An innovative collaboration between South East Coast Ambulance Service (SECAmb) and Ashford and St Peter’s Hospitals is bringing emergency X-ray services to the homes of patients – a first of its kind for a UK ambulance trust.
The four-month trial of the Emergency Community X-Ray Service has been so successful that – as well as supporting patients, reducing Emergency Department (ED) admissions and improving ambulance utilisation – it has shown the initiative would also save the NHS money.
The X-ray service aims to support patients being able to remain at home, particularly in cases where hospital attendance could potentially impact their wellbeing, such as those living with frailty or dementia.
“It’s been very successful,” said Andrew Moth, consultant radiographer and co-creator of the project.
Andrew, who is also a community first responder, a volunteer member of the community trained to respond to emergency calls in conjunction with SECAmb, added: “This is a revolutionary service, the first of its kind in the UK.”
For two days a week across four months, an Advanced Paramedic Practitioner (APP) from the Chertsey ambulance station and a radiographer from St Peter’s Hospital reviewed 999 calls and crew referrals to attend patients who would suit the project’s community service criteria, often incidents involving a fall.
Of the 38 patients seen, 25 were able to stay at home, with 21 patients shown to have no fracture and four having a fracture that could be treated conservatively and did not require hospital treatment. With 66% of patients able to stay at home, the scheme provides other benefits by avoiding a hospital trip.
“Being treated in the community helps reduce patient anxiety and avoids the risks associated with hospital admission, whilst receiving the same care.” said James Fern, Practice Development Lead at Chertsey, who helped co-create the community scheme.
The X-ray equipment from Fuji is very compact, consisting of a backpack and carry case, allowing the mobile team to take it wherever needed. “It’s very portable equipment, especially compared to the traditional X-ray equipment used within hospitals,” said James.
Although small, the kit delivers high-quality results. The mobile images are immediately sent to St Peter’s Hospital and are examined by a reporting radiographer in the same process as all other X-rays.
“It’s not a lesser service in any way. The image quality of the X-ray is very good. Patient experience has been high with 100% of patients saying they were happy to have the X-ray at home,” said Andrew.
The Emergency Community X-Ray Service fits perfectly with the NHS 10 Year Health Plan for England, shifting focus from hospital to community, using innovation and technology to provide more care on people’s doorsteps and in their homes.
Figures show 34.5 hours of ambulance utilisation were saved during the pilot trial. Working out the costs of conveying patients to hospital and hospital admission, Andrew has estimated the project could save hundreds of thousands of pounds per annum for the NHS if the scheme was adopted full-time at Chertsey.
It could provide significant potential savings if rolled out at other ambulance stations and hospitals across Surrey.
“It is a great example of professions working together to provide a cost-effective service which significantly benefits our most vulnerable patients,” said Andrew.
The success of the pilot scheme means the Emergency Community X-Ray Service is now being expanded to five days a week from February until the end of May.