Top tips for the NHS Pathways system

David Davis, Clinical Lead for NHS Pathways and South East Coast Ambulance Service NHS Trust, takes time out to talk about the NHS Pathways system and provides tips for organisations wishing to implement it.

In any organisation, implementing and utilising NHS Pathways is a project that requires time and effort to get the best out of the system.

Every step of the way, project management and staff engagement are priorities when implementing and using NHS Pathways; even into the post-implementation phase. Engaging with both clinical and non-clinical staff when a new system is implemented is an absolute must.

It is important to recognise that switching to NHS Pathways is not simply about learning how to use a new system; it is all about managing the change. Changing the way calls and patients are handled and managed for ambulance services means a shift in thinking and careful management of expectations - of patients, the public and commissioners.

South East Coast Ambulance Service NHS Foundation Trust knows how important it is to manage the change effectively. To help other organisations wishing to adopt NHS Pathways, David Davis - Clinical Lead for NHS Pathways at the Trust, has come up with a handy top tips video guide to implementation.

He said, "There are things you need to know when you come to implementing NHS Pathways within your system.
"Firstly, don't underestimate the project. It will need direct project management with a dedicated person or team to deliver it. It isn't just about implementing a technology or triage system, it is about changing cultures and systems and that requires engagement with all your stakeholders - both internally and externally. In the ambulance context it also means engagement with the emergency operational crews."

A new team structure needs to be considered to successfully run NHS Pathways. Liaising with similar services who have experience of the system is helpful, but careful monitoring once the system is live will help identify whether or not the staff structure is working for the organisation.

Mr Davis said, "Do not underestimate the training need. It goes beyond just the basic NHS Pathways and call handler training. You need to engage with the staff that will be delivering the service and also those who work around it. There are a variety of other factors to consider and plan for - such as dealing with vulnerable adults, falls referrals, regular callers - the things that make the service work within the context of your organisation.

"It is a big investment in people to get this right - both in terms of time, money and the support you are going to need to provide people with in order to excel with this system."

The clinicians working with NHS Pathways systems also play a critical role in managing the calls, not only in terms of home management and dealing with conditions over the phone, but also in supporting and mentoring the call handlers day to day -dealing with either emergencies or non-emergencies.

Mr Davis said, "Getting the number of clinicians right is really important. Some of the factors that you need to consider are what else they are doing in addition to the statutory NHS Pathways work. Are they providing other functions within the environment? If they are, then you will need to increase the numbers.
"Choosing the right clinicians is essential - clinicians with a broad range of primary care and urgent care experience to make the right judgement call at the right time."
In addition to this top tips guide, the NHS Pathways team have created an Ambulance Engagement Toolkit for pre/post implementation.

This toolkit provides support to Ambulance Services already live with NHS Pathways and those who are planning to switch. It offers ideas for best practice, top tips, supporting tasks, and key element adoption guidance.

It provides a range of ideas, approaches and case studies that will support any organisation in making the system work for them and will guide those looking at using NHS Pathways.

The toolkit is set out to highlight key factors that will influence system performance after go live. These include Directory of Services (DOS) population and management, clinical and staff engagement, training materials and delivery, mapping and integration into local services.

For ambulance services - what happens in the 999 control centre, both clinically and operationally, can directly impact performance across the organisation. The areas covered in the toolkit are just some of the key points that should be considered - there will also be a number of factors that individual organisations will find which affect the optimisation of NHS Pathways.

Mr Davis said, "Since we began using NHS Pathways, we have more than doubled the number of cases we are able to handle over the phone. What do I mean by that? Well, with 999 calls that don't require a traditional ambulance response, we can provide care and advice to get the patients to the right place at the right time. Around 1 in 10 of our 999 calls are handled in that manner.

"The benefits are that we have increased availability of resources to be able to send ambulances to those that need them and provide the care they need when they need it as well. Overall, it puts us in a better position to be able to deliver a high-quality service within the changing context and demands of modern healthcare."