Ambulance Today Winter 2012 by Declan Heneghan

Winter 2012 - Issue 5 | Volume 9

TODAY

Ambulance

Europe's leading magazine for NHS,Voluntary and Private Ambulance Services

A MERRY CHRISTMAS AND A HAPPY NEW YEAR TO ALL OUR READERS

SUPPORTING AND IMPROVING PARAMEDIC PRACTICE David Davis explains the role of the College of Paramedics

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Also Inside: n

Jo Webber on Falls strategy

Caring at Christmas - supporting ambulance care in India and the Philippines

RCA Ambulance Redesign Update

UNISON’s Hope Daley says protect staff from violence

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supporting ambulance staff across the UK

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Editor’s Comment

New Year’s Resolutions: 1: Help design a better ambulance 2: Join the College of Paramedics Declan Heneghan Editor, Ambulance Today

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supporting ambulance staff across the UK

Support the Ambulance Services Benevolent Fund throughout 2013 by visiting their website at: www.asbf.co.uk and making a donation. Or make a payroll donation through ‘Pennies from Heaven’ at: www.penniesfromheaven.co.uk Don’t forget to specify that you’d like your donation to go to the ASBF

Enter 70070 into the "to" box Write in the code 'ASBF44' and then add the amount you want to donate which can be £1, £2, £3, £4, £5 or £10 - Your text might look like this 'ASBF44 £5' - Press 'Send' Congratulations, you've just donated to the ASBF...it's that simple!

Early in the New Year, the Helen Hamlyn Centre for Design will be holding a consultation day in London which will form a vital part of its ongoing project to redesign the A&E ambulance.The aim of the day is to bring ambulance people from a number of countries together to share their views on different aspects of the potential vehicle’s design with both ambulance builders and experts in as many areas of clinical technology as possible. The thinking behind the day is very sound. The HHCD team, led by Research Fellow, Ed Matthews, firmly embrace the notion that good design should never be foisted on the end-users but should instead be arrived at by specifically encouraging the users of any new design to enter a dialogue with the design team which, in its very process, helps them crystalise and then express their own sometimes initially vague ideas on what it is that they really want from the future design. It’s not rocket science, it’s just the simple commonsense understanding that in most scenarios the best people to tell you what a new or improved product should consist of are obviously the people who will eventually use it. If it seems that this year has been a relatively quiet one for the ambulance redesign project the honest answer is that, yes, on one level it has been. Like many other ambulance projects, many of the people we have wanted to consult with have been a bit busy with another project – the 2012 Olympics! But having said that, rest assured that, a bit like a duck in water, lots has been going on just below the surface, even if things have seemed a bit calm above the waterline. The HHCD team and myself have attended quite a few key ambulance events and have also engaged in an impressive number of one-to-one meetings with ambulance builders and associated technology suppliers. So, if this is a project that you’re still interested to find out more about, or, better yet, if you have your own clear views on how the ambulance of the future should look, please feel very welcome to contact me by either phone or email and I’ll be delighted to pass on your views to the team who, I am very confident, will be equally delighted to get back to you to hear your ideas in more detail. For those interested by the way, the HHCD (part of the Royal College of Art) ambulance redesign project won a major and very prestigious design accolade this year when it was awarded the British Design Council’s Transport Design award; so, with your help and input, I

am confident that 2013 will see it take great strides forward. Another group of people who have only the best interests of the ambulance community at heart is the College of Paramedics (CoP) and inside this edition you’ll find an interesting article by David Davis their Director of Communications, offering you a clear and concise briefing on the role of the College and the advantages of membership it offers to paramedics. As many of you know, the College of Paramedics began as the British Paramedics Association and it has been achieving great things for frontline ambulance workers in recent years - especially in the areas of Continuous Professional Development and Curriculum Guidance. Currently the College has almost 4,400 members but, with over 18,000 paramedic registrants in the UK it’s quite clear that they can achieve even more on your behalf if more of you take the plunge and swell their growing ranks. So, if you find yourself with a few spare moments between hectic shifts this Christmas, take my advice and spend a few moments browsing their website. I’m confident that if you take a good look around and then maybe have a chat with one of your work colleagues who is already a proud member of the College of Paramedics, you’ll quickly decide that joining up is one New Year’s Resolution that you’ll spend all year feeling proud of. Oh and to avoid confusion, you’ll see the name ‘David Davis’ crop up on two major articles in this edition. This is not a Christmas BOGOF offer. The second David Davis, also a Director of Communications, writes excellently on the forging of links between the UK and Romania on behalf of the Independent Ambulance Association (IAA). Both gentlemen are highlyexperienced and highly-regarded in their respective fields. It just seems to be the case that the monikor ‘David Davis’ seems to fall frequently on highly-gifted communicators! Ambulance Today will be working closely with CoP throughout the coming year and it will be our aim to bring you as much news and information as possible on their behalf so, again, if there are any issues you’re keen to tell them about please feel free to email me and I’ll be happy to pass your messages on. Best wishes for a Merry Christmas and a Happy New Year, Declan Heneghan Editor, Ambulance Today

EDITOR: Declan Heneghan email: editor@ambulancetoday.co.uk CORRESPONDENCE: All correspondence should be sent to: The Editor, Ambulance Today, 41, Canning Street, Liverpool L8 7NN DESIGN & PRODUCTION: Wordplay Graphics email: mark.mcalister@merseydocks.co.uk FOR ADVERTISING ENQUIRES CALL: +44 (0)151 703 0598 OR +44 (0)151 708 8864 COPYRIGHT: All materials reproduced within are the copyright of Ambulance Today. Permission for reproduction of any images or text, in full or in part, should be sought from the Editor. PUBLISHER’S STATEMENT: Ambulance Today magazine is published by Ambulance Today Ltd, 41 Canning Street, Liverpool L8 7NN. The views and opinions expressed in this issue are

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not necessarily those of our Editor or Ambulance Today. No responsibility is accepted for omissions or errors. Every effort is made to ensure accuracy at all times. Advertisements placed in this publication marked "CRB Registered" with the organisation's "CRB Registration No." means that the Organisation/Company meets with the requirements in respect of exempted questions under the Rehabilitation of Offenders Act 1974. All applicants offered employment will be subject to a Criminal Record Check from the Criminal Records Bureau before appointment is confirmed. This will include details of cautions, reprimands or final warnings, as well as convictions and information held by the Department of Health and Education and Employment.

December 2012 | Ambulancetoday

Issue 5, Volume 9 : December 2012 Next Issue: March 2013

CONTENTS

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I N S I D E YO U R W I N T E R I S S U E : P7 - Let’s stamp out violence against ambulance staff!

P24 - Caring at Christmas Be kind this Christmas! John Dale asks for support for Filipino ambulance and Roy Williams asks the same for India

Unison’s Ambulance Sector Lead, Hope Daley, wants employers to take a proactive approach to tackle this most pressing workplace issue

P27 - Romanian ambulance follows IAA lead David Davis of the Independent Ambulance Association on his recent visit to speak on public/private ambulance development

P9 - Supporting and improving paramedic practice David Davis, Communications Director of the College of Paramedics, explains its role and why all UK paramedics should join up

P18 - Have your say on ambulance redesign project Ed Matthews, Project Lead on the Helen Hamlyn Centre for Design’s ambulance redesign project, announces consultation day

P19 - Joining forces to drive down falls Ambulance Service Network Director, Jo Webber, argues the case for a national falls prevention strategy

P34 - London Trauma, Cardiac Arrest and Air Ambulance Gathering Read about London’s first-ever and highlysuccessful combined trauma, cardiac arrest care and air ambulance conference Also Inside:

P42 - Out & About The latest news from services around the UK

P46 - Products & Suppliers News Latest in new products, services & technology

Places are available NOW on our 2013 courses Our IHCD-accredited Blue Light Driving courses are open for booking from 4th-22nd February and from the 4th-22nd March Also available are IHCD FPOS (First Person on Scene) and HSE approved FAW (First Aid at Work) courses which are both available on a monthly basis. Ambulance Technician Level 3 BTEC courses are available throughout the year To book your place or for further information please contact Ian Rose on: 01737 649 946

UNISON Update Unison Comment

AmbulanceTODAY

Let’s stamp out violence against ambulance staff ! HOPE DALEY is UNISON’s Ambulance Sector Lead. Read on to find out about the key policy areas UNISON will be addressing on your behalf in their fight to prevent the many threats to ambulance services across the UK.

Ambulance staff have always provided frontline services but now they are finding themselves in a true battle zone as work related violence continue to rise and this is set to worsen as we approach the festive season. Christmas is one of the busiest times of the year for ambulance staff and many are use to being spat on, punched, kicked, bitten, slapped or worse on a more regular basis during this period. Figures from the 2010/11 NHS Staff Survey revealed that whilst employers have put measures in place to minimise the risk, incidents of violence continue to occur and in many ambulance trust physical violence from patients, relatives and members of the public continue unabated as 7% of NHS staff were victims of assault during that year. Yet, despite this, the government is continuing with an agenda of cuts that will threaten initiatives to prevent these attacks and the ability of the police to find and prosecute the perpetrators. Cuts to public services mean that it is workers such as Paramedics who often bear the brunt of frustration and anger from the public and the problem is not limited to England. In Scotland attacks on ambulance staff have soared 30% in the past two years – reaching an average of almost one a day and in the past year, workers were subjected to 297 assaults a significant increase on the previous two years when there were 219 attacks reported. In Wales, there has been an increase in the number of emergency workers who have faced violence at the hands of the public. Welsh Ambulance Service staff members suffered 218 physical assaults and 110 incidents of verbal abuse over a 3 year period including two incidents where ambulance staff were attacked with a weapon. And in Northern Ireland there has been a sharp rise over the last few years in the levels of violence against NHS staff that required police assistance.

