Firstly apologies for the delay – I haven’t done a blog for a few months, I got too busy at work and at home and had to let a few things go which did not come easily to me but was necessary.  To save time I did consider getting ChatGPT to write this for me as it seems to the be the trendy thing to do but in the end I decided against it …….or did I????? I guess we’ll never know…

Since my last blog I’ve been to Disney Land, had a near miss accident where a jet ski crashed in to my car (final destination!), my Grandad passed away peacefully, I got a new job and had to tell everyone I was leaving which was hard, started a loft conversion (huge mess), my youngest Fred lost his first tooth (thankfully the tooth fairy remembered), I got elected to the CIO advisory panel as vice chair which is exciting and we won a HSJ award for SMART sites (well done Matt and team!). And so life continues…

I have less than 2 working weeks left at NWAS and I wanted to write now about my reflections on the ambulance service which I have had the privilege to work for for the last 4 years before I start my new chapter at Lancashire and South Cumbria NHS Foundation Trust in September.

Our purpose at NWAS is ‘to be there when people need us most’. And I guess for any of us working in or with the NHS that’s why we do it – to help people, to save lives, to improve the health of our communities. But there is something about urgent and emergency care which means you literally are there – always, within seconds – when people need you. I wrote previously about my own experience and those times when 111 and 999 are the services always there to pick up the phone in our times of need whenever that may be. 

But the ambulance service is much more than answering the phone quickly and sending out ambulances – it is both a gateway to the urgent and emergency care system at large and our resilience and readiness to respond to major incidents and protect our public not forgetting in addition the Patient Transport Service who provide vital support for vulnerable patients who would not otherwise be able to travel to get the care they need. 

What opportunities does your ambulance service bring?

I recently did a presentation on the national CIO call in the ICS slot about this. In the North West our regional colleagues have helped us position ourselves as a system recognising both the complexities and opportunities that come from our scale across 4 ICBs. So what are these opportunities? Well here are my thoughts – based on my experience and from a largely digital point of view. 

Shared Care Records: I remember in my interview talking about how, in theory, we should be able to influence across the North West due to our size and the biggest opportunity for this has been shared care records. Your ambulance service is a great use case for the federation of shared care records across ICBs. In the North West we are part way through a piece of work to connect our shared care records through PRISM (Pan Regional Information Sharing mechanism). The technical work is done and we are now moving on to live information sharing. This will provide NWAS with a single point of access to all of the shared care records in the North West and enable us to share information back out in to the system ranging from real time information for Emergency Departments to notifications to GPs when we’ve seen their patients. Although NWAS is a big use case PRISM will be able to be used far beyond us, for specialist trusts and providers who treat patients across borders.

System Referrals and Intelligence: 111 is truly an exemplar of what is possible in terms of referral capability and we have a fantastic team of innovators in our 111 service leading the way nationally. On calling 111 the team can access your GP record and do anything from ordering a repeat prescription to booking an appointment with an appropriate service ranging from GPs to Mental Health and other services through to an appointment at an Emergency Department. This happens digitally using the Directory of Service (DOS). I’ve been so proud of the work our DOS team have done to develop this service now implemented in 999 also. They have really led the way and we are now the test site for the new national Booking and Referral Standard (BARs). There is huge opportunity for us to use the information we have in 111 to understand the patients journey through the healthcare system.

Resilience: I’ve said before in my blogs that I think there is a lot the wider NHS can learn from the ambulance service about resilience. Both in terms of readiness to respond to a major incident but also in understanding what a resilient digital infrastructure looks like. As a Category One Responder under the national Civil Contingencies Act there is a requirement to run a fully resilient service. This means we have a fully resilient set up enabling failover across multiple sites, multiple backup solutions ready to fail back to and advanced capabilities nationally to pass calls within seconds across to another service if one service is down. With the possibility of cyber incidents increasingly likely and the increased focus on telephony access in primary care and other services such as Mental Health there is definitely potential to collaborate with and learn from the ambulance service.

Collaboration on Innovation: Our focus at NWAS has been on building partnerships to support small scale testing with a focus on rapid scale up. At NWAS we have a number of pilots underway in collaboration with NHS partners, industry and academia with a focus on scale up built in to the evaluation. Ranging from point of care testing, drones, AI to SMART patient centred ambulances. It is worth noting also that there are only 13 ambulance services in the UK providing a great opportunity for more manageable scaling of new ideas. This is something the ambulance services themselves are working on through the National Ambulance Innovation Forum (sub group of AACE) which I’ve thoroughly enjoyed chairing.

These are just a few of my reflections and there is so much more I could say but I guess they’re my top tips for how you might think differently about your ambulance service.

Over the last 4 years I’ve been able to support the digital teams in collaboration with other directorates, clinicians, patients and industry to transform our digital infrastructure (see previous blog: level up but reach for the moon). Some of this has taken time, there are still some basic things to finish (digitising HR processes for example will continue) and innovations that need more testing and development. In the next few weeks all frontline crews will have the new EPR (phase 2) on their Personal issue iPad with access to the GP record and the new SMART tech on stations. The architecture we’ve developed over the years to enable safe access to our critical systems remotely will enable our new clinical model as part of the Urgent and Emergency Care recovery. I look forward to hearing about the significant time saved when we get digital referrals from scene in place (don’t take no for an answer Jay!), how we’ll use the algorithm (once refined) that we’ve developed that can predict the outcome of a call and support risk stratification, how virtual reality training could support our readiness for major incidents, and I know we have the people, the partnerships and the belief to get these things over the line. 

I have absolutely loved my time at NWAS. I’ve made good friends and worked with so many inspirational, dedicated and talented people across the trust. I am more proud that I can express of the digital teams I’ve had the pleasure of supporting over the last 4 years. Every single one of them is there to make a difference for patients and staff. It’s been a relentless 4 years, not least due to my constant pushing for us to improve things, but the digital teams have never said no, have always found a way, they’ve kept us safe and shown me what is possible and have achieved outstanding results. It’s been an absolute honour and I will truly miss you all.

And so as one chapter closes another begins – I’ve already met some fantastic people from LSCft and can’t wait to get stuck in in my new role as Chief Digital and Infrastructure Officer. Watch this space to see how I get on! 

So long….