Understanding Variation in Rates of Ambulance Service ‘Non-conveyance of Patients to an Emergency Department’ (VAN)

PROJECT TITLE	UNDERSTANDING VARIATION IN RATES OF AMBULANCE SERVICE ‘NON-CONVEYANCE OF PATIENTS TO AN EMERGENCY DEPARTMENT’ (VAN)
Funding body	National institute for Health Research; Health Services & Delivery Research Programme: 13/54/75
Total funding	£328,706.32
Team	Ms Janette Turner University of Sheffield Dr Emma Knowles University of Sheffield Dr Rachel O’Hara University of Sheffield Mrs Joanne Coster University of Sheffield Dr Richard Jacques University of Sheffield Mrs Margaret (Maggie) Marsh, Sheffield Emergency Care Forum Professor Niro Siriwardena, University of Lincoln Professor Jon Nicholl University of Sheffield Professor Julia Williams, University of Hertfordshire
Overarching aim	The aim of the VAN study is to need to understand how to increase non-conveyance rates without compromising safety in terms of higher re-contact rates or other adverse consequences. We intend to explore the drivers of variation to identify ways of increasing non-conveyance rates appropriately in the future.
Objectives	Primary objectives To identify the determinants of variation between and within ambulance services for three different types of non-conveyance: ‘hear and treat’, ‘see and treat’ and ‘see and convey elsewhere’. To identify the determinants of variation between and within ambulance services in potentially inappropriate non-conveyance for three different types of non-conveyance. To explore organisational variation in the provision of ‘hear and treat’ in three ambulance services. To understand variation between and within ambulance services in three different types of non-conveyance.
Methods	Sequential mixed methods study.
Outcomes	The most important expected outcomes of VAN will be to identify the determinants of variation between and within ambulance services for three different types of non-conveyance: ‘hear and treat’, ‘see and treat’ and ‘see and convey elsewhere’.
Outputs	Peer reviewed publications and presentations to the health service leaders, general public, ambulance services and organisations, Department of Health, commissioners, policy experts and national and international conferences. Peer reviewed publications: O’Cathain A, Knowles E, Bishop-Edwards L, Coster J, Crum A, Jacques R, James C, Lawson R, Marsh M, O’Hara R, Siriwardena AN, Stone T, Turner J, Williams J (2018). Understanding variation in ambulance service non-conveyance rates: A mixed methods study. Health Services and Delivery Research 6 (19). Conference presentations:
Impact	This study aims to identify learning for ambulance services and commissioners of ambulance services. Increasing non-conveyance rates is a key focus for policy makers, commissioners and ambulance services and is likely to continue to be so in the future There is a lack of data on patient outcomes following non-conveyance and better understanding is needed to drive up quality of care.

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