Delivering clinical case management for frequent callers to ambulance services.

Ambulance services in England are playing an increasing role in the provision of care. Their role has changed from one of picking up patients in the community and dropping them off at an emergency department (ED) to more advanced care models. These now include the provision of clinical advice over the telephone (hear and treat), the treatment of patients on-scene (see and treat) and the more traditional conveyance to the ED. These changes have been occurring during a prolonged period of increased demand on all areas of emergency care, including a 47% rise in ED attendance over 15 years. Further, it is known that frequent users of healthcare use a disproportionate amount of resources.