Sir Bruce insisted that patients would not be worried about being treated at home.
People trust their GPs, people trust hospitals, but they also trust ambulance services, he said. They are very highly trained people. Theres a big opportunity there for us to see how we can use the expertise the ambulance services have.
An NHS England spokesman confirmed that more home treatment was on the table in Sir Bruces review. Fundamental change was needed to meet burdens on A&E departments, he said.
It was not clear last night exactly how the policy would work, but one option would be for paramedics to provide heart attack victims with anti-clotting drugs and stabilise them at home, before taking them to a specialist clinic to recover, thereby bypassing accident and emergency.
Moving towards more home treatment for acute cases would reverse recent trends in medical practice. Over the past decade paramedics have provided less and less treatment to heart attack victims, and instead take patients directly to specialist heart attack centres where they undergo a procedure to open up a collapsed/blocked artery using a tiny tube. About 100,000 people suffer a heart attack each year, but last year 200 heart attack victims were given anti-clotting treatment by paramedics, down from 824 the previous year.
A spokesman for the Royal College of Physicians said there was a better clinical outcome for patients taken straight to a specialist centre.
Stroke patients are not given anti-clotting treatment by ambulance staff, as without a CT scan of the patient, doctors cannot know whether they are suffering from a clot-induced stroke or a bleed. The latter would be exacerbated by anti-clotting drugs. One solution, as pioneered in Germany, would be to equip ambulances with mobile CT scanners.
Dr Anthony Rudd, Britains leading stroke expert, said Sir Bruces suggestion was a bit of a surprise. He said: Patients should be admitted directly to a stroke unit. If they need clot-busting treatment they have to have that in hospital. They cant have that in an ambulance.
Mr Hunt will announce that GPs will be responsible for ensuring the elderly can look after themselves at home, in order to reduce unnecessary hospital stays. From April, GPs will be expected to speak to vulnerable elderly patients at home, not just when they walk through the surgery door. The policy will restore the ideal of family doctoring undermined by changes to GPs contracts in 2004.
Excerpt from:
Treat heart attacks and strokes at home, says senior doctor