LONDON AMBULANCE SERVICE PROJECT

Poor planning results in poor performance

London Ambulance Service Project

London Ambulance Service Project

The London Ambulance Service NHS Trust (LAS) is the largest "free at the point of contact" ambulance service in the world. It responds to medical emergencies in Greater London, England with the 400 ambulances at its disposal.

It is one of 12 Ambulance Trusts providing England with Emergency medical services, and is part of the National Health Service, receiving direct government funding for its role. There is no charge to patients for use of the service, and under the Patient's charter, every person in England has the right to the attendance of an ambulance in an emergency.

The LAS employs over 4,500 staff, and responds to over one million calls for assistance a year. All requests from the public are answered at the Emergency Operations Centre (EOC) in Waterloo, Lambeth, which then dispatches the appropriate resources. To assist, the command and control system is linked electronically with the equivalent system for the Metropolitan Police. These means police updates regarding specific jobs will be sent directly to the ambulance responding to this call.

LAS Overview

The major objective of the London Ambulance Service Computer Aided Dispatch  (LASCAD ) project was to automate many of the human-intensive processes of manual dispatch systems associated with ambulance services in the UK. The major rationale expressed for such computerization was typically that a number of problems existed with the manual CAD systems. Most such problems related to the time-consuming and error-prone nature of activities such as: identification of the precise location of an incident, the physical movement of paper forms, and maintaining up-to-date vehicle status information.

The basic functionality of the intended LASCAD system was as follows: British Telecom (BT) operators would route all 999 calls concerning medical emergencies as a matter of routine to LAS headquarters (HQ) in Waterloo. 18 HQ 'receivers' were then expected to record on the system the name, telephone number and address of the caller, and the name, destination address and brief details of the patient. This information would then be transmitted over a local area network to a locator. The system would pinpoint the patient's location on a map display of areas within London. The system was expected to monitor continuously the location of every ambulance via radio messages transmitted by each vehicle every 13 seconds. The system would then determine the nearest ambulance to the patient.

Experienced ambulance dispatchers were organized into teams based on three zones (south, north-west and north-east). Ambulance dispatchers would be offered details of the three nearest ambulances by the system and the estimated time each would need to reach the scene. The dispatcher would choose an ambulance and send patient details to a small terminal screen located on the dashboard of the ambulance. The crew would then be expected to confirm that it was on its way. If the selected ambulance were in an ambulance depot then the dispatch message would be received on the station printer. The ambulance crew would always be expected to acknowledge ...