Abstract

Background and Aims
Ambulance services are often the first point of contact for patients in respiratory distress, disproportionately affecting the most deprived communities. Leveraging this rich and largely untapped reservoir of data offers a powerful opportunity to inform targeted interventions, optimise care pathways, and ultimately improve outcomes for this high-risk population.
This study analysed ambulance service data to examine trends in calls related to breathing problems and deprivation.

Methods
This exploratory retrospective study analysed 83,800 calls categorised as ‘breathing difficulties’ using Advanced Medical Priority Dispatch System (AMPDS) triage. Additional analysis using integrated care datasets was conducted to understand frequent Emergency Department (ED) attendances and outcomes.

Results
• Calls for breathing difficulties increased 78% since 2021, with clear winter spikes, particularly in the most deprived areas.
• 72% of all calls for breathing problems were conveyed to hospital. Under 18s were more likely to be conveyed than adults (82% compared to 71%) and under 5s were most likely to be conveyed (89%), although national guidance may bias crew behaviours.
• Analysis of the data through a health inequalities lens revealed that 41% of calls came from the most deprived quintile, compared to 9% in the least deprived.
• There is significant variation in the rate of calls by local authority. This correlates with index of multiple deprivation scores.
• ED data showed high rates of low-acuity outcomes. Individual patient-level data analysis revealed an increase in ambulance usage over time indicating the potential to work more collaboratively to deliver more appropriate, preventative care for these individuals.

Conclusions
This study highlights the intersection of respiratory health, deprivation, and urgent care. Better leveraging of ambulance service data to pilot new models of care could realise improved outcomes for patients with breathing difficulties.
A separate study has been conducted evaluating the role of ambulance service specialist practitioners in urgent care in managing category 2 calls for breathing difficulties. Findings aim to inform more equitable and effective care for patients with high-acuity respiratory presentations.