25 Oct 2017
There is one man in particular who has dedicated himself to the development of our Physician Response Unit (PRU). Driven by his desire to improve the quality of patient care and push the boundaries of prehospital emergency medicine, Tony Joy has worked tirelessly to introduce a new and improved service.
“When I was a Junior Doctor at The Royal London Hospital, I was inspired by London’s Air Ambulance doctors like Gareth Davies and Anne Weaver who would bring their patients into the old emergency department. They were my introduction to trauma and prehospital emergency medical care, and it was at that point I knew I wanted to work for the charity.
“Eventually in 2014, I was lucky enough to join London’s Air Ambulance as a HEMS registrar on a 12 month secondment. During this time I was lead registrar for the PRU — a service relatively few people knew about.
“The PRU is a vehicle that delivers the emergency department to patients, focusing on high-quality clinical care and patient experience. An emergency medicine doctor and London Ambulance Service (LAS) clinician treat and diagnose patients in the community, whether that’s in their homes, offices or at the roadside, meaning people can avoid going to the emergency department and, most importantly, won’t end up getting unnecessarily admitted to hospital.
“I always knew this was an important service, but there was potential for it to be developed. In the Spring of 2015 I started writing a business case to increase the hours and change the model, creating a service that could deliver even better care and make a greater impact in local communities.
“It’s a difficult time in healthcare at the moment and resources are tight. This meant I had to work hard to persuade people that the PRU is a truly cost-effective service. I have no doubt the service will help save the NHS money by reducing patient admissions and I am sure we will be able to demonstrate its hugely positive impact over the coming months and years.
“Despite my initial struggles, the new model is now up and running. This means we can start building an integrated system where we work together with the London Ambulance Service, hospitals and other community providers to better understand patients and use the local knowledge we develop to help improve our work in the emergency department.
“Patient feedback has been overwhelmingly positive. The experience of having an emergency medicine doctor and LAS clinician offer a completely focused consultation in a familiar environment, with access to advanced treatments and diagnostic tools usually only found in the emergency department, is something people have responded very well to.
“The PRU is helping offer a system-wide solution to problems in healthcare at the moment. It’s a very innovative model and I don’t see any reason why it couldn’t spread to other London communities and even across the country.”