Ensuring equitable access for critical care patients across London
Our pioneering super-ambulance service for transporting critically-ill patients between hospitals is being adopted as the model for the whole of London, from tomorrow (1 April 2023).
Barts Health will host a new Adult Critical Care Emergency Support Service (ACCESS) in a partnership with St George’s and Imperial NHS hospital trusts, and the London Ambulance Service (LAS).
A fleet of specialist ambulances will be on standby across the capital so that the sickest patients who need expertly-tailored care at a specialist hospital (such as a cardiac centre or a hyper-acute stroke unit) can be safely moved from local hospitals.
The four vehicles will carry extra equipment, including ventilators and specialist monitors, and be staffed by expert clinicians so they effectively act as a network of mobile intensive care units.
The ambulance fleet will be based at sites across London, including one at The Royal London Hospital, and together are expected to transport about 2,000 patients a year.
The new pan-London service is a collaboration modelled on the successful North East London Critical Care Transfer And Retrieval (NECCTAR) service.
NECCTAR earned its reputation during the Covid pandemic for the safe long-range transfer of adults with complex needs, particularly respiratory patients on ventilators.
Crews travelled as far away as Cardiff and Newcastle, although most transfers are between London hospitals: e.g taking critically-ill heart patients to St Bartholomew’s for cardiac surgery or St George’s for care following a brain injury.
South East and North Central London will also benefit from this scaled up service.
Clinicians will call LAS on a dedicated phone line, staffed by experienced call handlers at the Service’s emergency control centre, who will dispatch vehicles once agreed by the ACCESS duty consultant.
As lead provider for ACCESS, the trust will organise a duty rota of registrars and practitioners to staff the modified ambulances, under consultant supervision. LAS will supply call handling, crews and vehicles, with other support functions carried out by partners in South West and North West London.
Dr Mamoun Abu-Habsa, Joint Clinical Director of ACCESS said:
“Moving critically unwell patients across hospitals is inherently a high-risk activity, this transformational mobile ICU capability streamlines practice, education, transfer operations and overarching governance within a single service and a unified vision of equity of access to specialist care”
“Our Pan-London Specialist Teams will facilitate equitable access to highly specialised cardiac, trauma, neurosurgical and burns care and repatriate patients back to their local Intensive Care Units anywhere in the country. This is the largest such service in England.”