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Early Intervention Vehicle helps keep frail elderly people out of hospital

Early Intervention Vehicle team

A 999 call for an ambulance doesn’t always result in a hospital admission for elderly people in east and north Hertfordshire.

An assessment by East of England Ambulance call centre staff could result in one of two Early Intervention Vehicles being sent to the patient.

The vehicles provide immediate response, via screened 999 calls, to residents in east and north Hertfordshire with the primary role of keeping them safely in their own homes. It is part of a package of interventions which make up the Vanguard programme, a health and social care initiative, funded by the NHS.

Hertfordshire County Council, East and North Hertfordshire CCG and Hertfordshire Care Providers Association have been working together on the programme for over a year with the sole aim of supporting frail, elderly residents to stay in their own homes – whether that is a care home or their own home.

Jeanette Akunebuni who works in health and community services at Hertfordshire County Council – one of the partners in East and North Hertfordshire CCG’s Vanguard programme – is managing the project, alongside the East of England Ambulance Service.

The EiV team does not respond to life threatening conditions, drug or alcohol cases and it is not equipped to take people to hospital because it is packed full of equipment - medical, occupational and physiotherapy.  

Patients are assessed by the crew – normally a senior paramedic and an occupational health professional, physiotherapist or social worker. Assessments take at least an hour, if not longer, with the result of 80% of people staying in their own homes.

“After the initial medical assessment, the crew assesses the patient and carer functions within the home environment to see whether the patient can remain at home with community resources and assistive equipment,” said Jeanette whose background is in occupational therapy.

“Needing an ambulance can be stressful and disorientating for many elderly people. If we are able to help them stay at home it is so much better for their wellbeing.”

The vehicle is available to respond to elderly people in their own homes, sheltered accommodation and nursing and care homes. If the patient does require a visit to hospital an emergency ambulance will be despatched to take them, leaving the EiV crew free to attend other calls.

Steve Davey Senior Locality Manager, East of England Ambulance Service NHS Trust said: “Paramedics working on the vehicles provide medical assessment and work jointly in providing treatment, support or referral to enable patients to remain in their own home. This scheme has been really successful and I am delighted that it has been extended to benefit more people.

Case study

The family of a 96-year-old lady called an ambulance because she was not eating or drinking properly and they were concerned about her deteriorating state of health.

999 call entre operators despatched the EiV team who, after medical and functional assessments ascertained that the lady was dehydrated but not in need of hospitalisation. Their main concern was that the family was not coping well with their mother/grandmother’s deteriorating health.

“The lady herself was accepting of the fact that she was coming towards the end of her life, and wanted to stay in her own home,” said Jeanette.

“It was clear that the family needed support to help her achieve this so our team contacted the lady’s GP and rapid response services who were able to assess their needs and put in place a care package and practical aids to help maintain her hydration and wellbeing. Altogether the team was with the patient for two hours but they were able to help her achieve her wishes and ease the burden on her family – a very satisfying outcome for everyone.” 


  1. The first EiV went on the road in April, initially working just 9am – 5pm. Now it is operational 07:30-18:30 every day with a second vehicle operating 07:30-15:30. Paramedics are seconded to the service on a 12 week rota 
  2. Our NHS Vanguard programme ‘Better care in care homes’ is a partnership between East and North Hertfordshire Clinical Commissioning Group, Hertfordshire County Council and the Hertfordshire Care Providers Association. To find out more please visit the website: