The LMC have had several recent enquiries from practices who have been contacted by EMAS while attending a patient due to a 999 call.
Practices have asked us what their contractual responsibilities are as some report that EMAS crews have told practices it is their contractual responsibility to support the crews.
Practices should aim to support their patients by cooperating with other organisations who may also provide care to their patients. However, there is no contractual obligation for practices to give clinical advice to EMAS crews.
We know that general practice is extremely busy, as are our colleagues in EMAS. They wish to assess and conclude appropriate disposition of the patient while practices are simultaneously dealing with patient clinics and other urgent matters.
There should be senior clinicians in the EMAS control centre available when EMAS crews have a clinical query. Sometimes, crews may need to contact the GP practice to gain medical history, which your administrative team may be able to provide from the patient medical summary.
It is the choice of the practice if their team give advice to EMAS crews but is not contractual and practices are under no obligation to respond in certain timeframes as some have reported they have been told they must by EMAS crews.
Practices may wish to consider a policy which may cover:
- Ascertaining the reason for the EMAS contact to the practice.
- Provide medical history relevant to support EMAS assessment of the patient.
- Escalate the contact to appropriate clinician if the practice has chosen to do so.
- Informed EMAS of possible timeframes of any response.
- Practice may offer advice if they choose but may also redirect EMAS colleagues to their own clinical supervision and advice pathway.
If offering clinical advice to an EMAS colleague, do consider that you are advising based on a clinical assessment you did not perform and so you must be confident in that assessment.
We have discussed with both EMAS and the ICB that if a service involving urgent practice response to EMAS crews which may include clinical advice was expected, this would be non-core GMS and would require an enhanced service specification.
If you are having contacts from EMAS where you are experiencing requests that are outside your contractual obligations or reasonable practice policy, then do send us examples so we can raise directly with both EMAS and the ICB.