GWAS leads the way on improving emergency care for dementia patients

*** Adapted from GWAS media release ***

Great Western Ambulance Service (GWAS) is working with the Department of Health (DH) to look at ways it – and other ambulance services – can provide better care for patients suffering from dementia.

“While dementia is high on the national agenda for improving care and patient and carer experience, it presents very different challenges to ambulance clinicians as the condition itself is invariably not the cause of the emergency,” explains Vicky O’Leary, Paramedic Clinical Lead for GWAS.”

“The emergency may not even be directly linked to the patient’s dementia, but the condition can make it difficult for the clinician to identify particular symptoms or gather specific information that they need to treat the patient.”

The work GWAS is carrying out in partnership with the DH has led to the development of a strategy to improve ambulance staff’s awareness about dementia.

Vicky O’Leary says:

“We began by asking all our clinicians to complete a survey detailing what they believed were the challenges when attending a patient with dementia, and how frequently they attend them.”

“From this information, we have developed the strategy and also shared the findings with our local university so the learning is incorporated in future training and development for our staff.”

The findings are also being made available to ambulances services nationally.

“The strategy covers raising the awareness of dementia among our clinical staff, including the range of presenting characteristics, medications in use and some simple tips on how to communicate with patients who have the condition,” continues Vicky O’Leary.

Dementia: An introductory guide for ambulance clinicians

“This has been developed as an information leaflet available to all clinicians. We have also provided information to our staff on further education and additional reading around the subject of dementia.”

“The next step is to open up alternative ways of providing care that will result in a patient with dementia not automatically being transported to an acute hospital emergency department unless it is needed to receive treatment to a specific clinical condition linked to the emergency call.”

“The final stage of our strategy is the introduction of an information leaflet designed to provide support, information and useful links for patients suffering from dementia, their families and carers.”

Alongside this, there is continuing work to raise awareness within GWAS about dementia. David Francis, the DH dementia and ambulance link, has been invited to one of GWAS’s regular clinical open days to meet clinicians and discuss the challenges faced by ambulance crews.

In addition, an article about dementia has been submitted for a future issue of GWAS’s own journal of clinical practice, Quality and Innovation.

David Francis at the DH says: “The role played by ambulance clinicians in supporting people with dementia and their carers is very significant and often overlooked. Providing training, pathways, clinical support and alternative options to hospital admission has to be a priority”.

For more information, or to share what you are doing about dementia in your region, please contact Vicky O’Leary (

Case study

Vicky O’Leary’s continuing experience as a paramedic, responding to 999 calls, has helped inform her of the challenges faced by clinicians in identifying and treating patients suffering with dementia.

Here, she describes a typical situation she encountered:

“I was called to an emergency where a member of the public had found an elderly lady wandering along the side of a very busy road and dialled 999. The lady was distressed and confused but was wearing an alert bracelet which enabled me to identify that she had dementia.”

“This lady lived alone and had wandered some distance from her home. She was not injured and, although confused and distressed, she was not unwell. I was unhappy about just taking this lady home as if left in the house again she may have injured herself.”

“Therefore, I attempted to find her a bed in a care home as a place of safety until she was able to be assessed fully. However, I was unsuccessful so felt I was left with no other alternative than to transport her to the emergency department. ”

“This fairly typical case highlights what ambulance staff face regularly. Firstly, crews do not always know the patient has dementia; they could be confused for several reasons such a having a urinary tract infection or suffering a blow to the head.”

For more information, please contact:
John Oliver – External Communications Manager
Great Western Ambulance Service
Tel: 01249 858842 / 07920 786 397
Email: or

Great Western Ambulance Service NHS Trust provides emergency and urgent care, and patient transport services across Wiltshire, Gloucestershire and the former Avon. The Trust employs more than 1,680 staff across 33 operational sites – 30 ambulance stations and three emergency operations centres – and in its headquarters. Last year (2008-09), GWAS responded to more than 233,000 emergency calls. The Trust covers an area of 3,000 square miles with a population of approximately 2.2 million people.