2018. After they had completed testing and assurance on the new circuits NEAS were able to stop using the Transition Network (formerly N3) in early November 2018. 

In migrating to HSCN connectivity NEAS moved from a 10mb and a 6mb N3 connection to a 100mb asynchronous connection at each of their sites. The trust chose to put a resilient (back-up) connection in place, providing greater confidence that the trust can still deliver high quality and vital care even in the event of issues with their primary connection. 

Despite increasing capacity by over ten times what was available over N3, the cost of their connections hasn’t increased. Prices have been driven down by advances in technology and multiple suppliers competing to provide HSCN services.

The increased capacity is allowing NEAS to push ahead with digital transformation initiatives that are reliant on fast and reliable network connectivity. These include:

Mobile working and remote video links

NEAS can now equip paramedics with HSCN connected mobile devices. These make video feeds and vital health data available at the point of care. NEAS are also supporting the introduction of video conferencing in nursing homes.

Joined-up health data

NEAS are taking advantage of greater access by linking their health data to patient mental health and care plans - the outcome being safer patient care. NEAS have appointed a new mental health care lead to understand and meet patient needs especially during periods of crisis.   

Increased usage of clinical resources

Reduced latency and improved access to clinical information has increased usage of clinical resources. While on N3 clinicians reported  issues related to oversubscribing Spine traffic – this has not been a problem since the move to HSCN.

Better use of patient management software

Previously, limited bandwidth and high latency caused delays when pharmacists were accessing online medical resources. Moving to faster connectivity has enabled better use of the Medical Interoperability Gateway (MIG) for accessing patient records and direct access to CLERIC software, used for managing patient transport and real-time emergency medical services. Clinicians now have greater support to make decisions because they have better access to pertinent clinical information from a variety of integrated electronic patient databases.

More efficient use of staff

Home workers can now work remotely and access information via HSCN enabled network connections from variety of locations. This helps to create a modern, well-equipped workforce which is more resilient, flexible, and quicker to react to the surges in demand inherent in this type of care.

In the future the trust plans to:

• increase collaborative working with regional partners
• integrate patient records, such as the Great Northern Care record. 
• migrate their existing wide area network (WAN) onto HSCN.
• introduce video conferencing in nursing homes, allowing clinical staff within the call centre to see and assess the needs of patients in more detail than currently possible via over the phone  - the vision is for staff to be able to visually assess a deteriorating patient faster to ensure timely care is provided
• implement new technologies to make the most efficient use of resources, help prioritise ambulance call outs and ensure that they provide ambulance services fastest to those in the most critical need.
• pool data from various care settings and use "big data" analytics to better manage population needs