December 2012 | Ambulancetoday

The Health and Safety Executive (HSE) highlights some risk factors for violent behaviour which include impatience; frustration; anxiety; resentment; drink, drugs and inherent aggression/mental health problems and working alone. Ambulance staff face these factors on a daily basis and is set to get worse particularly as the cuts faced by many ambulance trust starts to bite. UNISON wants to see employers taking a proactive approach to tackling this problem which is leading to injuries, sickness absence and high levels of stress. Prevention of violence is crucial but also key is appropriate support and follow up investigations to prevent further occurrences. They also need to encourage staff to report incidents and near misses so that risks can be properly assessed and appropriate action identified. For these reasons, the reporting and recording of violent incidents should be established as part of an overall strategy that can be seen to be tackling this serious workrelated risk. UNISON members are concerned that under-reporting is hiding the true extent of the problem and reports often exclude "routine" threats or many instances of insulting behaviour. Under reporting exist for a number of reasons. Staff will not report incidents unless they are confident about how their report will be received by management. Many have the fear, and some the experience, that involvement in a violent incident will be seen as their failure. Others may be distressed by the experience and believe that reporting it will add to that distress, particularly where no clear preventative measures are in place. Employers must take urgent action to ensure that ambulance staff are protected. It is no good saying that some of these assaults were the result of a patient’s medical condition, staff have a right to a safe working environment. And it is up to the employer to provide it by assessing risks and managing them. UNISON has campaigned for many years for violence against public sector workers to become a specific offence. It is an outrage that ambulance staff continue to be assaulted whilst carrying out their duties, and urgent action is needed to prevent and deter these attacks. It is right that the police have special protection under the law from assaults, but this should be extended to all public sector workers including ambulance staff. Violence meted out to staff cost money that would be better spent delivering patient care

Happy Holidays 2012 has been a difficult year for many of us and is set to be tougher in 2013. On behalf of UNISON I would like to thank all of our members, stewards and reps for all of the work they have put in this year. Enjoy the festive break, when you can and I look forward to working with you all in 2013. Wishing you and your families a happy, healthy and safe Christmas. EMAS/UNISON Learning Agreement The Learning Representatives in UNISON EMAS (East Midland Ambulance Service) Branch are proud to announce the official signing of a Learning Agreement reached between the Trade Unions and EMAS. It is believed that this is the first such agreement in the Country to be signed between an Ambulance Service and a Trade Union. The agreement will be signed on 17th January 2013 at East Midlands Ambulance Service, Trust Headquarters in Nottingham by the Chief Executive of EMAS along with the UNISON Learning representatives who led the negotiations, and representatives from the associated Unions. This special event will run between 12 and 2.00pm. EMAS management, UNISON members and UNISON at a National and regional level along with Union learn (the learning and skills organisation of the TUC) will be there to show their support for this significant achievement in employee learning development. This agreement will outline the commitment of EMAS and the Trade Union to work together to help source and signpost members to learning opportunities of interest and relevance to them. These may include work or personal interests to help frontline crews in their day to day experience whilst also aid towards a better patient experience. UNISON in EMAS believes in investing back into its membership and this is only the start of good things to come. There is a growing team of UNISON Union Learning Representatives (ULR’s) and they are actively seeking to recruit other ULR’s to help spread the word of learning opportunities open to members. Lee Goddard. Union Learning Representative. UNISON EMAS Branch.

Focus on The College of Paramedics

Why do paramedics need a professional body? Director of Communications for the College of Paramedics, David Davis, argues the case for why a strong College is needed to improve and protect paramedic standards in the UK. This article marks the start of a series of editorial features that Ambulance Today will be running throughout 2013 to spread awareness of the College’s valuable role so if you have any views or comments on its content please feel free to contact the editor at the email address shown at the end of this article and we will be happy to pass your thoughts on to the College’s Council We are often asked why paramedics need a professional body and what is unique about its role in comparison to the regulator (the Health and Care Professional Council [HCPC] formerly the Health Professions Council [HPC]). We are also asked why paramedics should join their professional body when they are already represented by a trades union. So what is the role of the professional body and what does the College of Paramedics do to represent the interests of paramedics? This article is the first of several that will appear in Ambulance Today which aim to address these questions. Readers’ questions are invited, and they will appear in Ambulance Today along with responses.

education programmes that lead to registration. The regulator can and, indeed does, take action against professionals who do not meet the standards it has set; B; Holding and maintaining a register of professionals who meet the standards set by the regulator and who are permitted to use the protected titles to identify themselves. There are some parallels with the medical profession but also some differences. For example, the General Medical Council (GMC) sets the standards and maintains the register for doctors whilst each arm of medicine has its own professional body such as the Royal College of Surgeons or the College of Emergency Medicine; additionally there is the British Medical Association,

THE ROLE OF THE PROFESSIONAL BODY The paramedic profession is relatively new having only been established at the turn of the Millennium; so it is understandable that paramedics might raise questions about the role of the professional body. This is described below, but first it is essential to describe the role of the regulator: The Regulator As part of the essential legal framework surrounding a registered profession, a regulator has to be identified or established with certain key duties focusing upon protection of the public, which are defined by statute. The regulator’s role is to protect the public and it does this by: A: Setting standards, defined in the ‘Standards of Proficiency,’ (HCPC 2007) and the ‘Standards of Conduct Performance and Ethics,’ (HCPC 2008) for the profession and approving December 2012 | Ambulancetoday

primary legislation, its primary purpose is therefore to protect the public by setting standards and holding professionals to account where necessary. In order to practice as a paramedic within the UK, paramedics must be registered with the HCPC. Read more at www.hpc-uk.org The Professional Body All professions have established professional bodies, for example the Royal College of Nursing (RCN) for nurses; the Royal College of Midwifery (RCM) for midwives; the Royal College of Speech and Language Therapists; etc. The HCPC describes the role of professional bodies as: n Promoting the profession (both to the HCPC and more broadly) n

Representing members’ interests in relation to profession-specific issues (rather than for example pay and conditions)

Developing the curriculum framework

Developing post-registration education

Continuing professional development (CPD)

It is expected for example that when the HCPC reviews the ‘Standards of Proficiency ‘and the ‘Standards of Conduct, Performance and Ethics,’ they work in collaboration with the professional body. This allows members of the professional body to take responsibility for their own professional future and development.

which provides a trades union type of function for doctors. Paramedics along with 16 other health and care professions are all regulated by the HCPC. The HCPC is a statutory body which is independent of the 16 professions it regulates. Supported by

The Professional Body and the Trades Unions It is worth reflecting on the similarities and differences between these organisations and note that some professional bodies also provide trades union functions; such as the British and Irish Orthoptics Society. In regards to paramedics, the College and unions may share concerns over issues such

Focus on The College of Paramedics

as pensionable age and the recent consultation on emergency driving laws. In other ways, the organisations are quite different. It has to be remembered that there are only just over 18,800 paramedic registrants in the UK and the professional issues that arise are often quite unique to that relatively small workforce. Whilst the trades unions represent its membership on pay and conditions and other matters of an industrial nature, the College of Paramedics focuses on professional issues unique to the paramedic profession and in issues where the trades unions might not, such as detailed above. Issues relevant to the Paramedic Profession The following are examples of issues that are either frequently raised by paramedics or which have been pursued by the College already: n Why do Ambulance Foundation Trusts not have a mandated paramedic presence on their boards? n

Airway management has been a matter of concern to paramedics over recent years. How can the evidence base be interrogated and interpreted by paramedics, often in the face of alternate views, to enable the profession to ensure that it plays a leading role in shaping its own clinical practice both at national level and in ambulance organisations?

How should specialist paramedic roles be increased and expanded to meet the needs of and enhance patient care in a range of situations and to avoid hospital attendance for urgent and unscheduled care cases?

What will be the role of paramedics and how will the profession develop given the recent establishment of a new medical sub-specialty in prehospital emergency medicine?

How will the future professional relationship between paramedics and medicine evolve? This is an important questions as it will influence the impact of paramedic practice upon patient care, the degree of autonomy and paramedics’ scope of practice, all of which link to the career framework, agenda for change and much more.

Taking independent paramedic prescribing forward, on the pattern established with pharmacy and as recently achieved by physiotherapists, in order to meet patient needs and deliver excellence in clinical care.

How can paramedic students access

December 2012 | Ambulancetoday

the NHS bursary scheme in the way that is common for all other allied health professions? n

How do paramedics influence workforce development, through functions like the Local Education and Training Boards (LETBs) and Health Education England (HEE) to ensure that the future provision of the paramedic workforce can meet emergent and continuing changes in patient needs?

‘essential’ as a high number of paramedics may already be union members. But if paramedics want to influence important decisions that affect their profession, they need to be sure that they have a professional body that is seen to be representative of the paramedic registrants in the UK so here are some more reasons why the UK’s paramedics should think about joining the College:

These examples represent just some of the current and important topics affecting paramedic practice, which are being taken forward vigorously by the College of Paramedics. In the past, paramedics may have complained that they are either powerless to influence improvements or too remote from certain issues for them to be relevant. The challenge for paramedics now is to act in an effective and compelling way to influence all of these issues in a professional and not organisationally led context.

