Evaluation of the emergency medical retrieval service - Scottish ...

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Aircraft used 5.16 Figure 5.5 shows the breakdown in missions by means of transport. Approximately 80% of retrievals were undertaken using SAS aircraft, either the Glasgow helicopter (Helimed 5) or the Glasgow fixed wing aircraft (King Air). In a further 18% of cases, the retrieval was undertaken on the Royal Navy Search & Rescue aircraft based at HMNAS Gannet in Prestwick. In just 2% of missions, alternative transport was used including road transport, the Coastguard SAR helicopter or police helicopter. Figure 5.5 Missions by aircraft type Source: EMRS database Referral patterns 5.17 Referrals were taken from across the pilot area. Stornoway had the largest single number of referrals with 25, followed by Stranraer and then Lochgilphead. The Service was used most infrequently in areas where there was a lower population such as Coll, Colonsay and Cumbrae. 42
Figure 5.6 Location of referrals Source: EMRS database 5.18 Figure 5.7 provides analysis of the location of referrals adjusted to reflect populations. This shows that the more remote areas and islands, particularly in Tiree and Colonsay, had a proportionately high number of retrievals. This can partly be explained by the small populations of these areas and their lack of hospitals. These figures suggest that the areas receiving, proportionally, the most benefit from EMRS are the remote islands and Lochgilphead (a place that is particularly difficult to travel to and from by road). Figure 5.7 Location of referrals (patients per 1,000 population) Source: EMRS database 43
Page 1 and 2: Health and Community Care Evaluatio
Page 3 and 4: This report is available on the Sco
Page 5 and 6: Value for Money Assessment 103 Conc
Page 7 and 8: 1 EXECUTIVE SUMMARY Introduction 1.
Page 9 and 10: 1.14 Patients are referred from acr
Page 11 and 12: 1.33 We assumed the following numbe
Page 13 and 14: 1.46 This leaves us with the remain
Page 15 and 16: 2.6 There were three core elements
Page 17 and 18: 3 BACKGROUND TO EMRS • EMRS is de
Page 19 and 20: • Consultant led retrieval allows
Page 21 and 22: Figure 3.1 Map of EMRS coverage and
Page 23 and 24: A note on primary retrievals 3.14 D
Page 25 and 26: 4 LITERATURE REVIEW • Air-based e
Page 27 and 28: The Red Cross Flying Doctors Servic
Page 29 and 30: Retrieval times 4.21 The Associatio
Page 31 and 32: setting and study design. Again, th
Page 33 and 34: difficult to prove this from existi
Page 35 and 36: cover (of both ambulance resources
Page 37 and 38: hospitals keen to provide the servi
Page 39 and 40: • Improved training and empowerme
Page 41 and 42: • Deliver a strategy for sustaina
Page 43 and 44: 5 PERFORMANCE OF THE WEST OF SCOTLA
Page 45 and 46: Figure 5.1 Summary of total mission
Page 47: 5.13 Figure 5.4 shows the location
Page 51 and 52: Figure 5.9 Final destinations for E
Page 53 and 54: Table 5.2 Average (median) retrieva
Page 55 and 56: Figure 5.12 Clinical indication for
Page 57 and 58: • ISS score - The Injury Severity
Page 59 and 60: • SAPS II - 156 patients were giv
Page 61 and 62: Qualitative assessment 5.49 This se
Page 63 and 64: 5.56 However, a number of patient r
Page 65 and 66: “Without EMRS, we would struggle
Page 67 and 68: 5.75 This view was supported by one
Page 69 and 70: 5.87 Generally, there was support f
Page 71 and 72: • The literature review highlight
Page 73 and 74: Table 5.8 QALYs under Estimate 1 As
Page 75 and 76: epresenting an improvement in EMRS
Page 77 and 78: always err on the side of caution.
Page 79 and 80: 6.4 The demand estimates presented
Page 81 and 82: • High estimate - 345 cases per a
Page 83 and 84: day time admission is at their plac
Page 85 and 86: 7 OPTIONS DEVELOPMENT AND SHORT LIS
Page 87 and 88: Option / option Overview Key driver
Page 89 and 90: 7.6 This exercise provided us with
Page 91 and 92: Table 7.5 Guidance notes for scorin
Page 93 and 94: Table 7.6 Scoring of the options Cr
Page 95 and 96: • Option 2 - revert back to Argyl
Page 97 and 98: 8 COST AND VALUE FOR MONEY ASSESSME
Page 99 and 100:
8.10 For Option B, therefore, the s
Page 101 and 102:
Staff costs 8.17 The following assu
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staff rota. To err on the side of c
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Aircraft 8.28 It was clear during t
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• In addition, it has been estima
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Value for Money Assessment Cost per
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8.49 The final column of this table
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8.59 Option C, regardless of which
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Table 9.1 Risk matrix of key risks
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Table 9.2 Health boards involved in
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10 ADDITIONAL DATA 10.1 Since the e
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10.11 This model is not sufficientl
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Appraisal audited afterwards, perha
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covering other rural parts of Scotl
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K S Berns, DG Hankins and S P Zietl
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Appendix B - Secondary Retrieval Li
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Author Title Journal (if applicable
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Other EMRS Literature Author Title
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Page 137 and 138:
Author Title Patients Journal (if a
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Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Appendix C - Risk Matrices Option A
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that a number of transfers were avo
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Increase in additional air transfer
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Table C.3 Risk matrix for Option C
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EMRS may lead to less ICU admission
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Increase in case workload Simultane
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Table C.5 Risk matrix for Option E
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Adverse weather May prevent SAS air
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RRIG Membership (as of 16 December
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APPENDIX E - GLOSSARY Acronym Full
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ISSN 0950 2254 ISBN 978 0 7559 7841
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