How appropriate are the data produced by NHS Pathways for identifying suitable cases for involvement of enhanced care teams?

Introduction: Enhanced care teams (ECTs) are a well-established part of trauma systems. However, their success depends on the ability of these teams to arrive at appropriate incidents. It is important to determine which dispatch criteria for ECTs are more efficient at targeting deployment to critically ill patients, and whether the call screening process is adept at supplying information to determine these criteria.

Methods: A service evaluation was undertaken within South Central Ambulance Service NHS Trust, to determine the appropriateness of the nature of call produced by NHS Pathways as a dispatch criterion for ECTs working for Thames Valley Air Ambulance (TVAA) and Hampshire and Isle of Wight Air Ambulance (HIOWAA) charities. Quantitative data (January‐July 2016) were collected from iCAD and NHS Pathways to determine dispatch dispositions for ECTs. In these charities, ECTs may be on Helicopter Emergency Medical Service (HEMS) or a car-based Enhanced Care Response Unit (ECRU).

Results: Of 1171 dispatches, 734 attended scene. This indicates a large overtriage rate for dispatch criteria based on nature of call. The results found in the data analysis support that the nature of call can be highly sensitive but poorly specific. Nature of call based around mechanism of injury (MOI), such as major trauma and road traffic collision (RTC), were the most accurate in the data analysis. Specific dispatch criteria, such as RTC entrapment, were the least accurate, lacking both sensitivity and specificity. This could be due to the size of the dataset, or the data being diluted as both medical and trauma dispatch criteria are pooled for the analysis.

Conclusion: This evaluation supports the implementation of a standard operating procedure (SOP) to establish approximate physiological parameters from patients/bystanders at the time of call, as well as clinicians requesting ECTs advising on physiological parameters prior to dispatch.