Parity with other professions Paramedics frequently complain that their profession does not have the same standing as others such as nursing, midwifery, and physiotherapy for example. It has to be remembered that the other professional bodies have been around for a long time and have travelled a journey in which they have established strong bases and structures because they have proportionately large memberships (some at almost 100 percent of all registrants). This has enabled them to establish credibility and gain respect so that when they take up issues, the public and employers pay attention because they know

ENOUGH INFORMATION OR STILL ASKING ‘WHY JOIN THE COLLEGE OF PARAMEDICS?’ As previously identified there are currently more than 18,800 paramedics registered with the HCPC in the UK. The College of Paramedics has almost 4,400 members and has enjoyed positive growth in its membership over the last two years and now has around 15 percent of all paramedic registrants in the UK are College members. This figure stood at 10 percent two years ago. This is probably not an unusual situation for a profession established relatively recently and it is even less unusual because the College of Paramedics, unlike some other bodies, is not also a trades union; and therefore not seen by many members as

they are voicing the opinions or concerns of the majority of registrants, and that they are the authoritative source for opinion. High uptake of membership means they are wellresourced organisations that are able to direct dedicated and expert effort to the projects and causes they see fit to pursue. Growth over recent years has meant the College of Paramedics has been able to recruit and employ a part time workforce but it also relies on a network of elected College officials who are all paramedic registrants and give their time in a voluntary capacity to provide advice on professional issues. Having a substantial and representative membership means that the College is in a strong place to achieve Royal College Status, which is important for future engagement.

Focus on The College of Paramedics

Recognition A common complaint amongst paramedics is that they feel their profession in general is not always recognised, particularly by the main employing organisations which may have appointed clinicians from other professions to senior posts, and because as already mentioned, there is no mandate for a paramedic to be present on an Ambulance Service NHS Foundation Trust board. This is probably too complex to address in these few paragraphs but it is worth pointing out that whilst the paramedic profession has come a long way in a short time, it also has some way to go in its development and establishment. It is easy to turn around the question of recognition by asking paramedics whether they themselves recognise the importance of having an effective professional body. Recognition also applies to how other professions see paramedics. Because others are well-resourced and well-structured, they exert significant influence over education, training, and ongoing professional development provision. It is obvious that the paramedic profession does not yet have those sorts of footholds and leverage; but growth has been consistent since 2010 with a 70 percent increase in membership, which indicates the professional body is increasing in significance and that footholds and potential leverage continues to be strengthened. Contemporary examples of influence NHS Ambulance service trust are grappling with the challenge of right service, right place, right time and this is visible in initiatives to appropriately manage lowacuity non-urgent cases, quite rightly aimed at avoiding unnecessary hospital attendance. These initiatives have been developed to varying degrees with different approaches across the country, but all paramedics know that the risk in deciding not to take someone to hospital is much higher than that for conveyance. While many would willingly expand their scope of practice to meet these objectives, they want to be sure that all training is sufficiently well-structured to give them the skills and knowledge they need. The same goes for specialised courses targeted at the critically ill or injured patient. The College of Paramedics has developed new sections to address these areas in its third edition of its Curriculum Guidance and December 2012 | Ambulancetoday

Career Framework and whilst it expects that these will be accepted as best practice, there is no absolute requirement for education providers and employers to adhere to it. This would probably not be the case for other well-established professions which over time have built memberships and reputations which mean their guidance is the single most important benchmark against which all programmes would be expected to comply. In 2011, the medical profession followed a rigorous process in developing a new medical sub-speciality in prehospital emergency medicine (PHEM). Whilst the College of Paramedics will always support any initiative that enhances patient care and services, it also believes that the professions’ lack of standing and experience in such matters may have contributed to some questions being left unanswered regarding how the identified need in these patient services could be addressed in the wider context. Could paramedics fill part or the entire new role? Will it require doctors at all stages and in all situations, or could doctorled remote advice combine with expanded paramedical services in all or some cases? This is not a criticism of PHEM, but does demonstrate that a relatively small professional body is highly unlikely to exert influence when important decisions are being taken which will inevitably determine the allocation of resources and potentially affect the role of paramedics. Summary The College of Paramedics has established approvals processes and strong relationships in the higher education sector and is proactive in continuing professional development, mentorship programmes and other professional activities. It is keen to pursue charitable status and when full membership reaches 51 percent of the UK registrants it will also pursue status as a Royal College. Paramedics have many issues which occupy their thinking about their profession. The College of Paramedics addresses as many of those issues as possible but has to do so through careful allocation of its resources. It could concentrate on continuing to grow membership – but whilst doing solely that, there will be important matters that come and go without the input of the profession. It could continue to address the main issues as they arise as it has done for the past 10 years, but that means membership may grow at a slower rate than is needed to ensure the development of the profession. Members fees for the College of Paramedics are amongst the lowest of all professional bodies and in many cases significantly less, so it really is good value for money too!

Biography: David Davis Communications Director for the College of Paramedics, David Davis, is also the NHS Pathways Clinical Lead for South East Coast ambulance service. David represents the profession at a range of national stakeholder groups, including the National Clinical Governance Group for NHS Pathways. In addition, David is currently seconded for part of the week as National Clinical Lead for Allied Health Professionals at the Department of Health, Informatics Directorate. David joined SECAmb in 2001 and was registered as a paramedic in 2004. David’s clinical and managerial specialities include prehospital management of stroke care and he was the College’s stroke lead for a number of years. Playing an active role in stroke development nationally and regionally, David’s work has featured in a number of high profile publications, including the NHS 60th Commemorative Brochure and the second of the Darzi Reports where he was featured as a clinical leader. David remains a Clinical Associate of the NHS Stroke Improvement Programme. In his spare time David is currently trying to finish an MSc in Management & Leadership for Clinicians, as well as being a member of the Journal of Paramedic Practice Editorial Board! FINALLY It is hoped that this short article has addressed some of the questions in relation to the College of Paramedics which are frequently raised by paramedics. In the next issue of Ambulance Today, there will be an overview of the structure the College, its key position-holders, and the activities it has been engaged in and how it has represented the interests of paramedics. In the meantime, if you have any questions about the College of Paramedics you would like to ask or comments you would like to make, please send them to Ambulance Today editor, Declan Heneghan, at: editor@ambulancetoday.co.uk Follow us on Twitter: @ParamedicsUK or #CollegeofParamedics Visit us on Facebook: http://www.facebook.com/ CollegeofParamedics?fref=ts

Focus on London Trauma, Cardiac Arrest and Air Ambulance Conference 2012

London Trauma Conference a Huge Success!

Once again, the London Trauma Conference excelled, putting on four days of inspiration, insight, ideas & education and featuring the profession’s most celebrated trauma leaders. Delegates, including doctors, ambulance teams and nurses, travelled from over 20 countries to attend the conference. Topics were current, relevant, well thought out and provoked lots of discussion amongst its audience and on the twittersphere, where the event’s official hashtag, #LTC2012, was trending. Commenting on the conference, Professor David Lockey said: ‘Once again we assembled a great line up of trauma professionals, at the very top of their chosen specialities from both the UK and overseas, for the UK’s premier trauma conference. Delegates travelled from all over the world to attend the conference, feedback was outstanding and enquiries for bookings have started rolling in for next year’s conference, which will be held on 10-14th December.” For the first year ever the Cardiac Arrest Symposium, which was sold out, was held as part of the conference. Topics included prehospital Cardiac Arrest, Cardiac Arrest in the young, Sudden Cardiac Death, Cardiac Arrest in sporting events and Mr Mark Whitbread gave an insight into the future of Cardiac Arrest for paramedics. Key note address was given by Prof. Maaret Castren and there wasn’t a dry eye in the house following a talk from cardiac arrest patient, Chris Solomons, who bravely shared his experience. Delegates were treated to the first ever air ambulance symposium, which was hosted by the Norwegian Air Ambulance. Led by Prof. Hans Morten, this day gave insights into December 2012 | Ambulancetoday

Pictures by Paramedic, Lee Parker

London Trauma Conference 2012 featured the profession’s most celebrated trauma leaders and attracted delegates from over 20 countries worldwide. For the first time it incorporated one day symposiums on Cardiac Arrest Care and Air Ambulance provision.

important areas of the air ambulance arena looking at air ambulances of today and the future of air ambulances, which was covered by Dr Gareth Davies. Mr Graham Professor Sanjay Sharman Chalk gave an overview of the dispatch of air ambulances in trauma, Prof. Hans Morten covered prehospital thrombolysis in Stroke, Prof. Dr Gareth Grier Wolfgang Voelckel gave an insight into head trauma and Dr Anne Weaver shared the progress of carrying blood on board London’s Air Ambulance, nine Mr Jerry Overton months on. Other days covered pre-hospital care, major incidents and trauma issues with an eponymous lecture held in honour of the contributions of Douglas Chamberlain to cardiac arrest management and The Peter Baskett Memorial Lecture was given by Professor Michael Parr, from Liverpool Hospital, Sydney, who discussed, ‘The highly

performing Trauma System: How good can we get?. Keynote speakers were Professor Maaret Castren, Dr. Gareth Davies, Dr. Stephen Solid and Professor Jim Ryan. Breakaways, both enjoyable and educational, included the Trauma Research Forum hosted by Prof. Karim Brohi and Core Topics in Trauma, for junior doctors, nurses, paramedics and medical students. Another first for the conference was the thoracotomy masterclass, which was hosted by Major Thomas Konig. Following theory which covered the history of thoracotomy and post thoracotomy care, the audience were treated to a thoracotomy moulage by a doctor and paramedic from London’s Air Ambulance. As ever the stand-up science evening, led by Dr Gareth Grier, was hugely entertaining and popular and even attracted medical students who presented their research to the panel of experts and sceptical audience. London Trauma Conference 2013 will take place on 10-14th December at the Royal Geographical Society in Kensington, for more information and bookings visit www.londontraumaconference.com and for enquiries contact enquiries@londontraumaconference.com or call 0844 335 0377. For updates throughout the year, including photos, videos and blog posts please visit the website or follow @LDNtrauma.

