Description of how these justifications apply
The Medical Priority Dispatch System (MPDS) is embedded within the Welsh Ambulance Services University NHS Trust (the ‘Trust’) 999 service and any change to the existing system would involve significant operational, financial, and strategic challenges.
The MPDS is fundamental to the Emergency Medical Service provided by the Trust, and enables the safe, efficient, and clinically appropriate prioritisation of 999 calls. Replacing the MPDS would be a complex undertaking and at present no other viable alternatives are commercially available.
Another factor is that 999 call-handlers are trained and certified through the International Academies of Emergency Dispatch (IAED) to use MPDS. Transitioning to a new system would require the retraining off all 999 call-handlers within the service, which could disrupt operations and require significant time and resources.
MPDS is a clinically validated solution, with robust evidence of safety, accuracy, and effectiveness. Any alternative system would need to meet rigorous clinical governance standards and demonstrate equal or better prioritisation outcomes. Any replacement would need to be piloted, evaluated, and benchmarked against existing performance metrics to ensure either existing standards can be maintained or exceeded. A process which could take a significant period that could entail several years, depending on the level of clinical assurance already achieved, and a process which would also need to be transparent, and data driven.
In addition, the MPDS disposition coding structure is integral to the prioritisation of emergency calls received and facilitates interoperability with all other UK ambulance services, crucial for example for cross-border emergency call transfers and overflow support from other services. Furthermore, the MPDS is integrated with other systems used by the Trust for secondary triage and clinical assessment and the MPDS coding is critical for accurate tracking and comparison of outcomes across the Trust’s services.
Replacing the MPDS would require investment, and a clinically validated strategy that addresses technology, training, governance, and provides clinical assurance. However, there is a lack of commercial solutions available in the marketplace with NHS England for example having developed their own in-house solution and NHS Scotland using MPDS also. Accordingly, there is currently no other readily available commercial solution to enable the prioritisation of 999 emergency calls.