Home News Archive Publications Conferences Latest Evidence Contact Details
Background Search/ Site Map Presentations Guidelines Regional Groups Links

AMBULANCE SERVICE ASSOCIATION
NATIONAL CLINICAL EFFECTIVENESS PROJECT

DEVELOPING CLINICAL AUDIT & CLINICAL EFFECTIVENESS
IN UK AMBULANCE SERVICES

Annual Report to the NHS Executive

May 1999
Stuart Nicholls
ASA Clinical Effectiveness Project Manager

Contents

Background
Progress since December 1998
National Developments
Project Base
Agenda until March 2000

ASA National Clinical Effectiveness Project - Annual Report 1998/99

Background

The Ambulance Service Association National Clinical Effectiveness Project evolved from the Northern & Yorkshire Regional Clinical Audit Project, which was funded by the NHS Executive for three years from October 1995. Following from the success of the regional project the Joint Ambulance Service Association / Joint Colleges Ambulance Liaison Committee (ASA/JCALC) Clinical Effectiveness Committee endorsed and submitted a proposal drawn up by the regional project team to establish a national clinical audit resource unit for ambulance services.

Funding for the national clinical effectiveness project was agreed by the NHS Executive and was due to start in October 1998, following on from the Northern & Yorkshire Regional Ambulance Clinical Audit Project. There were a couple of unexpected and unavoidable delays, which meant that the national project manager did not take up the post until December 1998.

The work programme of the project is based on the objectives as laid out in the proposal submitted to the NHS Executive and is steered by the Joint ASA/ JCALC Clinical Effectiveness Committee. This Committee promotes initiatives covering clinical audit and clinical effectiveness for all UK public sector ambulance services through regional representatives.

This is the first annual report of the ASA Clinical Effectiveness Project covering the period from December 1998 to March 1999.

Back to top

Progress since December 1998

National Developments

The Ambulance Service Association Clinical Effectiveness Project Manager started in post on 1st December 1998 (Appendix 1).

A workshop was held by the Joint ASA/ JCALC Clinical Effectiveness Committee with the project manager in early December 1998, to redefine the Committee’s Mission Statement and Terms of Reference in light of developments such as the project itself, and Department of Health initiatives like the implementation of the National Institute of Clinical Excellence.

A national survey was commissioned by the Joint ASA/ JCALC Clinical Effectiveness Committee. Its’ aims were:

  • to establish the level of clinical audit in all UK ambulance services
  • to find out what sources and types of evidence are being used to introduce change in clinical practice and service delivery
  • to highlight progress being made towards the implementation of clinical governance

The survey was distributed to all UK ambulance services in January 1999, with 39 out of the 43 services responding. Appendix 2 outlines the survey documentation, and Appendix 3 provides a brief summary of the results. The full and final report will be submitted to the ASA/ JCALC Clinical Effectiveness Committee and the Department of Health in June 1999.

The national survey mirrored the previous survey conducted by the Northern & Yorkshire Regional Clinical Audit Project and collected additional information regarding clinical governance.

The ASA/ JCALC Clinical Effectiveness Committee sanctioned a clinical audit newsletter – Candour - (Appendix 4) which appears in every issue of Ambulance UK, the official publication of the Ambulance Service Association.

Recommendations for the collection of a minimum data set for ambulance service patient report forms will be submitted to the Committee in June 1999. This will act as a basis for the development of common clinical audit tools which will more readily allow for collaborative and comparative clinical audit.

The development of a structure for regional ambulance clinical audit groups based on the example set by the Northern & Yorkshire Regional Clinical Audit Project will also be discussed in June 1999.

Awareness of the project has been raised through various initiatives:

  • In February 1999 a leaflet outlining the main objectives of the project was sent to all UK ambulance services (Appendix 5). Further copies will be distributed in the near future.
  • The progress and objectives of the project to date were presented at the Joint ASA/JCALC Conference in May 1999 (Appendix 6).
  • To highlight the project and the need for collaboration between ambulance services and hospital trusts an article was published in the National Centre for Clinical Audit Briefing (Appendix 7).
  • To promote joint working with hospital trusts copies of clinical pathways workbooks were obtained by the project and distributed to all UK ambulance services (Appendix 8).
  • An abstract has been submitted for Clinical Excellence ’99 the annual conference of the National Institute for Clinical Excellence (Appendix 9).

Back to top

Project Base

Following the successful appointment of Stuart Nicholls as the ASA Clinical Effectiveness Project Manager in December 1998, the project headquarters were set up in Kent Ambulance NHS Trust. Stuart Nicholls had previously been their Clinical Audit Manager.

Back to top

Agenda until March 2000

- Appoint a part-time assistant to support the work of the ASA Clinical Effectiveness Project Manager.
- Confirm the Regional Clinical Audit Group Structure.
- Develop evidence based standards in collaboration with ambulance services and the National Institute for Clinical Excellence.
- Develop a series of audit tools to enable collaborative and comparative clinical audit projects.
- Develop pathways of care involving primary/ secondary care providers.
- Presentation at AMBEX ’99, the annual conference of the Ambulance Service Association in July 1999.
- Plan for a third ASA/ JCALC Conference for early 2000.
- Develop a website to disseminate information about the project.
- Develop various databases to store all relevant information surrounding the project. For example audit projects, events, workshops etc.
- Develop links with the Journal of Pre-hospital Immediate Care in order to promote the work undertaken in the field of pre-hospital clinical audit.
- Develop clinical audit training within UK ambulance services.
- Conduct a further survey of clinical audit activity within UK ambulance services - Evidence for Change III - in January 2000.
- Annual Report to NHSE.
- Continue the support and development of clinical effectiveness in UK ambulance services beyond March 2000.

Back to top