Call handling
WMS has a dedicated call centre based in Chippenham. Experienced and carefully trained call handlers take calls from members of the public who feel they require medical assistance out-of-hours. The call handlers will ask for demographic details (name, address etc) and will ascertain the nature of the problem. They will ask questions to identify any immediately life threatening problems and if necessary, transfer the case to the ambulance service. Call handlers have to deal with a wide range of calls and are able to refer patients to the most appropriate medical service.
Telephone triage
An important role of the service is to provide telephone triage for patients. This is performed by nurses and GPs who are based in the same location as the call handlers to ensure good communication between the two groups of staff.
Patients will have their medical needs assessed by the triage team who will provide advice on self care or if necessary arrange an appointment with an out of hours clinician. This will be at one of the Primary Care Centres or in appropriate circumstances a home visit.
We believe that clinical triage (supported by call handlers) is the most effective way of balancing the need for excellent patient care and operational efficiency.
The face-to-face clinical team
WMS’s clinical team consists of doctors, Nurse Practitioners and Emergency Care Practitioners (ECPs).
Doctors: The majority of WMS’s medical workforce are local GPS. This means they have an excellent understanding of all local healthcare matters.
Nurse Practitioners: These are specialised nurses with advanced skills in managing illness in primary care. Most are able to issue prescriptions directly to patients.
ECPs: are specialised ambulance personnel who have received additional training in the management of illness and injury in the community
Supervising the team
Our supervisors work behind the scenes to ensure the smooth functioning of our service. At busy times this is a dedicated role allowing the supervisor to oversee the whole operation and ensure the highest possible standards of care and service. At quieter times this role is combined with other responsibilities in order to ensure the service remains efficient as well as effective.
Medical Vehicles
The service operates dedicated medic vehicles. They all have high-visibility markings, green emergency lights and are equipped with a broad range of medical equipment. They all have four-wheel drive capability for adverse weather conditions. The main aim of these vehicles is to transport clinicians to their patients.
Management and Administration
The managerial component of Wiltshire Medical operates 24 hours a day 7 days a week. Making sure everyone is in the right place at the right time and that the service is running as it should is a full-time job. The service employs several full-time staff who order medical equipment, plan and fill rotas, manage the finances and payroll and perform a host of other essential tasks.
Clinical Governance
The service works closely with its doctors, other medical staff and the Primary Care Trust to continuously evaluate and improve its performance. This includes keeping informed of changes to NHS guidelines, gathering feedback from stakeholders and planning ahead to provide the safest, effective clinical environment for all patients. We have thoroughly documented frameworks in place to ensure this process is kept up to date. This is subject to continuous internal audit and is externally audited, annually.
Service Developments
OoH Dental Call Answering and triage
Wiltshire Medical Services provides dental call answering and triage for Swindon and the county of Wiltshire, covering some 650000 patients. Patient calls are answered and triaged by our team and if treatment is required we arrange an appointment with the Dental Access Centres provided by Swindon and Wiltshire PCT’s.
Access to Care - Read More
Since May 2007 Wiltshire Medical Services has been working in partnership with NHS Wiltshire to establish Access to Care. This is essentially a single point of access for health and social care professionals. It is the route via which patients are referred into a range of PCT provided community services.
These facilities include:
- Neighbourhood Teams
- Community Hospital general medical beds including Stroke beds.
- Falls Service: This service provides rapid intervention to prevent the unnecessary admission of patients experiencing falls, in circumstances where Neighbourhood Teams are unable to respond with the appropriate health professional, in a timely manner.
Shortly, Access to Care will assist in the referral pathway for some patients
needing urgent admission to the Royal United Hospital, Bath; Salisbury Foundation
Trust and the Great Western Hospital, Swindon.
Overnight Nurse Service
This service was initially set up as a pilot and started in November 2007 covering West Wiltshire.. The main focus is on the care of patients with End of Life needs and catheter problems between the hours of 2200 and 0700. To date the service is still running as a pilot and still covers West Wiltshire, with slight geographic expansion, dependant upon the individual nurse’s home location. The service proved to be very beneficial to patients that have accessed it and the remit for the service has expanded to take into consideration some other cases that are deemed to require immediate care from a District Nurse such as stoma care. It is not anticipated that there will be any noticeable alterations to the service until completion of the PCT Urgent Care tender process in April 2010.
Nurse Practitioner Development
Wiltshire Medical Services prides itself in workforce development. One of the areas where we have had considerable success is the establishment of a Nurse Practitioner Team. These nurses are highly skilled clinicians with prescribing qualifications who see and treat patients at our Primary Care Centres. During 2008 we extended their role to include home visiting, expanding the team by a mixture of internal development from the triage nurse pool, and external recruitment.
IT and Communications Infrastructure
Wiltshire Medical Services has created a new bespoke health communications hub in Chippenham. Significant investment has been made in this facility to ensure we provide a high quality, efficient urgent care service. Our operational team have developed a sophisticated and robust IT and communications infrastructure which we use to receive patient calls and transmit information to:
- clinicians in our Primary Care Centres throughout Wiltshire
- mobile teams in our medic vehicles
- community health services such as Neighbourhood Teams
- minor injuries units
- community hospitals
- ambulance service
- district general hospitals
Telecare
This pilot, which started in September 2008, provides ‘Care Assistant’ intervention for patients who require urgent assistance within their own homes. in effect, WMS acts as the 3rd key holder. Staff respond to urgent requests for assistance from clients who are connected to the Telecare response system.
The objective of such a response is to provide an alternative pathway for non-medical issues, which might otherwise be forwarded to the Ambulance Service unnecessarily.
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