More patients may be treated at home by paramedics

MORE patients calling an ambulance in Scotland could be treated at home by paramedics rather than going to hospital, a report on the future for the service reveals.

The "strategic vision" for the Scottish Ambulance Service (SAS) over the next five years suggests more conditions could be treated without going to hospital, reducing trips to busy A&E departments.

At present, conditions that can be dealt with by paramedics at home under so-called "see and treat" guidelines are panic attacks, fainting, minor head injuries, fitting and epilepsy, diabetes and asthma. The report also said the service would work with "vulnerable" rural communities to improve the services they received, including more home care.

The SAS said it would develop a new system with NHS 24 and local out-of-hours providers to make sure patients got through to the right service they needed, after its consultation suggested widespread public confusion.

It comes after The Scotsman revealed last week that doctors were increasingly concerned the NHS will not be able to cope with rising demand for emergency out-of-hours services.

The report, which follows a lengthy public consultation, looks at plans to improve the care given to patients from 2010 to 2015.

Demand for ambulances is growing every year. Between 2003-4 and 2008-9, call-outs went up 35 per cent, with a 41 per cent rise out of hours. At the same time, more patients are being treated in Scottish A&Es. This year, it is expected they will deal with more than 1.6 million patients.

Ambulance staff are already able to deliver some treatments in people's homes, such as for minor wounds and managing diabetes. "This not only improves the patient experience, but delivers greater financial and resource efficiencies for the whole NHS," the report said.

It goes on to say that more conditions could be dealt with at home where appropriate.

"Our aim is to shift delivery of our service and the perception of our emergency and unscheduled services towards better triage, enhanced treatment and less unnecessary transport, but always within the boundaries of clinical safety and excellence," it said.

As well as treating minor conditions, the report also suggests paramedics could take blood samples to avoid trips to hospital.

Pauline Howie, SAS chief executive, said: "We recognise that our planned developments will have to be delivered in the context of fiscal restraint, providing the best possible value for money and best outcome for patients.

"To achieve this, we will undertake a comprehensive review of efficiency and effectiveness in conjunction with the framework."

The Liberal Democrat health spokesman, Ross Finnie, said: "It will be better for the patients and for the NHS if those who can be treated at home aren't dragged into A&E unnecessarily.

"But it's equally important that patients feel confident that, if they require hospital treatment, Scottish ambulances will take them directly to A&E."

A Scottish Government spokeswoman said: "We welcome the fact that – where it is clinically safe and appropriate – patients can be treated and supported by ambulance staff at home, avoiding an unnecessary trip to hospital."