Nadya Essam, PhD student at CaHRU, was awarded her PhD at the recent College of Social Science graduation which took place at the magnificent Lincoln Cathedral. She successfully defended her thesis titled: ‘To convey, or not convey …? The effect and usefulness of the National Early Warning Score to support paramedics’ decisions to convey patients to hospital or treat closer to home’, supervised by Professors Niro Siriwardena and Steve McKay. The study involved mixed methods to investigate the introduction of the National Early Warning Score (NEWS) to help paramedics determine which patients could be safely treated at scene or via an alternative care pathway, rather than being transported to hospital.
Nadya used an interrupted time series design to analyse ambulance data before and after NEWS was introduced, examining numbers and proportions of patients not conveyed to the emergency department and numbers and proportions treated and left at scene who recontacted the ambulance service within 24-hours. She also used semi-structured interviews and observations of staff to explore their perceptions of using NEWS. There were no significant differences in the numbers of emergency calls attended to by ambulance, although numbers of life-threatening calls increased significantly, while the numbers and proportion of patients being treated closer to home remained constant.
The effectiveness and usefulness of the NEWS to support paramedics’ decision-making to treat patients closer to home was compromised by a failure to use NEWS as intended and lack of access to alternative care pathways. The findings will be of value to service providers seeking to achieve NHS England’s ambition to increase the uptake of the NEWS to 100%, and those responsible for redesigning and commissioning integrated care services.
By Prof Niro Siriwardena