Paramedic’s idea eases A&E pressure by keeping ‘frequent callers’ away

Rhian Monteith now works as the High Intensity User lead with the RightCare programme

A senior paramedic’s innovative idea has reduced A&E visits from “frequent callers” by up to 90% in her area and is now being rolled out across the country.

Frequent callers are classed as those who call at least five times in a month, or at least 12 times in three months, and cost the NHS millions of pounds a year.

Rhian Monteith, 39, was working as an advanced paramedic in Blackpool when she noticed that a small group of people took up a great deal of NHS resources and staff time in the area.

Working with other NHS teams, Ms Monteith drew up a list of 23 patients, many suffering from mental health problems or loneliness, who had visited A&E 703 times in the previous three months, mostly by ambulance.

She decided to try to tackle their problems by simply meeting them for a coffee and a chat.

Through personal mentoring and one-to-one coaching, as well as getting them involved with community activities and encouraging them to phone her rather than call 999, Rhian helped A&E attendances, emergency calls and hospital admissions drop by around 90% among the group.

Eventually the patients were able to cope for themselves and came to call Ms Monteith less often.

The High Intensity User programme was then scaled up to cover about 300 patients in Blackpool over the following three years, saving the NHS more than £2 million.

It has now been rolled out to around a fifth of the country, with 36 local health teams adopting the scheme.

NHS England now wants all remaining clinical commissioning groups to take on the idea through the RightCare programme, which aims to improve care for patients while making the NHS more efficient.

It said there were about 5,000 people who attend major A&E units around the country more than 20 times each year.

In 2016 they accounted for 0.05% of A&E visitors, but about 3% of spending or £53 million.

Ms Monteith, who now works as the High Intensity User lead with the RightCare programme, said: “This scheme is about making sure people are not left behind in society and not medicalised or criminalised.

“Every individual is put in contact with a person in their lives who cares about them, and stands with them in their time of need.

“I’m incredibly proud to see how my idea has grown and it shows how, if you are armed with a phone and a high level of emotional intelligence, and ask people ‘what matters to them’ instead of ‘what’s the matter’, the difference you can have to people who need a hand up in life.”

Tessa Walton, director of NHS Delivery, said: “The High Intensity User programme is a fantastic example of what we are trying to achieve – improving patient care while reducing some of the pressure on NHS services through new ways of working.

“We really want to see all local NHS areas using this idea to benefit their patients and services.

“The fact that it was an advanced paramedic working on the front line of patient care that spotted the potential demonstrates that, regardless of where in the health service someone works, a good idea can have a huge impact across the whole NHS.”