Ambulance services are different to other Health and social care services and need an extra injection of support to kickstart development of QI.  There is no national infrastructure to support the development of QI in Ambulance Services and Ambulance Q has started something unique in terms of a new grassroots movement.  Ambulance Services have almost entirely distributed workforces, significant workforce shortages in all services across the UK, and usually are very lean in terms of management infrastructure.  Development of QI has been slower and in conversation with other colleagues through the Ambulance Q network we’re all working out how to engage front line staff in projects when getting staff released from front line practice is so difficult.  Building a culture of improvement is also complicated – often because of the autonomous nature of front line working with often non-stop calls, there is little opportunity for ‘coming to work to do my job and improve my job’ – feeling like a cohesive part of wider organisational objectives is not something front-line staff traditionally identify with.

All of these issues are shared by those of us trying to pioneer Ambulance QI and working on ‘building will, building capacity and delivering results’ (IHI Leadership model).  Our Ambulance telecalls are growing (with participants joining from as far away as the U.S. and Qatar as well as across the UK Ambulance Services!), however they are usually 1-2 hours and fairly rushed. We’ve shared improvements such as Ambulance Trigger Tools, PROMs and Clinical improvements. To truly build the network we need longer and face to face time together.

The opportunity to meet would have the following objectives:

1. To hear and learn about where each participating service is in terms of strategy, number of people trained, number of projects completed, plans for the future etc. This will enable us to learn from each other about what has worked well and what could have been done differently.

2.  Through learning from each other about how we can engage effectively with our dispersed Ambulance workforces regarding Improvement to build supportive cultures, devise resources to use in Ambulance services to support this infrastructure development.

3.  Share examples of live improvement projects and how these have made a difference to staff and patients.

4. Continue conversations which have begun in Q teleconferences about shared projects between services – joint initiatives, learning together etc. PROMS work in Ambulance Services is in fairly early stages so this might be a key area of work.

In addition, the National Ambulance Quality Indicators group have expressed interest to think how Ambulance Q could strategically align and collaborate with them for greater impact since the growing Ambulance Q network has the benefit of working at a range of levels in our respective services and working hard to engage widely with the front-line.

The key outputs will be: 

• Use of learning to shape strategy and implementation of Improvement science in each Ambulance service
• Production of resources

• Development of new initiatives taken forward as a result of these events. This will build on successes already emerging from Ambulance Q eg Clinical Learning Seminars to share learning between NI Ambulance Service and Scottish Ambulance Service in June 2018.

• Pilot and review of shared projects
• Evaluation of the events (using longitudinal evaluation to determine benefits one year later)