Focus on Dutch Ambulance Care

AmbulanceZorg Limburg-Noord faces some specific challenges

Optima helping optimise resources and deliver improved performance in the Netherlands for AmbulanceZorg Limburg-Noord AmbulanceZorg Limburg-Noord is committed to improving performance and meeting a Government set target of responding to 95% of A1, life threatening calls within 15 minutes. Having implemented all recommendations within the National Ambulance Plan, the ambulance service found that it still couldn’t meet this particular target and A1 performance is falling below the required standard at 89%. Optima was asked to provide an independent evaluation of the number of resources required to achieve the target performance in the region. André Lemmen, Director, AmbulanceZorg Limburg-Noord explains “Having done everything we can to optimise our service and performance given our current resource levels, we felt that we may be falling short of the required number of ambulances or not making best use of our existing ambulances, and we may need to review the best locations for our vehicles. We needed to fully understand the situation and provide compelling supporting evidence to accurately present our case for making any changes.” Optimising resources and locations Optima addressed this question using Resource Location Optimiser (RLO), the optimisation module of Optima Predict™. RLO is used to identify the locations that maximise the coverage of call demand by using historic incidents. The whole geography was assessed meaning that new locations that would improve performance were identified. In order to provide a highly accurate model, RLO takes into account a number of factors: n Coverage is calculated using the tuned road network, meaning that coverage is December 2012 | Ambulancetoday

based on historic ambulance journey data, and accounts for time of day, day of week, lights and siren and non-lights and siren travel

show how 95% performance can be achieved. The options included: n Only using existing bases

Incidents are covered by a resource if they can be reached within a target response time

Using completely new locations

Using a mix of existing and new locations

A workload factor considers how busy a resource is likely to be; once a resource reaches the workload factor, it cannot respond to any additional calls. This leads to the RLO putting multiple resources to cover busy locations

Resources are provided as an input to the model and resources are added until the coverage reaches the target level

Coverage and Demand – New Bases Comparing the coverage between the baseline scenario on the left and the optimised new base scenario on the right.

Challenging environment The Limburg region provides the ambulance service with some particular challenges. Bordered by Germany and Belgium, the long and narrow region is divided by a river. There are relatively few bridges crossing the river, leading to increased journey times and congestion. Optima’s RLO analysis considered a number of different options for locating the ambulances, with each option then modelled using a variety of resources to

André Lemmen said “The final report from Optima gave us some solid recommendations for improving our A1 performance. It clearly shows that we ideally need three additional resources and we need to make some changes to our temporary and permanent locations around the region to maximise our coverage. It has given us a convincing case to present to our stakeholders to implement these changes and secure more funding.” Moving forward Optima’s full report has now been accepted by governing bodies and AmbulanceZorg Limburg-Noord is in the process of putting together a detailed plan based on Optima’s findings, for approval and implementation. Optima Predict is being used in-house to carry out further detailed modelling, providing a unique evidence base that other analytical tools cannot match. This will identify further options for Dutch ambulance services to continue to improve services and maximise efficiency and effectiveness in these challenging times. Optima Predict is also now fully installed and providing critical new strategic information in Scotland, South Central and East of England as well as 43 other ambulance services in 9 countries around the world. For more information, please call +44 1189 036602, email info@theoptimacorporation.com or visit www.theoptimacorporation.com

Focus on RCA Ambulance Redesign Project

helen hamlyn centre for design

Have Your Say on Ambulance Redesign Project Ed Matthews, Project Lead on the Helen Hamlyn Centre for Design’s ‘Redesigning the A&E Ambulance’ project is arranging a consultation day at the RCA in Kensington early in 2013. The consultation exercise is intended to progress the project towards prototype construction and ensure that ambulance providers in both the UK and across Europe have an early opportunity to contribute ideas on the vehicle’s eventual design. “We’re delighted that Dr Anthony Marsh, Chairman of the Association of Ambulance Chief Executives (AACE) and CEO of West Midlands Ambulance Trust has found some time amongst his many commitments to open the day, alongside prominent, already committed supporters of the ambulance redesign project, and long-term supporters of the Royal College of Art (RCA)”, he commented, adding: “It’s essential that we receive clear feedback from all parts of the ambulance service and, because AACE is committed to ensuring that ambulance staff at all levels have a voice in determining ambulance delivery across the UK, Anthony Marsh’s presence and influence will help us gather the input we need.” Mr Matthews continued: “We’re conscious that Ambulance staff might feel that the project has gone a little quiet since we launched the Demonstrator Unit last year. The main reason for this is that many of the ambulance people whose input is crucial have understandably had a large chunk of 2012 dominated by their responsibility for

Olympics delivery. We can relate to this since our own college was used as a main world media base throughout the event. However, the fact is that beneath the quiet exterior we’ve been extremely busy – there are many complexities attached to achieving our next objective, which is to build working prototype vehicles, put them to the real test of working in frontline service, and develop the design for commercialization.” “Our launch event was very successful and the audience of clinicians, industry experts, NHS leaders and manufacturers responded very positively to the proposed new treatment space. Former LAS Chief, Peter Bradley, lent his personal support to help us to progress as far as possible towards the next development stage prior to his move back to New Zealand, and wisely nominated their fleet lead, Nick Pope, to continue LAS’s support after he stepped down as CEO. Nick has given us excellent support and, despite strenuous 2012 delivery commitments, he’s been there for us whenever we’ve needed his advice. We can’t thank him enough for this.” Stressing the need for consultation, Ed added: “We’ve continued to develop our dialogue with ambulance staff, both in the areas of clinical effectiveness and the business case. As before, we’ve consistently found that people from all sections of the

Lord Darzi and Lady Helen Hamlyn - leading supporters of the project ambulance community are open-minded and enthusiastic in their support for the development of a vehicle better designed to reflect the major changes in clinical science that, over recent years, have influenced the way in which patient care is delivered. It became clear to us that a major consultation event was needed to bring together the key stakeholders, whose knowledge and experience needs to be fed into the development programme so we can ensure that the end result matches today’s clinical, financial and operational requirements.” He finished: “A number of your readers may be aware that we’ve put a lot of time into building up a database of the people whom we need to invite to the event. These will include individuals from both the public and private sectors, and we’re putting together a series of presentations to make it absolutely clear what the proposed design is, and the clinical benefits that it can deliver at a manufacturing cost that is the same, or maybe even a little less, than that of current vehicles. We’ll also be discussing the operational impacts, in terms of training, new technologies, changes to existing systems, and the business case”. The event is planned for late February, 2013, and invitations will be sent out shortly. If you would like to find out more about the project or if you would like your ambulance service or technology provider to be involved in the consultation day, please email Ed Matthews at: ed.matthews@rca.ac.uk

helen hamlyn centre for design December 2012 | Ambulancetoday

Focus on Need for a National Falls strategy

CEO of the Ambulance Service Network, Jo Webber, presents a compelling case for investing in rehabilitation and falls services that link up organisations across health and social care

A stumble or trip can knock the confidence of the most active and independent person, but the impact of a fall on someone who may already be vulnerable – isolated, frail or otherwise in poor health – can be devastating. The numbers are shocking, as you can see from the ‘Falls in numbers’ infographic on page 21. n Falls are one of the leading causes of mortality resulting from injury in people over 75 in the UK. n

One in three people over 65 and half of people over 80 will suffer a fall each year.

Half of those with hip fracture never regain their former level of function and one in five die within three months.

Joining forces to drive down falls

By Jo Webber, Director Ambulance Service Network following a fall. And falls and fractures among the over-65s take up 4 million hospital bed days each year in England alone, costing an estimated £2 billion. But the impact of falls reverberates far beyond physical health and wellbeing and their effect simply cannot be measured in statistics, performance measures or financially. The psychological impact of falling can be devastating. Having a fall can drastically lower levels of confidence and independence in older people, and these

But just as we don’t have to accept falls as an inevitable part of aging, nor must we accept as inevitable the burden which falls place on the health and social care service. Ambulance services are often the first point of contact when an older person falls, and so are ideally placed to take a lead role in developing the collaborative approach which evidence points to being the best way to reduce falls, and lessen their devastating impact for individuals and for the health service.

December 2012 | Ambulancetoday

Making the case The Department of Health has estimated that a falls prevention strategy could reduce the number of falls by 15 to 30 per cent. But while ‘slipper exchanges’ an other initiatives have undoubtedly had some degree of impact, overall, studies have shown that these policies have not been entirely successful. Many patients still experience disjointed care as falls and fracture services are not integrated and not enough is done to stop people falling again. Working with service leaders from ambulance trusts and the urgent care sector, and their counterparts in community-based services, the NHS Confederation has drawn together evidence that demonstrates a clear case for investing in rehabilitation and prevention falls services that link up organisations across health and social care.

Falls account for 10 to 25 per cent of ambulance call outs for the over-65s.

Picking up the pieces Falls account for approximately up to 25 per cent of ambulance call-outs for the over 65s, and cost around £115 per call out. Every year, over 500,000 older people attend UK emergency departments

Working together, community health service providers and the ambulance service can play a crucial part in the delivery of comprehensive care pathways for falls and fractures.

We want to see a concerted drive – from the national level through to the most local – to tackle falls. The ongoing reforms in the NHS, including the establishment of Health and Wellbeing Boards which will look at the wider local inter-agency picture, are the perfect time to seize the chance to get the health service, social care and local authorities working together.

consequences – along with increased isolation and depression – often slow down recovery.

There are mechanisms available in the NHS reforms to make joint working possible but they will require leadership from national to local level to really work.

