InFORM: Improving care for people who Frequently call 999: co-production of guidance through an Observational study using Routine linked data and Mixed methods

Abstract

Background People who frequently call the 999 ambulance service present an operational challenge to providers and their needs are inadequately met by current service provision. Aim of research To understand patterns and health outcomes of frequent calling and to work with stakeholders to co-produce guidance for formal testing in a future evaluation. Methods In this mixed methods study I will carry out a scoping review of national and international literature, including grey literature. I will identify two cohorts of patients 12 months retrospectively who meet the frequent caller threshold. Twelve month health outcomes for both cohorts will be explored through anonymised linked data outcomes using general linear model. I will examine the views of patients using qualitative Bio-photographic interview method with a follow up interview at six months. This will be supported with provider focus groups. All interviews will be thematically analysed. I plan to use information collected from this study to work with two public members, patients and stakeholders to co-produce guidance for optimal care. Results Findings will include follow up of eligible patients (n=400); successful data matching and data linkage; retrieval of outcomes within 12 months. Outcomes will include: adverse events, deaths, emergency admissions; 999 attendances. Bio-photographic interviews with completed scrap books and interviews based on the books (n=34). Care provider focus groups (n= 22). Output Co-produced guidance developed with stakeholders. Conclusion Frequent callers with high needs represent a significant policy challenge to emergency ambulance services. This study will inform on the characteristics of frequent callers and how to address their care supported with a co-produced guidance for care providers.