Connected Ambulances

Hybrid Connex is a joint NHS and commercial initiative uniquely combining 4G, 5G and satellite connections, ensuring that ambulance crews wherever their location are always online with a high-speed connection.

This case study covers a partnership programme set-up between the NHS and a range of commercial technology companies with €5.7m of funding from the European Space Agency (ESA). This joint NHS and commercial technology initiative is providing the UK ambulance sector with a resilient connectivity solution for ambulances which combines 4G, 5G and satellite connections, and means that the crew onboard the vehicle will never be offline.

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https://hybridconnex.co.uk/

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What is the problem to be solved?

With healthcare systems around the world under growing pressure, their staff need to provide treatment as efficiently as possible. One way to do that is for paramedics and ambulance crews to treat people in the right place first time, increasing the possibility of ‘See & Treat’ in the community avoiding conveyance to hospital when it is clinically safe to do so. To that end, the UK’s National Health Service (NHS) is trialling a new connectivity solution designed to enable ambulance crews to do much more in patients’ homes or in the Community.

Though not limited to a single sector, the European Space Agency project targeted ambulance and healthcare settings, aiming to address current challenges and future-proof the sector. This focus was particularly prescient, as the post-pandemic world demanded increasingly digital, data-driven solutions within an evolving, complex health and social care system. 

Developed by Excelerate Technology, with co-funded support from ESA’s 5G/6G strategic programme line and the UK Space Agency, the solution uses a combination of 4G, 5G and satellite technology to ensure that paramedics are continuously connected, even when in remote and rural areas.

The ultimate aim of the project – called Hybrid Connex Digital Ambulance of the Future – is to enable the widespread use of technology so crews are ‘Always Connected.’  A significant benefit of this would be the opportunity to roll out telemedicine pathways in which ambulances, or even patients’ homes, function as remote consultation rooms as crews have access to a senior clinician to support the diagnosis and delivery of patient care. Thus, improving patient care, increasing efficiency, and saving significant money, time and resources.

This case study is aimed at Ambulance Trusts and Care providers, in NHS or private providers, who rely on efficient ambulance service provision.

Potential barriers to adoption are the integration with existing NHS infrastructure and technologies, along with the need for a national adoption and integration into existing care pathways.

What is the solution to the problem?

The Hybrid Connex project is funded by the European Space Agency with a partnership between the NHS Arden and Greater East Midlands, Excelerate Technology, Catapult Satellite Applications, and a range of commercial technology companies including Livewire Digital and Vodafone.

Hybrid Connex is a project whereby a technology platform has been developed that leverages the benefits of digital transformation via ‘true hybrid’ satellite and cellular connectivity.  

Commercial model (Business Case)

The business case for Hybrid Connex has been built largely on the patient and paramedic benefits that are driving the change.

In 2018 the Carter Review highlighted that reducing unnecessary ambulance conveyance would save the NHS at least £300 million a year. Advanced Connectivity is the key to unlocking reduced conveyance by enabling correct decisions to be taken at the scene.

There are additional savings resulting from conveyance choices – avoiding the default of taking patient to the largest acute hospital when a specialist, smaller unit might be more appropriate. These savings have not yet been quantified.

The other direct savings result from reducing multiple SIMS and more efficient management of billing.       

Benefits

Complementing the next phase of the Ambulance Radio Programme (ARP) rollout (part of the ESN) this advanced level of permanent connectivity will:

· Open the door to new patient care pathways, taking advantage of digital advances

· Increase the range of point-of-contact diagnostic services and tests that ambulance crews can carry out on-the-spot, without taking patients to hospital.

· Be better prepared and able to take advantage of developments in telemedicine and video technology, like Stroke Care Pathways.

· Ensure that crews can quickly and easily access immediate clinical information through electronic patient records and speed up patient handover at Hospitals.

· Enable crews to remain in constant contact with specialists about patients and their conditions while travelling to receiving hospitals.

· Enable crews to locate patients faster in areas where connectivity is compromised.

· Help crews find key information about local health and social care services at their fingertips, enabling them to signpost patients to more appropriate, alternative sources of health and care.

· Help fleet managers and financial managers within ambulance services handle the often-complex commercial aspects of connectivity - such as billing - in a much more efficient way

In terms of financial benefits these can be summarised under the following headings:

• Reduced connectivity costs:
• Optimized network usage:
• Simplified billing:
• Improved operational efficiency:
• Potential for telehealth applications:

By utilizing a hybrid network that seamlessly switches between cellular and satellite connections, the need for multiple SIM cards and contracts is minimized, leading to lower overall connectivity costs. 

The system intelligently selects the most appropriate network based on signal strength, reducing unnecessary data usage and associated costs. 

Hybrid Connex provides a single point of contact for billing, simplifying the process for ambulance services and potentially reducing administrative overhead. 

Reliable connectivity in remote areas, enabled by satellite integration, can lead to better decision-making in the field, potentially reducing unnecessary ambulance transfers and associated costs. 

The robust connectivity could facilitate wider adoption of telehealth services within ambulance operations, which could lead to cost savings by reducing unnecessary hospital visits. 

Lessons Learnt 

• Working on a European Space Agency (ESA) funded project is exciting and rewarding but adds a layer of complexity in project monitoring and reporting.
• Obtaining subject matter input from over-stretched ambulance staff is challenging.
• Likewise, setting up pilot vehicles in an environment with high continuous demand is challenging for paramedic and other service staff.
• The general challenge of co-ordinating a large technical delivery team across multiple vendors.
• It is important to maintain an "open" environment for discussion with the other consortium members and NHS staff this paid great dividends. By being completely "open book" and not having one set of information for one party and one for another pay’s dividends. 
• Having a solid subject matter expert in the programme (in our case AGEM) was a massive help. 
• 3rd party reliance can cause challenges when it was identified that the a third party connection was dropping out, we had to then prove this to the third party which took over a week of repetitive testing before they would assist properly in a resolution. However, lessons from this experience have been put to good use for a later project with EEAST which resulted in scheduling an automatic reboot.
• Due to the trial being on live operational ambulances we had not factored in the challenges we would encounter with vehicles going off the run for mechanical issues/accidents/servicing etc, are outside of control of the project team and the project needs to dynamically change to compensate for the availability of the ambulances.