Association of Ambulance Chief Executives

“We have received feedback through our networks that since we issued the revised guidance it is helpful and that it has been used to support the delivery of breech babies.”

“Consideration to be given for the national JRCALC guidance to include the London Ambulance Service's JRCALC Plus recommendation that where delivery is not progressing the patient should be conveyed to an obstetric unit.”

“My officials have raised these concerns with NHS England (NHSE) as the body responsible for the oversight of the operational delivery of ambulance services nationally. NHS England have responded to confirm that they are working with the Association of Ambulance Chief Executives (AACE) to support their review of the concerns you have raised. I understand that AACE will be responding to you shortly on the action being taken.”

“will now review the asthma guideline and make changes if these are deemed to be required”

“We note your suggestion that the issues raised in your report should be considered in the development of our new guideline on adrenal insufficiency, particularly that replacement steroid therapy must be given to patients with adrenal insufficiency who have suffered trauma or physiological stress.”

“recommend that all health and care providers ensure their organization has put processes in place to ensure the four actions on the National Patient Safety Alert have been addressed.”

“The revised guidance includes wording to highlight that the police officer on scene should call the local ambulance service and include in the information passed whether the patient is being actively restrained and if so how, and if acute behavioural disturbance (ABD) is suspected. Ambulance trusts will assign a Category 2 response to patients detained under S136 and suspected of having ABD unless there are other immediately life-threatening clinical features that would warrant a Category 1”

“EEAST's Mental Health team have also been working on updating the guidance documents for our partners in relation to managing s.136 patients within the community setting. This document 'Requesting Conveyance for Patients Detained under the MHA' will be sent to you once the review and update has been completed in December 2021.”

“The Trust has already introduced a new EOC Standard Operating Procedure (ESOP) specifically for Mental Health calls and has now made a further revision to the document. Within this ESOP, guidance is given that if the call is abandoned and therefore has incomplete triage (i.e. we haven't been able to seek responses to all the triage questions), and the information provided suggests the patient is actively at risk due to action they have already taken, or currently taking to harm themselves or end”

“we have worked closely with NHS England and other partners to reduce the variation as far as possible. Specifically, in relation to anaphylactic shock we have previously made representation to NHS England through the now disbanded Ambulance Response Programme Delivery Group (ARP DG) Chairman: Professor [name redacted] C Marsh QAM SBStJ DSci (Hon) MBA MSc MA FASI Managing Director: [name redacted] and the Emergency Call Prioritisation Advisory Group (ECPAG) requesting that the clinical coding inconsistency”

“Following Ms [name redacted] death, the Practice undertook an audit in October 2019 of all patients who were being prescribed Emerade to ensure that the dosage was in accordance with the BNF based on the respective patients' weight and age. Indeed, all patients who use AAI pens have had their doses reviewed. Patients have been contacted to ensure that they have the correct dose and appropriate knowledge about the use and storage of the pen. Letters were sent to patients on Emerade, which included”

“we will consider how best to make clear In CG134 the advice that 2 adrenaline auto-injectors should be prescribed, which patients should carry at 811 tfflls.”

“providing additional Continuous Professional Development training around Acute Behavioural Disturbance”

“We will address each of your concerns, insofar as we are able.”

“My concern is that this has not been rolled out nationally and therefore many other forces will not understand the implication of this condition and how best to treat it. | suggest contact is made with Chief Inspector | Og WMP for full information on the changes made in the West Midlands Area”

“We have made a recommendation to the National Education Network for Ambulance Services leads (NENAS) that each trust considers including, if not completed already, the education of front line staff and control room staff in acute behavioural disturbance to raise awareness of the condition and how it can present in a patient.”