SECAmb call handling: improving decision‑making and efficiency in emergency call management

Summary

We worked with South East Coast Ambulance Service NHS Foundation Trust (SECAmb) to support a structured review of emergency call handling processes across the Emergency Operations Centre (EOC) and Unscheduled Care Navigation Hubs.

Through process‑mapping workshops and an eight‑week scoping project, Health Innovation KSS helped SECAmb understand how calls are currently managed, identify pressures and inefficiencies in the call stack and explore how digital/AI and workforce changes could support faster, safer clinical decision‑making. The work resulted in a set of evidence‑based recommendations and options appraisals to inform future investment and improvement, helping SECAmb strengthen service efficiency and patient safety at a time of rising demand and workforce pressure.

Challenge

Ambulance services in England are experiencing growing demand, alongside treating patients with more complex needs and a wider health system that is under pressure. The system at large is struggling to manage flow across the urgent and emergency care pathway, due to using an operating model that is outdated and not fit for managing future demands.

Like many ambulance services, SECAmb experienced increasing demand for emergency services alongside significant cost and workforce pressures. Rising call volumes, variation in call handling processes and inefficiencies within the call stack created risks of unnecessary ambulance dispatches and delays in care. These pressures also affected staff experience, with high levels of workload and burnout reported in call handling environments.

To manage demand sustainably while maintaining patient safety, SECAmb needed to increase the capacity and capability of clinical staff in the EOC and Unscheduled Care Navigation Hubs, and to improve risk‑based clinical decision‑making earlier in the pathway before ambulance dispatch.

In response to these challenges, SECAmb commissioned Health Innovation KSS to support a focused piece of work to better understand current processes, identify gaps and explore options to improve efficiency, patient safety and workforce sustainability.

Our approach

We led a structured, system‑level review of call handling processes, working closely with SECAmb staff throughout the project. The approach combined practical, frontline insight with analytical assessment and options development.

We facilitated two detailed process‑mapping workshops, bringing together a wide range of SECAmb staff, including leaders and teams from ambulance hubs, digital services, audit, improvement, workforce and operational leadership. These workshops mapped the end‑to‑end pathway from the start of a 999 call through to decisions on whether an ambulance was dispatched. Alongside the operational mapping process, the team mapped and identified technologies currently used across the pathway and undertook a gap analysis to pinpoint inefficiencies, risks and opportunities for improvement.

Three key opportunities for improvement were agreed:

1.  Enhanced prioritisation checking and automated allocation (to support early recognition of deterioration)
2. AI‑supported audit and learning
3. Ambient AI for note transcription, as well as leveraging existing 111 IVR and SMS tools

Building on this work, Health Innovation KSS was funded to deliver an eight‑week scoping project. The team developed an options appraisal based on the three opportunities identified, focusing on the feasibility, costs, risks and benefits. It also considered workforce requirements, supplier capability and opportunities to strengthen the call stack and hub model. The work produced a series of structured documents designed to support executive‑level decision‑making and longer‑term planning for digital and operational transformation within the EOC.

Throughout the project, we supported needs articulation, provided system insight, and helped SECAmb translate operational challenges into clear areas for action.

Impact

The project successfully delivered a comprehensive, evidence‑based options appraisal for SECAmb. Key outputs included a suite of core documents and recommendations, such as an options appraisal, an executive summary exploring potential artificial intelligence (AI) enhancement within the Emergency Operations Centre, analysis of workforce implications linked to digital transformation, and an assessment of supplier capabilities.

The work gave SECAmb executives a clearer understanding of how different digital solutions and system enhancements could support improved clinical decision‑making, reduce inefficiencies and contribute to more sustainable service delivery. As a result, changes were adopted within existing systems and improvement programmes, helping to standardise processes and align call handling improvements with wider productivity and efficiency work already underway.

At a system level, the project also supported learning and collaboration beyond the organisation. Relationships were established with Scottish and Welsh ambulance services, enabling shared learning on similar transformation approaches and contributing to wider collaborative discussions across ambulance services in the south of England.

The project identified future opportunities for SECAmb, and while these opportunities have not yet been implemented or evaluated, they provide a clear foundation for future improvement work.

Spread and scalability

The approach used in this project is transferable to other organisations and urgent and emergency care settings facing similar challenges. The structured combination of process mapping, gap analysis, needs articulation and options appraisal enabled SECAmb to develop a shared understanding of its call handling pathway and identify practical areas for improvement and practical solutions. SECAmb is currently reviewing internal processes because of this work. Learning from collaboration with other UK ambulance services has also informed next steps and supports the potential for wider spread.

Find out more

To find out more about this work or to explore innovation solutions that could support emergency call handling and system efficiency, contact Jo Wookey or Alan Davies at Health Innovation KSS.