{
  "abstract": "Background Ambulance services, including the North West Ambulance Service (NWAS), are shifting from routine Emergency Department (ED) conveyance towards integrated care coordination that prioritises timely access to appropriate community-based services. NWAS’s Urgent and Emergency Care Transformation team has undertaken audits, evaluations, and staff engagement to identify key challenges and opportunities in supporting this transition.Methods This service evaluation synthesised findings from internal reviews, clinical audits, and stakeholder engagement conducted across the NWAS footprint. Particular attention was paid to the implementation of the ‘Call Before Convey’ model, referral outcomes, and operational challenges in co-ordinating care with external providers.Results NWAS clinicians currently access around 20 external contact points, with wide variation in availability and maturity. Pilots in Greater Manchester demonstrated the benefits of consultant-led hubs and digital integration. However, system-wide care coordination remains hindered by provider capacity, inconsistent escalation routes, limited digital access, and fragmented telephony systems. High rates of Health Care Professional (HCP) and Inter-Facility Transfer (IFT) admissions persist, often without appropriate clinical justification or review. Positive outcomes included enhanced clinical decision-making through referral discussions, improved use of community pathways, particularly for older adults, and reductions in ED conveyance linked to digital referrals and Urgent Treatment Centre (UTC) bookings.Conclusion Integrated care coordination supports safer, patient-centred alternatives to ED conveyance, yet remains inconsistently implemented across regions. Addressing workforce education, digital infrastructure, documentation standards, and cultural barriers is essential. Further development of telephony solutions, clinical escalation pathways, and system interoperability will be key to embedding care coordination into routine practice and reducing avoidable ED attendances.",
  "authors": [
    {
      "affiliations": [
        "North West Ambulance Service NHS Trust, UK"
      ],
      "name": "Nicola Godley"
    },
    {
      "affiliations": [
        "North West Ambulance Service NHS Trust, UK"
      ],
      "name": "Mark Newton"
    },
    {
      "affiliations": [
        "North West Ambulance Service NHS Trust, UK"
      ],
      "name": "Steven Scholes"
    }
  ],
  "title": "PP16 Advancing care coordination in ambulance services: the NWAS experience",
  "uid": "613a3e23-447f-50f1-95b7-ff6dacaa703d"
}