{
  "abstract": "Background Urgent & Emergency Care (UEC) Recovery Planning Guidance for 2024/25 set out the need to setup ‘call before you convey’ best practice models to increase Ambulance referrals into alternative pathways to conveyance to an Emergency Department (ED). Wirral and West Cheshire were two areas which experienced long delays in hospital handover at its two EDs, long patient waits in the community and impacts on staff well-being.Methods A quality improvement methodology with PDSA (Plan, Do, Study, Act) cycles was adopted to test initiatives to reduce conveyance by up to 20%. This comprised of Ambulance representatives who linked into local UEC providers. Tests of change included bespoke staff engagement, bespoke communication materials, testing ‘conveyance champions’ and the development of a ‘call before you convey’ pathway with a local NHS Trust. The Wirral went live on 09/12/2024 and West Cheshire followed on 20/01/2025. An evaluation was undertaken following 16/03/2025.Results The percentage of patients not conveyed to ED increased from a year-to-date (YTD) position of 27% to a quarter-to-date (QTD) of 28.3%, equivalent of 4 more patients per day. Ambulance conveyances remained stable at circa 123 patients per day despite variation in daily incident levels. However, direct conveyance to non-ED units (e.g. Same Day Emergency Care) increased by a mean of 4 patients per day. Several lessons learnt were identified through the PDSA cycles, which include better staff education on non-ED pathways, workforce culture challenges and better communication of new initiatives.Conclusion The collaborative established that increased engagement with Ambulance staff on safe alternatives to conveyance to ED, combined with dedicated non-ED pathways, can enable safe care closer to home for more Ambulance patients. Further work is necessary to promote sustainability and explore how it can be scaled up for wider patient benefit.",
  "authors": [
    {
      "affiliations": [
        "North West Ambulance Service NHS Trust, UK"
      ],
      "name": "Steven Scholes"
    },
    {
      "affiliations": [
        "North West Ambulance Service NHS Trust, UK"
      ],
      "name": "Nicola Godley"
    },
    {
      "affiliations": [
        "North West Ambulance Service NHS Trust, UK"
      ],
      "name": "Mark Newton"
    }
  ],
  "title": "PP17 Just 2 more - reducing variation in ambulance conveyance to emergency departments",
  "uid": "3ed12dfd-fffb-5612-933b-4bcae78287ef"
}