London Ambulance Service Experience of COVID-19

COVID-19 presents a significant and unprecedented public health challenge which is placing enormous strain on global health services. In London, we have seen exponential growth in the number of cases of COVID-19 and significant public concern which has been felt across healthcare systems. The London Ambulance Service NHS Trust (LAS) is consistently experiencing its busiest days on record and is at the frontline of the response to COVID-19. Whilst knowledge of the progression and clinical manifestations of the disease is improving, there is a lack of knowledge of how COVID-19 patients access and use emergency medical services (EMS), and what interventions are required to manage these patients in their prehospital phase. This knowledge is vital for the planning and delivery of EMS care as the pandemic develops. Similarly, although evidence is emerging from the in-hospital setting about the toll of caring for COVID-19 patients, little is known about the effects on the mental wellbeing of EMS staff who are faced with considerable uncertainty when triaging, assessing and treating patients with limited access to support, resources or testing. This mixed method study will have two parallel work packages: Work package one will aim to rapidly improve knowledge of how patients with COVID-19 access and use EMS services. Patient records will be reviewed for patients who present to LAS and go on to receive a diagnosis of COVID-19. Characteristics and trends in these presentations will be reported to inform the ongoing planning and delivery of EMS care to these patients. Work package two will explore, through questionnaires and interviews, the personal and professional impacts of triaging, assessing and treating patients who receive a diagnosis of COVID-19. This will inform the ongoing support requirements for EMS staff and provide evidence to support the planning for future pandemic disease outbreaks.