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Focus on Need for a National Falls strategy

Joined up care: n

Health and wellbeing boards need to ensure services and commissioning for falls are joined up.

Organisations across public health, the NHS, social care and local government should share data.

Organisations should use the NHS patient number to keep track of people who fall and assess the care they receive

Health and social care budgets should be shared or aligned to support joined-up falls services.

Commissioning n

The NHS Commissioning Board and Public Health England will need to enable clinical commissioning groups to work together to deliver a range of integrated falls services across health and social care locally.

As part of local authoritiesâ&#x20AC;&#x2122; public health mandate, councils should provide falls prevention information and support services.

Falls should play a major part of the needs assessment undertaken by commissioners.

Mechanisms to deliver better care:

December 2012 | Ambulancetoday

Falls and fracture indicators should be part of the Adult Social Care Outcomes Framework and new ambulance performance measures.

NHS trust quality accounts should prioritise reducing the number of and harm from falls

Commissioning quality and innovation (CQUIN) targets should include an indicator for reducing falls and avoidable admissions that encourages organisations to work together.

Focus on Role of Scotland’s Emergency Medical Retrieval Service

Flying High to Raise the Clinical Bar In a country where, for all its beautiful scenery, communities and individuals can find themselves experiencing a health crisis in the most inaccessible locations, far from major treatment centres, the Emergency Medical Retrieval Service (EMRS) makes a world of difference! Their Critical Care Practitioners (CCPs), a new and challenging role for paramedics, help ensure that all patients, no matter how remotely located, can have the emergency department resuscitation room or intensive care department brought directly to them, before being swiftly transported to the right treatment centre for their specific condition or trauma. CCP Neil Sinclair reports. After 10 years’ experience as a paramedic working in various environments, I felt the need to find a new clinical challenge. I had previous knowledge of the Emergency Medical Retrieval Service (EMRS) so when I heard they were creating the new role of ‘Critical Care Practitioner (CCP) for nurses and paramedics, I knew the opportunity to be actively involved in retrieval medicine was exactly the challenge I was looking for. Along with four paramedics and one nurse I am now 12 months into a secondment with the EMRS in the role of Critical Care Practitioner. The EMRS is an NHS-funded service based in Glasgow and our service provides critical care to acutely ill and injured patients across Scotland in a variety of locations and environments. Retrievals are either from the pre-hospital environment (primary retrieval) or from a remote and rural health care facility (secondary retrieval). “Retrieval is the deployment of a critical care team to a seriously ill

or injured patients’ location to undertake resuscitation and stabilisation prior to safe transfer to definitive care” Secondary retrievals are necessary due to the unique geography of Scotland, there are many remote healthcare sites situated on the west and north coast. These retrievals take place from a variety of health care facilities including district nurse practices, remote GP surgeries, community hospitals and rural general hospitals. The patients who arrive at these facilities are often critically ill and, with limited equipment and specialist staff available, these patients can easily exceed the local critical care capability. The service provided ensures that these patients have equity of access to the appropriate level of care, by bringing the emergency department resuscitation room or intensive care department to the patient - regardless of location. Primary pre-hospital critical care is provided across the west coast area of Scotland. In these circumstances we respond as the EMRS Trauma Team. Within the greater Glasgow

area this is done in one of the service dedicated response vehicles, whilst further distances are reached by helicopter in a Helicopter Emergency Medical Service (HEMS) configuration. The team is dispatched by the ambulance service control centre, or after requests for assistance from the ambulance clinicians onscene. Transportation of the patients in remote areas is predominantly done by air and the service works closely with the Scottish Ambulance Service, utilising their fixed wing and rotary aircraft. At times, due to aircraft demand and adverse weather conditions we utilise military or coastguard helicopters to provide transport, ensuring the service can deliver care regardless of the unpredictable Scottish weather. “Flying at low level in a military helicopter in the dark at 3am makes me appreciate the magnitude of the job we’re involved in” The service is consultant-led and delivered and has two teams available 24 hours a day. Each two-person team is comprised of a consultant from emergency medicine, intensive care or anaesthetics and either a senior trainee doctor from one of December 2012 | Ambulancetoday

Focus on Role of Scotland’s Emergency Medical Retrieval Service

Biography: Neil Sinclair Neil Sinclair Joined the Scottish Ambulance Service (SAS) in 2003 as an ambulance technician and qualified as a Paramedic in 2006 whilst working in Edinburgh city centre. Throughout his career he has gained a variety of experience and clinical skills working in ambulances, rapid response units, cycle response units, helicopter and fixed wing aircraft across Scotland. Neil has specialist interests in pre-hospital cardiac arrest management and prehospital clinical governance standards. He counts his current position as a Critical Care Practitioner with the Emergency Medical Retrieval service as his greatest professional challenge to date and the highlight of his career so far. the same specialities or one of the critical care practitioner team. Working alongside nurses in the same role is a new experience for me and the other paramedics, making us a true multidisciplinary team. The CCP team is led by CCP Stuart Daly, a nurse with extensive emergency department, critical care and pre-hospital experience. This defies convention for UK practice with nurses and paramedics sharing the same role – both actively involved in pre-hospital and inhospital intensive care level of patients. The CCP team draws clinical skills from a rich background and from many different areas, resulting in significant knowledge and experience that each of us can bring to the team. We also train together regularly and learn from each other to provide optimal patient care. “It took time to become comfortable with dealing with the complexity of intensive care level ventilated patients” The challenge of being part of a team practising retrieval medicine has completely met my desire for further challenges. The

mix of work from primary and secondary retrievals is potentially one of the most diverse and challenging paramedic roles within the UK. At present this role differs from other advanced paramedic roles in the country as it moves away from sole autonomous practice and focuses on integration into a medical team. This leads to additional opportunity as working under the supervision of a consultant allows us to practice and gain experience in skills which are usually reserved for medical staff. Interventions the team will regularly have the opportunity to practice Include: n

Emergency anaesthesia and ventilation

Advanced analgesia and sedation

Chest thoracostomy

Invasive monitoring

Use of a large variety of non JRCALC drugs

An example day I experienced recently started with an emergency tasking by road to a primary mission to a crane collapse in the city centre, with several critically injured people who required critical care interventions. Directly afterwards, we were tasked to attend a secondary retrieval mission which, due to its location, required a helicopter flight to a small island off the west coast to an isolated GP surgery. Once on-scene we had to perform an emergency anaesthetic to a tiring asthmatic in the GP’s small treatment room. I had not accounted for before joining EMRS was the value of working one-on-one with a consultant, this leads to an apprentice-style education with exposure to levels of clinical leadership and teaching I have not experienced before. The clinical exposure, leadership and education I have received has led to an evolving knowledge and skill set in acute medicine and trauma. This has greatly increased from my previous paramedic skill set. The unique workload and the way in which knowledge and skills are gained make me feel it would be difficult to have learnt the same from a book or a course.

“After exposure to advanced treatment and assessment in many environments, it is apparent how important it is to do the basics well” The future holds opportunities for a wider scope of autonomous practice for the CCP team as our experience, knowledge and extended skills grow. The present goal is for the CCP team to work towards being able to independently manage single organ failure patients. The role of critical care practitioner with the EMRS provides an excellent opportunity for both the advanced paramedic and nurse role, bringing us together in an appreciation of both skill sets and allowing us to be the most effective retrieval team members. If you would like Ambulance Today to focus on your specialist ambulance project, email us at: editor@ambulancetoday.co.uk Wherever you are in the world we’ll be happy to spread the word!

December 2012 | Ambulancetoday

Caring at Christmas

FIESTA UK TO THE RESCUE!

Focus on ambulance care in the Philippines

Some response cars donated by Dutch Ambulance supporters

Dreaming of owning an ambulance and with just one stretcher and one cervical collar at their disposal… This is the harsh reality of ambulance care in the Philippines! Former Two Shires Assistant Ambulance Chief, John Dale, has been a popular figure in UK ambulance circles for three decades. But while many are aware of the contribution he has made to ambulance care in the UK as the first ambulance leader to develop NHS Direct services in 1998/9, few but his closest friends are aware that John has also dedicated much of his boundless energy in recent years to the creation of FIESTA UK (Filipino International Emergency Services Training Association) a charity which provides much-needed ambulance training and resource support to the inhabitants of the 7,000 islands that make up the Philippines – one of the most economically deprived and environmentally-challenged countries on earth. Below John explains how you can help him make a big difference to his Filipino friends this Christmas by offering them invaluable support -no matter how big or small. The Philippines is steeped in history and alive with natural phenomena. Possessing some of the most breath-taking beaches in the world and some of the most beautiful scenery it also however suffers from more than its fair share of natural disasters. Typhoons, hurricanes, landslides, earthquakes, volcanic action, tsunami and flooding are all sadly commonplace natural phenomena that blight the lives of its mostly poverty-stricken population. Add to this man-made disasters, such as shanty town fires; ferry disasters and major bus and vehicle crashes, and you soon realize it is a country that needs good, reliable

October 2011 | Ambulancetoday

ambulance and rescue services far more than most. Sadly though in many places across the Philippines such services are in desperately short supply. The ambulance service in the Philippines is divided into a number of categories. In the country’s two main cities – Manila and Cebu – as across most other areas – private ambulance companies provide services to either designated private hospitals or on behalf of insurance companies. These ambulances tend to be well-equipped and staffed by Americanstyle paramedics. Davao is the country’s third city on the southern island of Mindanao and this city

has taken on itself the task of providing an ambulance service for its residents. This service is well co-ordinated, equipped and staffed and is run alongside the fire service with whom they share a joint 911 centre which also deals with calls for the police. Central 911 also provide a Search and Rescue Service. All services provided from Central 911 are free of charge to the public. You can find more information on this service at: http://www.youtube.com/ watch?v=iBn-OLxP5xM) On the island and city of Cebu another organisation providing free ambulance, fire and rescue services is the Emergency Rescue Unit Foundation (ERUF). This service operates out of a number of bases in the adjoining cities of Cebu, Mandaue, Talisay and Lapu-Lapu. ERUF is effectively a charitable foundation and although it receives some funding from the City Government it is strongly reliant on support from other countries including the

