Date lodged: 28 August 2018
To ask the Scottish Government, further to the answer to question S5W-17620 by Jeane Freeman on 23 August 2018, how calls are coded for the purposes of prioritisation.
Answered by: Jeane Freeman 13 September 2018
The Scottish Ambulance Service launched its New Clinical Response Model (NCRM) in November 2016, based on a detailed clinical analysis of around half a million 999 calls. Since then, following triage, 999 calls are coded to one of five categories based on the likelihood of serious outcomes or the requirement for specific interventions:
Purple: where a patient is identified as having a 10% or more chance of cardiac arrest. Purple codes represent approximately 2.5% of total 999 call volume and the actual cardiac arrest rate across this category is 53%.
Red: where a patient is identified as having a likelihood of cardiac arrest between 1% and 9.9%, or having a need for resuscitation interventions such as airway management above 2%. Currently the cardiac arrest rate in this category is approx. 1.5%
Amber: where a patient is likely to need diagnosis and conveyance to definitive care; for example, patients diagnosed with heart attacks who need to go to specialist centres for expert cardiology interventions or patients affected by stroke who need to be taken to specialist stroke units. The cardiac arrest rates for all of these codes are less than 0.5%
Yellow: a patient who has a need for emergency care but has a very low likelihood of requiring life-saving interventions. For example, patients who have tripped or fallen but not sustained any serious injury.
Green: a patient does not fit the above categories and there is potential for an alternative care pathway.
The rationale behind these changes were to maintain fast responses to those patients who needed active resuscitation, principally the purple and red categories, and for all other 999 calls, to match the best clinical response to patient need, even if that may take a little longer because this would enable the patient to more effectively access definitive care either in hospital or in a community setting.