Ambulance services: improving access to clinical information

Ambulance services across England responded to nearly 9 million 999 incidents in 2021. Of these, 80% involved a face-to-face attendance, and in 52% of all incidents, patients were conveyed to the emergency department.  

In addition to 999 services, some provide 111 and non-emergency patient transport services (NEPTS). They provide treatment in multiple settings, both over the phone and in person. Providing treatment options, guidance and assurance, they are often the sole provider in an episode of care. 

Our research has identified that many ambulance services lack access to sufficient clinical information about their patients at the point of care. There is an increasing need for accurate patient information to support decision making and support referrals into the expanding number of pathways that accept direct referrals from ambulance services.

Interoperability across data, systems and services will play a significant part in the evolution of urgent and emergency care, developed in partnership with commissioners and other provider types. This will contribute to reducing the number of non-elective acute admissions. 

The PODAC Team is working with digital leaders and system suppliers within the ambulance service to:

• encourage adoption of common standards
• promote adoption of national systems such as Summary Care Record, Summary Care Record Application, GP Connect
• help them integrate with Shared Care Records

These methods will increase digital interoperability and make it easier to access clinical information held by other health services.

Access to clinical information

Increasing access to clinical information for direct care has been identified as a priority for the ambulance sector.

This includes enabling clinicians to access a patient's Summary Care Record (SCR), which will allow them to view information such as allergies and adverse reactions, current medication and personal details, for example their address, at a minimum. The mobile nature of the ambulance workforce presents significant access problems, as do the existing authentication methods to access SCR. Work is underway to understand the current baseline of SCR usage within the ambulance service, identify barriers to access, and how to overcome them.

Access to clinical information will benefit ambulance services through:

• improved patient experience (accessibility and convenience)
• better outcomes for individuals and improved population health
• reduced risk of errors and harm to patients
• greater efficiency for staff
• increased system productivity

The Future Enterprise Architecture for ambulance services is a conceptual service blueprint to inform the development plans for IT system suppliers. It was developed through extensive strategic stakeholder, service user and supplier research during 2021 and 2022. It supports technology providers to define their product roadmaps to address user priorities. It also supports them to maximise the benefits from current and developing technologies and standards in the market. 

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