Safely Reducing Avoidable Conveyance to Hospital

The NHS’s Long Term Plan places ambulance services at the heart of the UEC system and commits to implementing Lord Carter’s recommendations, putting in place timely responses so people can be treated by skilled paramedics at home, or in the most appropriate setting outside hospital whenever it is safe to do so.

What does reducing avoidable conveyance mean?

An avoidable conveyance happens when a patient, whose health and social care needs could be effectively and safely met in a community setting, within or close to their own home, is conveyed to hospital unnecessarily.

So we have produced the Planning to Safely Reduce Avoidable Conveyance document to support local system plans to safely and sustainably reduce avoidable conveyance by the ambulance services in England, by 2023.

Planning to Safely Reduce Avoidable Conveyance

The document aims to build on the opportunities, enablers and a set of initiatives that support a safe reduction in conveyance.   These are:

  • Identifying the initiatives that have the greatest impact for helping people who have fallen; and care home residents.
  • Addressing the needs of people experiencing Mental Health crisis by facilitating access to Mental Health services and professionals.
  • Enabling paramedics on the front line to have immediate access to additional clinical advice.
  • Ensuring the right skill mix across ambulance services to ensure the right response to the patient.

Safe reduction in avoidable conveyance is a system-wide responsibility and challenge; it cannot be achieved by ambulance services working in isolation.

Therefore, this plan is intended to support working in partnership within local health systems to reduce the number of people taken to an Emergency Department (ED) when there is a more suitable care alternative, by:

  • using evidence to identify effective interventions already in use across the ambulance system;
  • evaluating new opportunities for safely reducing avoidable conveyance;

developing accessible examples of interventions to inform and support local transformation; exploring the appropriate incentives that are needed to enable the required changes.