Ambulance service supports 10,500 patients with telephone care at home

Paramedic Catherine Slate works in NWAS’ clinical hub undertaking telephone assessment and advice for patients.

More than 10,500 people across the North West avoided an unnecessary trip to hospital in April thanks to telephone clinical assessment and advice from the ambulance service.

North West Ambulance Service (NWAS) has a team dedicated to ‘hear and treat’, which involves getting back in touch with people who have called 999 and are not in a serious or life-threatening situation but could benefit from the right care at home without an emergency ambulance or trip to hospital.

The clinical hub, which comprises paramedics, nurses, pharmacists, mental health professionals, dispatchers and administration staff, will assess callers before arranging the right care for their needs. In most cases, this would be general self-care advice or a referral for safe care closer to home through a local primary care or community care service.

In the three months from Feb-April 2020, NWAS hear and treat rates increased by 35%. During April 2020 alone, at the peak of the COVID-19 pandemic, 10,616 patients received telephone self-care advice or onward referral – a 30% increase year-on-year.

As well as supporting patients, the clinical hub offers telephone advice to paramedic emergency service colleagues who are on scene with patients. It assists with decision making and can advise on locally available services, which may be appropriate to care for the patient if the face-to-face clinical assessment has determined they are well enough to avoid a trip to hospital.

The increase in hear and treat reflects efforts by NWAS to boost its workforce in response to COVID-19 pandemic and ensure emergency resources remain available to attend serious incidents. Remote and home working was implemented to support clinical hub colleagues at increased risk of illness to remain at work, while maintaining service capacity.

John Kelly, Clinical Hub Service Delivery Manager for NWAS, said, “The increase in hear and treat is significant, as it comes during a period when demand was intensified. We always want to deliver the right care, at the right time to patients and to ensure we can quickly reach those who need us, we should only send an ambulance when it is clinically required – not everyone who calls 999 needs an emergency response.

“The clinical hub continues to care for those patients who, despite not being in a life-threatening situation, still need our help to get the most appropriate support available to them.

“It’s important to highlight that in many cases, the clinical hub will refer patients to other local services in the community, which individuals may have been able to access more quickly themselves. Therefore we ask members of the public to consider carefully which health service would be most appropriate for them before dialling 999 – if the problem is not a life-threatening emergency, please visit for urgent care advice or speak to your GP or pharmacist. This helps us keep 999 free for the most serious incidents.”