STRategies to manage Emergency ambulance Telephone Callers with sustained High needs: an Evaluation using linked Data (STRETCHED) – a study protocol

Aslam, Rabeea'h W, Snooks, Helen, Porter, Alison, Khanom, Ashrafunnesa, Cole, Robert, Edwards, Adrian, Edwards, Bethan, Evans, Bridie Angela, Foster, Theresa, Fothergill, Rachael, Gripper, Penny, John, Ann, Petterson, Robin, Rosser, Andy, Tee, Anna, Sewell, Bernadette, Hughes, Heather, Phillips, Ceri, Rees, Nigel, Scott, Jason and Watkins, Alan (2022) STRategies to manage Emergency ambulance Telephone Callers with sustained High needs: an Evaluation using linked Data (STRETCHED) – a study protocol. BMJ Open, 12 (3). e053123. ISSN 2044-6055

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Introduction UK ambulance services have identified a concern with high users of the 999 service and have set up ‘frequent callers’ services, ranging from within-service management to cross-sectoral multidisciplinary case management approaches. There is little evidence about how to address the needs of this patient group.

Aim To evaluate effectiveness, safety and efficiency of case management approaches to the care of people who frequently call the emergency ambulance service, and gain an understanding of barriers and facilitators to implementation.

Objectives (1) Develop an understanding of predicted mechanisms of change to underpin evaluation. (2) Describe epidemiology of sustained high users of 999 services. (3) Evaluate case management approaches to the care of people who call the 999 ambulance service frequently in terms of: (i) Further emergency contacts (999, emergency department, emergency admissions to hospital) (ii) Effects on other services (iii) Adverse events (deaths, injuries, serious medical emergencies and police arrests) (iv) Costs of intervention and care (v) Patient experience of care. (4) Identify challenges and opportunities associated with using case management models, including features associated with success, and develop theories about how case management works in this population.

Methods and analysis We will conduct a multisite mixed-methods evaluation of case management for people who use ambulance services frequently by using anonymised linked routine data outcomes in a ‘natural experiment’ cohort design, in four regional ambulance services. We will conduct interviews and focus groups with service users, commissioners and emergency and non-acute care providers. The planned start and end dates of the study are 1 April 2019 and 1 September 2022, respectively

Ethics and dissemination The study received approval from the UK Health Research Authority (Confidentiality Advisory Group reference number: 19/CAG/0195; research ethics committee reference number: 19/WA/0216).

We will collate feedback from our Lived Experience Advisory Panel, the Frequent Caller National Network and Research Management Group for targeted dissemination activities.

Item Type: Article
Additional Information: Funding information: This project is funded by the National Institute for Health Research (NIHR) Health Services & Delivery Research (HS&DR) Programme (reference 18/03/02). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Subjects: B900 Others in Subjects allied to Medicine
L900 Others in Social studies
Department: Faculties > Health and Life Sciences > Social Work, Education and Community Wellbeing
Depositing User: Elena Carlaw
Date Deposited: 08 Apr 2022 16:07
Last Modified: 08 Apr 2022 16:15

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