CONSULTANTS are teaming up with paramedics on the road in Gwent to take the hospital into people's homes, preventing unnecessary admissions and journeys to busy A&E departments, and freeing up ambulances.

Assessing, cleaning and stitching an elderly lady's head wounds, thus avoiding a trip to hospital, and checking the conditions of three people involved in a low speed road collision, thus avoiding three ambulance journeys, are examples of the work of the Physician Response Unit (PRU) pilot project.

The unit consists of a fast response vehicle, similar to a rapid response vehicle (RRV) but with extra equipment, staffed on rota by consultants in emergency medicine from the Royal Gwent Hospital and a Welsh Ambulance Services NHS Trust paramedic.

Remote access to calls coming into ambulance control means the PRU team can self-select appropriate 999 incidents. They can also be sent on calls directly by control, or be asked by ambulance crews already on scene.

Dr Tim Rogerson, consultant in emergency medicine, said the PRU averages eight to 10 calls a day - 14 is the most - and daily keeps six or seven patients out of hospital.

"The Royal Gwent receives 50 to 60 ambulances a day, so if we are preventing those numbers of journeys, that's at least 10 per cent of those daily admissions," he said.

Even if a hospital admission is subsequently deemed unavoidable, a consultant's assessment of the patient can help them judge where in the hospital a patient should go, enabling them to for instance, book into the medical assessment unit (MAU), avoiding A&E and a potentially long wait.

An excellent example of the PRU's potential came following an incident at Trevethin, Pontypool, earlier this month when a tree fell on a school bus outside Ysgol Gyfun Gwynllyw.

"By screening and treating people at the scene, we stood down four ambulances and RRVs. Four people who would have been transferred to A&E didn't need to be, and those vehicles were freed up for other calls," said Dr Rogerson.

The Argus spent three hours with today's PRU team - Dr Rogerson and paramedic Mike Finiak - during which ambulance journeys were avoided for two elderly Newport patients, following assessments - one for a head wound - after falls.

A lady with breathing difficulties, also in the city, was assessed by Dr Rogerson too, subsequently being booked into the Royal Gwent's MAU, avoiding A&E.

The PRU, run by the health board in conjunction with the ambulance service, is unique in Wales, the health board having a number of consultants in emergency medicine with experience of treating patients 'pre-hospital' due to previous jobs, making Gwent an ideal base for a pilot project.

The effectiveness of the Monday to Friday, 9am to 5pm service will be reviewed at the end of March.