Mr. Robert Morton:

Probably the most interesting question anybody could ask is about understanding the clinical acuity of workload. Our call categorisation systems at the moment are focused on identifying or hunting for the sickest patients. They are referred to as purple or red, or echo or delta, calls. Those calls attract the targets. Our experience is those are not the sickest patients. The sickest patients are often over 75 years of age, have chronic comorbidities, multiple complex conditions and do not fall into the highest acuity categories. Those patients end up being transported to hospital and are twice as likely to be admitted to hospital as a person under 65 years. We are having a conversation with the designers of the medical triage system on the need to look at this again in terms of the impact age has on clinical acuity. To articulate that, where it is a 35-year-old man with chest pain versus a 75-year-old person with shortness of breath, the probability is the 35-year-old man will be categorised as a potential heart attack or a delta call and get a fast response while the 75-year-old who is short of breath but whose other indicators seem normal will get a slower response in clinical acuity terms, though that patient may be much sicker. Clinical redesign work needs to be done in the background by the people who designed the system.