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September 15, 2010

UK ambulance crews reduce hospital transports with 'See and Treat' system

By Lyndsay Moss
The Scotsman

GLASGOW, Scottland — Thousands more Scottish patients who call an ambulance are being treated at home or at the scene rather than being taken to hospital, figures show.

Last year 57,560 patients were dealt with under the "See and Treat" initiative used by the Scottish Ambulance Service (SAS) — up 8,332 (16.9 per cent) on the previous year.

Reducing the numbers going to A&E and being admitted to hospital is estimated to save the NHS around GBP13 million a year. But the SAS insisted that audits of the system showed it was not having a negative effect on patient care, and that those who needed hospital treatment were still taken to A&E.

The figures were revealed at the service's annual review in Glasgow yesterday, chaired by health secretary Nicola Sturgeon.

Use of See and Treat by ambulance crews has increased year-on- year for about the past six years. But George Crooks, medical director of the SAS, said the launch of a phone line linking crews with doctors to ask advice about whether a patient could be safely left at home had increased numbers significantly in the past year.

In 2009-10, 11.1 per cent of patients dealt with by the SAS were seen under see and treat. Dr Crooks said the intitiative could be used in patients with diagnosed epilepsy, who could be checked at home after a fit rather than being taken to hospital. The same system could be used in diabetic patients with non-serious complications, and patients with minor cuts or nose bleeds.

"What we will never do is leave a patient at home where there is a potential risk that the underlying illness will deteriorate, or that they have sustained an accident or injury where there is a chance where their condition will deteriorate insidiously over time," he said.

"Our protocols are all risk assessed in that way."

Dr Crooks said 15 years ago ambulance services took everyone to hospital. Now they could deal with simple conditions at home or on the scene, reducing the burden on A&E departments as well as inconvenience for patients.

Ms Sturgeon yesterday said she was satisfied checks had been made to make sure See and Treat was used appropriately.

"This is not about keeping people who need to be in hospital out of hospital," she said.

Yesterday's meeting also heard about the continuing burden on the ambulence service caused by alcohol abuse.

About 68 per cent of life-threatening 999 calls in city centres on weekend evenings are alcohol-related.

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