December 2012 | Ambulancetoday

Caring at Christmas

US, the Netherlands and the UK. In Cebu the telephone number to ring is 161 and this goes direct to the ERUF central control room in Cebu City. The Foundation runs stations in three locations and each is equipped with Fire, Ambulance and Rescue capability. The staffing is comprised of both EMT and Paramedics, some of whom are paid and others of which are volunteers. ERUF is the only rescue unit in the whole country with a host of multi-response capabilities and an internationally qualified complement to respond to Urban Search and Rescue,

Focus on ambulance care in the Philippines

Technical and High Angle, Haz-Mat and Dive Rescue. Its training school is qualified to teach all these subjects as well as training its own EMT’s and Paramedics. It is one of two centres in the South East Asia Regional area that is qualified to teach Prehospital Trauma Life Support and its trainers visit other countries to provide training. ERUF has also trained many villages in disaster preparedness and awareness. Davao and Cebu along with the private services in the Capital provide the best cover for the Philippines. However there are over 7000 islands in the Philippine chain and many places have little or no ambulance support for the population. While there are many embryonic services across the country, some fail and the majority of them struggle to succeed or to even stay afloat. In the City of Mati in the extreme South of the Mindanao Island and about two and a half hours from Davao, is a volunteer service that has been in existence for over ten

years. It has over two hundred volunteers and covers the City of Mati and the nearby smaller town of Lupon. The City Health Office staffs an ambulance between the hours of 9 to 5, Monday to Friday but all other cover is provided by a charity Dreams Rescue 166. Dreams provide this service with their volunteers during the evenings, nights and at week-ends. The trouble is that Dreams do not even own an ambulance of their own and have to borrow the City vehicle… when this 8 year old vehicle is available! When the ambulance is not available Dreams’ volunteers use pick-up trucks and cars to transport their patients. Dreams have been in operation for over 10 years and are now being trained to the UK Green Book standard by the City Medical Director. Resources are scarce and the ambulance they borrow is equipped with no more than a single stretcher and one cervical collar! The dedicated Dreams volunteers even have to supply their own first aid kits, masks and gloves purchased from shops in the town. They do this willingly though because they realize that no matter how meagre their resources may be, their presence alone is of the utmost importance to those whom they seek to support. Dreams have received help and support from Davao Central 911 and, thankfully, it is now starting to receive a little support from the UK. By the time this article goes to press they will have received some more collars, a bag and mask, yellow reflective jackets and tabards and some other equipment in a first box of support items from the UK. The local Hospital is also getting a Lifepak 10 Defib trainer courtesy of Wessex Medical Ltd which one day may be used to train ambulance staff. So as we in the UK take a deep breath and prepare for Mad Friday, missed family time over the Christmas holidays and the escalating Winter Pressures, I’m sure that you’ll agree that our dedicated and deeply committed fellow ambulance workers at Dreams Rescue 166 in Mati not only deserve our deepest respect but also, more vitally, as much practical support and encouragement as we can possibly give them. So if you’d like to support ambulance care in the Philippines by donating equipment, medicines or cash please email me at: dalejohno@aol.com You can also visit us at: http://fiestauk. homestead.com/Homepage.html John Dale, Chairman FIESTA UK (Filipino International Emergency Services Training Association)

December 2012 | Ambulancetoday

Focus on Sinclair Voicenet

Workforce Management Enhances Operational Efficiency Founded in 1967, Sinclair Voicenet Limited is the UK’s longest established specialist provider of multimedia interaction recording solutions to the public safety sector. They enable control centres to capture, store and manage voice, text and computer screen activities relating to multi-channel interactions by telephone, chat, email, SMS and radio. The company also provides quality management, interaction analytics and workforce management solutions that improve performance and operational efficiency. Many Ambulance Services are evaluating or implementing Workforce Management systems as they look for new ways to meet government targets. These highly configurable systems provide an effective and efficient way to forecast staffing needs, schedule staff and tightly control costs. They help to proactively manage daily events and quickly respond to changing conditions to maintain a high level of customer service. In addition, automating manual processes reduces the requirement for administrative time and enhances the productivity of both supervisors and call handlers. North East Ambulance Service The North East Ambulance Service (NEAS) has recently awarded Sinclair Voicenet a major contract to supply and install a NICE IEX Workforce Management system. The new solution will be deployed at three contact centres across the North East of England where 300 agents handle over 1.5 million calls every year. It will allow real-time scheduling of staff and resources to reduce the reliance on overtime working and enhance the operational efficiency of the service. According to Tom Howard, Head of Contact Centres for NEAS: “After conducting an extensive tender process, we awarded

Sinclair Voicenet this contract as it not only offered the most appropriate system, but it also shared our vision of what we wanted to achieve. The company also demonstrated that it could meet our requirement for delivering the highest levels of support both during deployment and on an on-going basis.” The robust and stable solution from Sinclair Voicenet meets resilience requirements with all databases and applications replicated on a separate server at a remote location. The NICE IEX Workforce Management system also has a powerful multi-site functionality which could be utilised in the planning and management of operational resources. “The NICE system will automate existing spreadsheet-based planning processes within the Contact Centre and replace the GRS (Global Rostering System) tool traditionally utilised by Ambulance Services,” continued Tom Howard. “This will deliver significant cost savings, allowing us to make further investments in future strategies.” Quality Management Quality Management is another technology being deployed by public safety organisations of every size to increase caller satisfaction, improve call handler effectiveness and optimise control centre processes whilst cutting costs. It delivers essential operational insights to improve efficiency and ensure compliance with internal procedures and regulatory processes. The performance of call handlers can be tracked in real-time with flexible recording rules, automatic monitoring of KPI targets, real-time alerts and root cause analysis tools. It is easy to select which calls to evaluate using advanced query tools with automated scoring, graphic visualisation and a wide range of search criteria including data generated from speech analytics, desktop analytics and customer feedback. This enables managers to quickly identify and take immediate action to resolve immediate quality issues such as

knowledge gaps or process inefficiencies. Technical Support High levels of technical support are essential to ensure that systems continue to operate at maximum efficiency to meet the demands of the mission critical environments in which they are used. Sinclair Voicenet has a flexible, responsive and proactive approach to delivering the highest level of service to customers and the fact that over 90% of its customers are supported on full maintenance contracts is a clear demonstration of the company’s commitment to service excellence. It provides a range of support agreements including 24/7 coverage to meet the requirements of Ambulance Services nationwide. This has recently been extended to users of CyberTech recording equipment that are looking for an alternative technical partner that offers a more proactive approach to supporting their recording platforms moving forward. About Sinclair Voicenet Sinclair Voicenet was one of NICE Systems’ first Platinum Partners and is the only company in the EMEA region to qualify as a NICE Master Distributor, the ultimate level of accreditation. It is also regarded by NICE Systems as the UK’s leading expert in the deployment of NICE services and solutions and often provides additional support to other approved NICE resellers. Sinclair Voicenet Ltd Tel: 01355 900 000 Email: enquiries@sinclairvoicenet.co.uk Website: www.sinclairvoicenet.co.uk

December 2012 | Ambulancetoday

Focus on the Independent Ambulance Association

Romanian ambulance companies look to follow IAA strategic lead Private ambulance companies in Romania are seeking a bigger share of the national healthcare budget and are looking to what’s happening in Britain for a strategic lead to combat critics who claim that increased privatisation will destroy the state system. The author of this article is David Davis, Director of Communications at the Independent Ambulance Service and the only foreigner invited to speak at a recent conference in Poiana Brasov organised specifically for government and independent healthcare executives to debate the public/private issue. According to the latest available information the Romanian Government’s healthcare budget of about €5 billion is the lowest of all 33 EU countries, bar two; spending little more than €250 a person, it is unsurprising the country's healthcare system is considered one of the worst in Europe, ranking again third bottom in the European Healthcare Consumer Index. To halt the slide the Government has tried to introduce reforms which would encourage heavily controlled privatization of the state health system, particularly the emergency services but this provoked street riots and the proposals were withdrawn. Fermenting the crisis has been the political unrest with a succession of health ministers who have come and gone, the latest is Vasile Cepoi who resigned on October 1 following a corruption row that saw him accused of conflict of interest and the pocketing of EU funds. Deputy health minister Raed Arafat – a popular figure as the founder and owner of SMURD, an emergency rescue service which complements traditional state ambulances, has taken over the day to day running of the ministry but only on a temporary basis. While all this upheaval continues, the private medical system has moved ahead with large investment in the construction of specialist hospitals. For as Razvan Stefanescu, Director at Romgermed, one of the investing companies, says: ”Unfortunately, whether we are in a crisis or not, people get sick, so unlike other December 2012 | Ambulancetoday

industry, health has not really been affected.” Much the same can be said for Romania’s public ambulance services. Together with SMURD they have exclusive rights for responding to all 112 emergency calls for which they receive the bulk of the €150 million allocated for all ambulances services leaving just 2.5% or around €3 million for private ambulances. The Association of Private Ambulance Services in Romania was set up in 2009 to fight for a larger share of the state budget, claiming its allocation is simply not enough for handling its task – handling around 700,000 calls covering 24 million kilometers a year. For many of the estimated 50 companies, this means operating at a loss. Lucian Florea, ASPAR’s Vice President argues: “Like the IAA, we do not want to compete with the state; we say that the introduction of private ambulances in the national emergency system will lead to less

intervention and the development of the system with zero-cost from the state”. As in Britain, most of the companies are small relatively local operations. For example, Florea runs Neuromed Ambulance which is part of the Neuromed Center for Diagnostic Imaging; it was founded in 1998 in Timisoara, as one of the country’s pioneers in the use of magnetic resonance (MR) and computed tomography scanning. Its fleet of 11 ambulances transports hospital patients to and from the clinic. The country’s largest private ambulance company is BGS Medical, which has a fleet of 270 ambulances and employs 650 trained medical people in Bucharest and Ploiesti; it meets the patient transport needs of public and private hospitals as well as corporations. Another leading service is Axis, with its main stations in Deva and Bucharest and a growing network of smaller bases in the

