Of all the issues raised by our staff, incidents of persistent
and regular callers to the 999 service is one of the most
significant.
Who is a frequent caller?
We define a frequent caller as a patient who
has placed at least 10 emergency calls in a month.
Although relatively small in number, these
patients make it harder for us to reach others with more serious or
potentially life-threatening conditions. We also recognise, though,
that they will often have complex health and social circumstances
which require us to work closely with other health and social care
organisations once we have identified them as being frequent users
of our service.
An extreme example is a patient who had called
999 over 700 times over a two-year period. She had also called the
GP co-operative over 120 times, been seen 18 times in the co-op
base, and had six home visits within four months. The patient was
obese, suffered with anxiety and behavioural problems as well as a
range of clinical problems. The estimated costs of providing a 999
service to her over a 12-month period was £110,880.
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Managing frequent callers
Historically, we did not have any formal
policy or procedures in place to manage patients defined in this
way. Referrals from our own staff and health and social care
colleagues were picked up by the Patient Advice & Liaison
Service (PALS) but this had to be managed alongside other
priorities in the workload.
Our frequent callers unit was created in
2007 as a dedicated taskforce to review and manage the needs of
patients who, for a variety of often complex reasons, persistently
place 999 calls. The unit sits within the Patient Experiences
Department and works across organisational boundaries to achieve
better care arrangements and alternative care pathways in relation
to the patient’s individual needs.
There are now of three full time officers and
one part time social worker dedicated to managing individual cases
and delivering our strategic
policy and practice. Initially, there were some 400 patients
who were referred to the unit. A review was conducted which
culminated in reducing the number of cases to 140, and this is the
usual workload with more cases referred on a daily basis.
Within this section we also look at:
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