Frequent callers to emergency services with dementia study.
People with dementia who make frequent calls to the ambulance service: what are the call characteristics and how can frequent calls be reduced?
- Dr Sarah Voss, UWE Bristol (Chief Investigator)
- Professor Jonathan Benger, UWE Bristol
- Sarah Black, South Western Ambulance Service NHS Foundation Trust
- Kim Kirby, South Western Ambulance Service NHS Foundation Trust
- Maria Robinson, South Western Ambulance Service NHS Foundation Trust.
People who make many and regular calls to the ambulance service are called frequent callers. This type of ambulance service use is very expensive and time consuming for the NHS, and patients often experience unsatisfactory care without having their underlying needs met. Due to this, ambulance services keep records of frequent callers.
Existing evidence suggests that there are certain groups of people who tend to make frequent calls, including older people and people with mental health problems. We estimate that around 6% of frequent calls are made by, or for, a person with dementia. This is important because frequent callers may be taken to hospital and admitted unnecessarily and for people with dementia, hospital attendance and admission can be very stressful and may make the situation worse for both the patient and their family. Moreover, these patients tend to experience a deterioration in their condition as a result of the admission. This means that they have to stay for longer and if they are discharged home, they are more likely to need to be readmitted.
We propose to carry out some work to better understand why people with dementia make frequent calls and which are the best options for helping to reduce this. This project is part of a wider programme of work in which we hope to improve the care of people with dementia by reducing avoidable emergency hospital admissions.
The project will carry out scoping work upstream of a potential acceptability and feasibility trial and future RCT of one or more potential interventions. We intend to prepare an application for NIHR RfPB funding.
This project could potentially run alongside an NIHR Academic Fellowship award as a component of a current programme of work relating to dementia in pre-hospital care and the reduction of avoidable hospital admissions and building on our existing collaborations with the regional ambulance service. This will be done in close collaboration with Dementia Health Integration Team (HIT) and The Avoiding Hospital Admissions Health Integration Team (ITHAcA HIT); Jonathan Benger is a member of the leadership team.
This study will provide an evidence-based understanding the call characteristics of people with dementia who make frequent calls to the ambulance service using comparative qualitative and quantitative data analysis. The aims are:
- To build collaborations with other researchers in this subject area.
- To compare the call characteristics (eg reason, time of day, length of time on scene, conveyed to hospital) of people with dementia who make frequent calls with those to people with dementia who do not make frequent calls, and with those of people who make frequent calls but don't have dementia.
- To engage stakeholders in considering the options for intervention, and to develop the most promising options for further refinement and testing in future research.
- To identify one or more interventions that can be applied to the setting.
This project is funded by the Avon Primary Care Research Collaborative (RCF 16/17 – 3SV).
Please contact Dr Sarah Voss (Chief Investigator).