England’s ten ambulance trusts occupy a unique position in serving large geographies, each spanning footprints of upwards of 30 CCGs, or 10 or more sustainability and transformation partnerships (STPs) and integrated care systems (ICSs). In the context of system working and place-based models of care, ambulance trusts across the country are taking up the challenge of negotiating the complex emerging systems within their geographic remit, engaging with leaders across multiple footprints, and adopting new ways of working to meet the needs of diverse systems across the populations that they serve. In the words of one chair, ambulance trusts can act as 'the integrator', connecting services at the level of place as well as across a system, and coordinating patient care across pathways - from 'hear and treat' services and, treating patients within their homes, to conveying patients to hospital when necessary and taking them home via patient transport afterwards.
We spoke to eight ambulance trust leaders in seven of the ten trusts to capture their experiences of engaging with STPs. This briefing highlights the opportunities, and challenges, that system working presents for ambulance trusts and explores what they can contribute to the journey of collaboration and more integrated care.