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Critical care paramedics can save more lives and cut costs

A study of specially trained paramedics at South East Coast Ambulance Service NHS Foundation Trust reveals they save lives and do so at lower cost than the alternatives.

The study, published on 11 March, looked at the use of paramedics at South East Coast Ambulance Service NHS Foundation Trust. New critical care paramedics (CCPs) have been given extra training to deal with the most acute cases such as serious car crashes and stroke.

Cost benefit analysis

The study, available in our publications library, includes a cost benefit analysis which shows that introducing CCPs helps reduce avoidable deaths and save lives. It also shows that they offer much better value for money.

The study’s analysis sets out the value of life saved using CCPs is just over £34,000 – more than £200,000 less than an equivalent doctor-led team. CCPs would also easily pass the National Institute for Health and Clinical Excellence (NICE) cost effectiveness standards for a new treatment.

The trust trained 25 CCPs with skills to use a wider range of drugs and advanced airway management. They focus on the most urgent of cases in teams that allow for better coordination with local acute hospital services.

Melbourne model of care

The CCP initiative is based on a model of care developed in Melbourne Australia which saw paramedics with advanced clinical skills being used on ambulances. Such paramedic-led systems have higher survival rates for trauma patients - up to 20 per cent higher in north America for example.

The CCP model is just one example of ambulance services run services using the advanced clinical skills of their staff to give patients high quality care. The NHS Confederation believes this study will make important reading for new GP-based commissioners.

Online webinar 17 March

Join our online webinar on Thursday 17 March to discuss the findings and lessons from the CCP programme evaluation at South East Coast Ambulance Service NHS Foundation Trust. 

The webinar between 12 midday and 1pm is free to members and you can participate or join as a spectator. 

Find out more on the event web page.

ASN and trust comment

Jo Webber, director of the Ambulance Service Network (ASN), said: “Critical care paramedics are part of the future of the ambulance service where patients get high quality clinical care rather than stabilised and taken to the nearest A&E department. Lives are being saved that otherwise would not be as a result of this work. Increasingly, ambulance trusts up and down the country are looking to use specially skilled clinicians to provide high-quality care, coordinated with the rest of the NHS to patients.”

Modern ambulance service capabilities growing

“Our report highlights that not only are lives being saved but also that this is an extremely cost-effective way of providing care. The clinical capabilities of a modern ambulance service are constantly growing and this report offers an insight into what ambulance trusts are doing to improve the quality of care for patients."

And Professor Andy Newton, consultant paramedic and South East Coast Ambulance Trust’s director of clinical operations said: “We know as the NHS we must improve the care we provide to critically ill and injured patients. Research suggests that nationally, between 450 and 770 trauma related deaths are avoidable. This in our view is simply unacceptable.

Delighted

“We therefore wanted to develop an initiative to improve the care we provide to these patients, thus improving their outcomes and so the CCP role was born. We are therefore delighted that the Confederation’s report recognises the benefits of this key paramedic role in improving outcomes for the critically ill and injured.

“We have reached an important point in the development of  the CCP and now have a much clearer insight into the all important health economic aspects of the initiative thanks to this work.  We must now develop our CCPs to their full patient care potential in order to continuously improve outcomes for this key group of patients, while also undertaking further research and evaluation to better understand  the contribution and advantages such innovations in patient care can bring to the communities we serve and the NHS.”

Read the study

Download Critical care paramedics from the NHS Confederation publications library.

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