I don't see doing discharge follow-ups or blood draws as part of the role of the ambulance service. Discharge follow-ups are the responsibility of the GP or if appropriate the District Nurses.
We've had a single responder for low acuity work in Auckland and Christchurch for about 4 years now. There is two in Auckland during the day and one at night, and one in Christchurch. Control will assign a priority to a job when it is called in; the two lowest priorities are green and grey. Grey calls are held for response pending further telephone assessment by a nurse or paramedic, and those deemed suitable for a response is what Sierra targets. Green calls are suitable to wait up to two hours for an ambulance and at the moment some of them are assessed and if suitable referred to Sierra (or somewhere else such as the GP, A&M clinic etc). In the future, when there are more nurses and paramedics in control, all green calls will also be rung back while awaiting an ambulance to see if they can be diverted elsewhere or sent Sierra instead.
Sierra doesn't have anything additional or special; they have the same referral options as all ambulance personnel and I think this is sensible. They are just there to target work with a high likelihood of non-transport rather than sending a traditional ambulance. There was talk of using Nurse Practitioners at some point but I don't really think this would work very well.
It works very well, it adds the equivalent of one extra ambulance per day apparently.
Did you want to know something specific?
