The OneLondon 999 Digital Transfer of Care Programme will improve the ambulance handover process here in the Capital. We hear from Katie Hackett, Senior Programme Manager at NHS England (London), about what is involved and the difference it will make to patient care (23 October 2024).

Tell us about the programme

In a nutshell this programme is about supporting our ambulance and Emergency Department (ED) teams to provide Londoners with the best possible care as quickly as possible.

Up to now the Electronic Patient Record (EPR) systems used by London Ambulance Service and the Capital’s 27 EDs only link up together in a limited way. This has meant that manual processes to record key information about patients have been needed during ambulance handovers which can take time and cause delays.

Our new OneLondon 999 Digital Transfer of Care programme aims to address this by linking up the different EPR systems to automate the transfer of patient information between London Ambulance Service and the receiving Trust. This will mean faster and more effective handovers benefitting patients and saving staff time.

Joining up ambulance and ED systems on this scale has not been attempted before. That is why the programme is part of the OneLondon partnership that brings together the right people needed to deliver a ‘Once for London’ approach so we can maximise the benefits in the most cost-effective way.

What difference will this make?

Currently the handover process involves ambulance teams briefing the local ED Teams on arrival about the reason for the call out, treatment and medications received, the person’s response etc. The ED team enter this straight into their local EPR system. This takes time and errors can occur.

The new OneLondon system links up London Ambulance with the different systems used by the EDs allowing key patient information to be automatically sent to the receiving Trust as soon as the ambulance team decide to convey the patient to hospital. There is no need for manual data entry of this information by the ED team as all patient and ambulance information will be on one system. This will help to eliminate data entry errors and key information not being relayed during handover conversations between the different teams. So it also improves safety.

It also means that ambulance teams and ED staff can use that handover time to have a much richer conversation about the patient focusing on the key care issues rather than using it to relay the more routine information.

Because EDs will receive this information before the patient arrives they may also be able to proactively plan their care before arrival. Potentially case information can also be sent on in advance to Same Day Emergency Care Teams or other referral services supporting more effective and faster care.

Automating the transfer of patient information will also help speed up the handover process. With around a million ambulance handovers a year in the Capital that could add up to a lot of time saved by ED and ambulance teams for the benefit of patients. And it will help to get ambulance teams back on the road sooner helping to reduce ambulance waiting times.

What is happening and when?

Earlier this year we secured NHS England Frontline Digitisation Funding to deliver this programme. Since then extensive discovery work has taken place with partners to gather information from London Ambulance Service and Trusts about their needs as it is essential any solution works for everyone involved.

This spring we agreed a design specification and ran a procurement exercise to choose a technical solutions and delivery partner. They will help London Ambulance Service and Trusts build and implement the change.

We are working with a small number of Trusts to run some beta test pilots and hope to announce these shortly and for them to begin early in the new year. Learning lessons from these beta sites we will finalise our London wide rollout which we aim to complete by March 2026.

It is great to work with so many people from across London who bring a variety of experience and skills to the programme. We are excited about the improvements we can deliver together over the coming months.