AXIS home care doctor’s car

Focus on the Independent Ambulance Association

and manager of a station located outside of Bucharest told me: “Emergency ambulance services must stay under public control but private companies should be permitted to respond to 112 emergency calls if they are nearer to the patient. When a major incident happens and there are not enough state resources, private companies are not even asked for help. That’s not right for the patient”. Without identifying her by name I planned to mention Lilian’s point of view to the Health Minister, Dr Cepoi at a meeting planned for later in the week. Unfortunately he resigned his post a few hours earlier. Politics move as fast as the ambulances (state or private) in Romania.

countryside. It employs more than 150 people and has a fleet of 60 vehicles, some of which are operated by doctors who treat patients at home. ASPAR openly admits that the IAA has achieved more in nine months in England than it has in three years in Romania in reducing the tension between the public and private ambulances and is studying the IAA strategy of more constructive campaigning. The conference attracted more than 120 executives; the speakers presented both sides of the ‘privatisation’ argument, provoking follow up debates between doctors, hospital and ambulance managers which became more and more heated, at times boiling over with some delegates walking out. In my presentation I explained how the IAA’s strategy of working with the government and healthcare regulators was starting to help foster a wind of change in Biography: David Davis David Davis: Before launching the Independent Ambulance Association in January 2012 David had a distinguished career in the media, including reporting for The Times, vice chairman of Edelman, the world's largest public relations firm which he helped to create, and in business television as International President of New York-based Medialink Inc. He is an experienced healthcare marketeer and spent more than 2 years as head of communications at Medical Services Ltd, a leading independent ambulance company.

the relationship between the NHS and private ambulance companies. As a result of the recently introduced NHS reforms some healthcare commentators were suggesting in 5 years Britain will have a national ambulance service, bringing together as business partners the best skills and resources of the NHS and the independent sector. The positive experience of the IAA since it was formed less than a year ago reflected the early signs of this new relationship and we believe “that in a relatively short period of time this mutual historic and unjustified mistrust will be replaced by a professional working relationship built on the most important principle of all - the patient comes first”. The audience remained respectfully silent to my comments until several delegates rose to say that the IAA approach and what was happening in Britain would be right for Romania. Representatives of the state run Bucharest ambulance service clearly didn’t agree. More people came up to me during the conference breaks, clearly it was easier for them to speak to me face to face than rather in open forum. Lilian, a 17 year state ambulance veteran

The Independent Ambulance Association was launched on 19th January 2012 and gaining the support of more than 45 member companies in less than a year it has achieved recognition by the public and private healthcare communities as the leading trade association for the regulated independent ambulance industry. It is a not for profit organisation,owned, managed and run for its members with all revenues devoted to activities in the IAA's best interests. David Davis Director of Communications Contact | david.davis@iaauk.org | M: 07831 558 745 T: +44 (0)207 566 3858 Devonshire House, 60 Goswell Road, London, EC1M 7AD Web | Twitter |Facebook Speaking up for regulated independent ambulances

December 2012 | Ambulancetoday

Roy Returns to India

Caring at Christmas

A Tale of Two ambulance Services! NWAS Volunteer First-Responder, Roy Williams, has been making annual volunteering pilgrimages to India for nearly 30 years. Using resources he has personally fundraised, his mission has been to travel to remote jungle communities to teach basic firstaid to isolated village communities; but, such is Roy’s dedication and so strong are the relationships that he’s built-up over the years, that he’s also helped establish a village school and donated to the start-up of an eye-care clinic. This year Roy returned to check out ambulance care in its capital, New Delhi, to see how ambulance care has been developing in India’s second most densely populated city, before heading off to a remote rural region to see how the other half received ambulance care. This year marked my 27th visit to India but it’s been four years since I last visited New Delhi, so, as you can imagine, I was anxious to see how the capital had changed. In the least decade alone its population has soared from around nine-and-half million people to nearly seventeen million inhabitants so I was interested to see whether or not its ambulance care system had been able to even slightly keep up with this growth and provide anything like a reasonable and accessible ambulance service. My first ‘shock-of-the-new’ came immediately on landing. I was pleasantly surprised to see how smart the recentlyrefurbished airport looked – long-gone were the four rickety immigration booths, which always signaled an interminably long wait before passing through passport control. This time I almost glided through one of 20 very new-looking passport control stations now in operation, clearly a part of the legacy of the recent 2010 Commonwealth Games. Work on creating efficient systems is still needed though as, once through immigration, the wait to collect my luggage was as long as ever. Once through the arrivals terminal it was good to see the big improvement to the pre-paid taxi rank, a real asset as it helps visitors to avoid the usual haggling-culture which is such a big feature of travel on the Indian sub-continent and can be really tiring and stressful when you first reach your destination. December 2012 | Ambulancetoday

On the hour long drive with my friend, Ashutosh, to the east of Delhi, where I was staying, the traffic was much heavier than on my last visit - not too much of a surprise either as the latest figures for new cars in the capital were an average of about 1000 new cars joining the traffic-jams every day, alongside the 55,000 (and growing daily) auto rickshaws which operate around the city. Thankfully the terrible disruption that the city had witnessed in preparation for the Commonwealth games was no longer evident. The new dual carriageway, which had been built for the athletes and many visiting V.I.P.'s to transfer directly to the stadium and avoid the chaos of the city traffic, was now in little use. Crawling along in the bumper-to-bumper traffic I was also able to see many deserted blocks of flats and half-built unused hotels. Ashutosh was the first of many to tell me that the games were poorly attended and, in all honesty, a flop in terms of offering economic or social benefits to the mainly poor population of the city. Too much endemic corruption was

mentioned to me too many times - a lot of the hotels I was told were still waiting for clients to pay over a year after the Games had packed up. I could see that while outwardly India had changed, sadly the same could not be said of the desperate social conditions that keep much of the local population barely subsisting in the sparsest yet most overcrowded of environments. During the next 10 days both in New Delhi, Agra and Hyderabad, I saw many of the new Force 10 emergency ambulances that have been steadily growing in India's cities whizzing around, each one with its own very large livery proudly promoting announcing the ‘108’ emergency number.

Roy Returns to India

Caring at Christmas

Even after the acquisition of 70 new ambulances in August this year by the cityâ&#x20AC;&#x2122;s Centralized Accident and Trauma Service New Delhiâ&#x20AC;&#x2122;s vast population is still only served by just over 100 ambulances. Compare this to London whose population of just under 9M population can rely on a fleet of over 250 A&E ambulances, supplied by London Ambulance Service - and this figure, of course, doesnâ&#x20AC;&#x2122;t take into account their 180 rapid response cars, their nonurgent patient transport fleet and numerous other specialist vehicles, let alone all the other ambulances run by numerous independent providers - and you get an idea of just how under-served this bustling city is in terms of ambulance cover. Nevertheless it seemed that every few

minutes an ambulance would come into view with flashing lights and loud horns blazing; however, their status as an emergency vehicle on blue lights carried little weight to other road-users as they struggled through the dense traffic, with absolutely no other driver showing even the slightest interest in giving way to them or letting them pass by unobstructed. For all the extra consideration they received they may as well have been ice-cream vans! Ironically, due to this prevailing air of total indifference I was able on a few occasions

to have pleasant chats with some crews and what an impressive bunch of ambulance people they were. Although poorly paid, they were intent on being as caring and professional as their training, their equipment and their demanding working conditions allowed. Time and again they told me how proud they were to be ambulance workers and how pleased they were that at least the numbers of ambulance vehicles out on the busy city streets are growing. While traffic made achieving response times an impossible dream they stressed that at

December 2012 | Ambulancetoday

Roy Returns to India

Caring at Christmas

least their patients would receive some sort of professional clinical care en route to being treated at a local hospital. And even though the hospitals are, by and large, similarly overburdened they assured me that the desire to provide a good level of clinical care to incoming patients was a priority for all involved. When you bear in mind that a government-employed ordinary ambulance driver without any special training would go out with a nurse for an 8 hour shift 6 days a week and earn a salary of just £125 to £140 per month, you realize just how dedicated these people are. Later on though when I travelled high up to the mountain resorts to avoid the 40+

