A crucial lifeline for Nottinghamshire's healthcare system: Uncovering the story of NEMS and its vital role during winter pressures.
In the midst of a challenging winter season, when hospitals are stretched to their limits, an innovative service steps in to fill the gaps and provide much-needed support. Meet Nottingham Emergency Medical Services (NEMS), a dedicated team working tirelessly to ensure patients receive the care they deserve.
But here's where it gets controversial... NEMS, a not-for-profit social enterprise, has become an essential piece of the healthcare puzzle, but its role is often misunderstood or overlooked. Let's delve into the story behind this service and explore its impact on the community.
The Evolution of NEMS
Established over two decades ago, NEMS has adapted to the ever-changing healthcare landscape, evolving its services to meet the needs of the community. Initially, it provided out-of-hours care when surgeries were closed, but now it offers so much more.
Medical Director Dr. Nita Mandhar describes NEMS as "a crucial piece in the jigsaw that helps to combine the system together." This service acts as a bridge, connecting primary and secondary care, ensuring patients receive the right level of attention without getting lost in the system.
Accessing NEMS Services
NEMS is easily accessible through the NHS non-emergency number, 111. If you call and require urgent care, you may be directed to the NEMS call centre, where a team of experts will assess your needs. From there, they'll guide you towards the most appropriate care, be it self-care advice, a pharmacy consultation, or a face-to-face appointment.
These in-person appointments could be home visits for vulnerable patients or appointments at one of NEMS' treatment centres. In some cases, patients who attend A&E may be diverted to urgent treatment centres, like the one at the Queen's Medical Centre (QMC), and occasionally, patients are even diverted to NEMS after calling 999.
Mitigating Winter Pressures
The NEMS urgent treatment centre at QMC has seen an unprecedented surge in patients this winter, according to Dr. Shane Green, the centre's medical lead. "This year, we've seen twice as many patients compared to last year, which puts an enormous strain on our service and the wider system. It's our job to mitigate these pressures with our partners," he explains.
The main goal of the urgent treatment centre is to relieve the emergency department by taking non-critical patients who still require same-day care. Located next to A&E, the centre acts as a first point of contact, with patients being assessed by a GP before being directed to the appropriate care.
Ashleigh Benson, a 22-year-old from Langley Mill, is one such patient. Initially advised by a GP to visit A&E due to a cyst on her back, Benson was quickly assessed and directed to the urgent treatment centre. "It's more helpful. It's a quicker way to see someone," she says. Dr. Green adds, "That bridge between these services is crucial, especially when people struggle to get GP appointments due to the pressures on the healthcare system."
The Challenges of Urgent Care
Increased demand is a constant challenge for NEMS, but when hospitals are under pressure, the strain can be felt across the entire healthcare system. NUH, for example, has declared two critical incidents this winter, allowing the NHS trusts to focus on critical services. During these incidents, NEMS takes extraordinary action to support the wider system, seeing extra patients and allowing ambulances to bring patients directly to the urgent treatment centre.
The call centre, which typically handles an average of 266 calls a day, can deal with up to 425 calls during the winter months. GP home visits, usually 90 per week, increase by 65% during the busiest times.
"Each service within the healthcare system has different pressure points, and close communication is vital to keeping everything running smoothly," says Mandhar. Part of NEMS' role is working closely with the East Midlands Ambulance Service to ensure ambulances are kept on the road and unnecessary conveyances are avoided.
A Call for Change
The deaths of two young men from Nottingham last year highlighted the potential consequences when the healthcare system fails to function as it should. Adam Hussain, suffering from appendicitis, called 999 and 111 repeatedly over several days before developing sepsis and passing away. An inquest into his death revealed a lack of information sharing between healthcare services and a failure to recognise the severity of his condition.
Both NEMS and the NHS trusts involved have apologized and promised change. Mandhar, who has been instrumental in implementing these changes, broke down in the coroner's court as she apologized to the families on behalf of NEMS. The coroner welcomed NEMS' detailed review and robust internal action plan to address the issues.
"We understand the pressures our colleagues in primary and secondary care face, and we work closely with them to facilitate the best possible care," Mandhar says. "We adapt our services to meet the changing landscape and ensure we play our part in keeping our community healthy."
Get Involved
Do you have any experiences with NEMS or similar services? Share your stories and thoughts in the comments below. Your insights could help shape the future of healthcare in your community!
