An expert review of 34 cases by Dorset’s most senior doctors and paramedics has concluded that increased travel times by ambulance would not have changed the outcomes for these patients at potentially higher risk.
The comprehensive review was carried out by a panel of clinicians, which included senior A and E consultants and medical directors from each of Dorset’s acute hospitals, leading paramedics from South Western Ambulance Services Trust (SWAST) and a Director of Nursing.
The aim was to re-investigate whether or not extended journey times resulting from changes to hospital services may increase clinical risk and could affect the potential outcome for patients.
The 34 patients reviewed were the same patients identified in the original SWAST report commissioned by Dorset CCG in response to the Clinical Services Review (CSR).
The expert clinicians had access to the full medical records held by SWAST and Poole Hospital for all the patients reviewed. This allowed detailed examination of the diagnoses, interventions, medications and diagnostic results, as well as the clinical outcome for each patient.
Each patient case was reviewed individually and the panel were given the actual journey time and what the additional journey time was predicted to be, according to the original SWAST report.
In each case, the panel discussed the order of events from the initial condition of the patient at the scene and diagnosis, any clinical interventions provided by the ambulance clinicians, arrival at hospital and any treatments provided in the emergency departments. In all cases paramedic and hospital notes were referred to, informing this discussion.
In all cases, the panel found interventions on scene, particularly by ambulance clinicians, had helped to stabilise each patient prior to further treatment in hospital.
At the end of each patient case review, the clinical experts were asked whether, in their professional opinion, the additional journey time resulting from the Clinical Services Review would have affected the outcome for that patient.
The expert clinical panel concluded that for all 34 patients, the additional travel time identified in the original SWAST report would not have changed the outcome for these patients.
Dr Angus Wood, Medical Director Poole Hospital “As a panel of clinicians from across Dorset and SWAST, we have thoroughly reviewed all 34 patients who were at potential increased clinical risk due to extended travel times and agreed that it would have made no difference to patient outcome.
As consultant doctors and leading paramedics we are reassured that extended ambulance travel times would not put patients at any additional risk over and above the severity of their condition. It is important to understand that if you are unlucky enough to need urgent medical help and an ambulance is called, your treatment starts when the paramedics arrive and continues as you are conveyed to the most appropriate hospital where your care will continue.”
Local GP and Chair of NHS Dorset CCG Dr Forbes Watson “We have known all along that the most important factors are getting ambulances on the scene quickly for the most serious of cases and then getting patient to the most appropriate facilities with specialist staff, even if this means travelling past the nearest hospital. This review by some of Dorset’s most senior clinicians has reaffirmed this fact.
There are inaccuracies being circulated and I would encourage anyone who wants to find out the facts and be assured these changes are the best thing for people in Dorset to read the report and make up their own mind.”