December 2012 | Ambulancetoday

temperature. A different story unfolded. After an 18 hour train ride followed by a gruelling two hours steadily rising up a steep mountainside in a taxi I arrived at the beautiful small town of Pachmarhi, 1,200.metres above the state of Madhya Pradesh. When I arrived at 04.30. I was unable to locate one of the only two rickshaws in the town, so I had to walk further uphill for three miles to locate my hotel, only to be told on arrival that checkin time was at 12.00 Noon. A small amount of rupees changed hands during a brief, quiet but polite conversation and, lo and behold, I found myself settled in my room within a matter of just minutes. Money talks any language in India and this I say, not as a criticism, but only as an acknowledgement that in a country so blighted by poverty, recognizing the need to accept this culture, is a regrettable necessity. My small 12 bedroom hotel was bliss with beautiful gardens and, best of all, because of the remoteness of its location, I was for most of my four night stay the only resident. Service, as always in such places in India, was low-key, friendly and efficient. With three good meals a day and all this for the equivalent of £18.00 per night, sterling, you soon begin to realize just how wide the gap in living standards often is between us in the developed Western world and our poorer cousins in places like rural India. After settling in to my hotel I was keen to travel the three miles into the small town, to have a chat with the locals regarding ambulance response times away from the bigger cities. Initially it was difficult to find a person with enough English to discuss ambulances, and, while I have picked up smatterings of regional dialects during my many years as a guest/volunteer in India, I do not delude myself that I am fluent. However I looked out for somebody carrying a briefcase - always a clue that the case’s owner is likely to have a decent command of spoken English – I soon found my briefcase-carrier and after a

friendly introduction we were soon sat outside a café, sharing coffee and information on local healthcare services. When I asked my new friend about ambulance care in the region I was not surprised at his response. Yes he knew of the ‘108’ ambulance service, and yes, they also had it in this region. However, as he was keen to stress, to access it here you have to pay. I pressed him to tell me what would happen in this small town if a lifethreatening call occurred? He thought for a while and then simply said he would call his own doctor back in the city where he lived, some 150 miles away, and he would arrange things. But how would this care present itself I asked? My friend was unable to answer at first, but then he said that maybe if he asked, somebody would take him to hospital which was some distance away. He had no more to add. This was the state of ambulance care in this most remote rural region of India. As is the case in New Delhi there are no government employed paramedics to call on – these are only supplied by private hospitals. And while the standard of care in India’s often large private hospitals is often excellent, since they are staffed by very-well trained doctors and nurses, are very clean and often boast the best in medical equipment, these services can only be accessed by the fortunate few who are wealthy enough to avail themselves of their services. But while there are quite a few goverment hospitals in New Delhi, with the largest, Lok Nayak hospital, having nearly 1600 beds, this isn’t the case in the rural areas where hospital care is much scarcer and much more rudimentary. Hence the reliance on citybased healthcare. Thankfully when I eventually flew home to Manchester I was suffering nothing more than a little jet lag and a renewed faith in the notion that, no matter how much we grumble about the imperfections of healthcare here in the UK, we do well to remember that, quite apart from the much higher quality-of-life even our poorest communities enjoy day-to-day, with access to amenities such as education, good roads, clean water and emergency services, when it comes to our NHS, for better or for worse, it remains the jewel-in-the-crown of our society. Which perhaps makes it all the more important that we do whatever we can to support and encourage our fellow ambulance workers who are struggling to provide care in places like India! If you’d like to assist Roy Williams by passing on ambulance resources or by making a donation towards his good work, please feel free to email Roy at: roy.williams1@yahoo.co.uk

December 2012 | Ambulancetoday

Thijs Gras’ Letter from Amsterdam

Wisdom in a bottle Doing night shift one weekend recently, a Monty Python ditty popped into my head.You probably know it: “Heidegger, Heidegger was a boozy beggar Who could drink you under the table. David Hume could out-consume Wilhelm Friedrich Hegel, And Wittgenstein was a beery swine Who was just as schloshed as Schlegel. There's nothing Nietzsche couldn't teach ya Bout the raising of the wrist. Socrates himself was permanently pissed...” Apparently wise men are sometimes drunk. Working on an ambulance, one is tempted to see things differently. A lot of the wounds – both physical and mental – we see people inflicting on themselves or others, are related to alcohol. Again, also recently, I went to a decent guy of 37 years who fell from his bike and almost scalped himself, not only his hair but also his skin: you could see his skull over a length of about 6 inches. Next night we went to an otherwise neat couple in their late forties, who fell from the stairs in a hotel, knocking down a heating radiator and leaving a big crush in the wall opposite the door of room number 9 because the key did not fit. I tried room number 8 and that door opened without problems. While we were busy helping them, the woman opened up the sluices at three ends. Quite remarkable baker Charlie. These people were quite manageable, but drunken people can be a damn nuisance, especially when they think they are smart. It is sometimes very difficult to restrain yourself, also when you deal with them in the control room. I trust the experiences of the colleagues on the other side of the North Sea do not differ much from ours. On the television we

see a lot of programs showing the grimmer side of the UK and the problems you have with the heavy drinking of young people. Is there a solution? Banning alcohol? I do not think this is realistic. Giving information and education might help. Raising the taxes on alcohol? It also could have an effect on some people. Raising the minimum drinking age – as we have just have done here in the Netherlands? Good idea. Recently the mayor of Amsterdam proposed to let drunken people pay the ambulance trip themselves (In the Netherlands this is normally covered by the health insurance). I do not think this is a good idea. An ambulance crew should be neutral at all times and should not judge people. We must never be associated with prosecution and guilt-finding. Now this is quite difficult sometimes, but it is our only certainty and our only guarantee that people keep trusting us, even when they are drunk. This trust is essential in our profession. And let's face it: if your son or daughter runs into trouble because they drank too much, you would like them to be taken care of, because they cannot do it themselves anymore. People who are drunk are legally unaccountable. I think we all have conflicting thoughts on this, because when you start drinking there is a phase where you are conscious and can be held responsible, but you end up in a state where you do not know what is happening. I always keep in mind that with alcohol intoxication one can end up in Intensive Care, especially young and inexperienced drinkers. And yes, of course I must admit that, once in a while… in my younger years… I have also had a little to much too. Luckily for me I did not run into trouble - but with a little or, worse yet, big bad luck, I could have ended up in an ambulance (or maybe even a hearse). Let’s not forget that hundred thousands of people get drunk and we never hear from them. They go to bed,

they sleep, they wake up (with or without a splitting headache), and sometimes they are hung-over for a day or two - drizzly and drowsy - but mostly they pick up their lives again, enriched with that weird experience of having been drunk. They might damn King Alcohol, but after a few days they are ready to serve him again. So, I ask, what is wisdom? For this we need the philosophers to guide us. “Know yourself,” Socrates would say. “Behave consciously, oppose opposition and realize freedom” Hegel adds. “The mystical part is the most valuable”, according to Wittgenstein. Heidegger wants us to “never forget the human experience”, whereas David Hume advises us to “look to every situation like a child, with a fresh unprejudiced view”. Nietzsche thinks we should “create the world and love the present”. And Schlegel explains why we will

never overcome the burden of alcohol: “Everything has its circle and keeps coming back.” I am afraid that, as ambulance people, we are doomed to face drunkards, dumb or wise, nice or annoying, shining or faded, always smelling and unpredictable when they open up the sluices at whichever end. So, as Christmas approaches, all we can do is to bear this burden, take care of them, each and every one, and pray for wisdom! Thijs Gras. If you would like to swap experiences on this subject with Thijs please email him at: th-gras@hetnet.nl

This edition of Ambulance Today goes out to all 25 Dutch Ambulance Regions courtesy of Procentrum

PROCENTRUM - LEARN TO FEEL THE DRIVE www.procentrum.eu December 2012 | Ambulancetoday

Focus on Primetech

An exciting time for Sat-Comms Primetech (UK) Ltd specialises in the supply, installation and maintenance of pioneering satellite communications and related technology. It offers an unrivalled range of interoperable solutions for the ambulance service. Revolutionising two-way communications for rapid response vehicle capabilities, Primetech is now able to offer Ka-band technology, providing a more cost effective, higher bandwidth communication.

“Imagine a small, mobile VSAT antenna system that can deliver blistering speeds of 8Mbps uploads and 20Mbps downloads using only a 3W BUC,” explains Henry Walker, Director of Primetech. “Now imagine that the bandwidth costs are only a fraction of what is currently available today. This is the

future of ka-band technology – higher speeds, greater bandwidth, lower power requirements and a lower cost-per-bit than any satellite before.” Primetech’s iNetVu® Ka-75V Drive-Away Antenna has recently passed its range tests at Eutelsat, which means that it is the ONLY type approved vehicle mounted system useable on the Eutelsat Ka Satellite Network. Because of its adaptability, it can be mounted on even the smallest vehicles including solo response vehicles which are being deployed in increasing numbers by Ambulance trusts. Working seamlessly with the iNetVu® 7024 Controller, it provides single push button, auto-acquiring, automatic beam recognition and fast satellite acquisition in minutes. It is ideal for any application that requires reliable and remote connectivity in a rugged environment. This new technology is just the beginning. Primetech has developed a KASAT Trailer for the UK emergency services. It is a selfcontained, versatile, resilient Command Support Unit enabling access to vast amounts of data quickly, reliably and at a lower cost. This multipurpose communications platform can be deployed by any driver on a standard UK driving licence using a conventional family saloon. The trailer is based on the world famous Sankey trailer, which means that it retains its

off-road capabilities and flexibility, whilst at the same time meeting the new weight restrictions. Its mobility means that it is quickly able to reach the scene of an incident, even over terrain which may present problems to traditional ambulance vehicles. Henry concludes: “This is a really exciting time for the industry. This highly advanced technology has benefits which will extend through the whole of the emergency services sector. ” For further information on KA-SAT, the iNetVu® Ka-75V Drive-Away Antenna and the KASAT Trailer visit www.primetech.co.uk or email Henryw@primetech.co.uk.

Focus on

It’s great to end a champion year on a positive note! Chairman of the Ambulance Services Benevolent Fund (ASBF), Paul Leopold, looks back on a year of celebrations and momentous historical events, including success for Team GB at both Olympic games, and reflects on the fact that 2012 also looks like the year when Team ASBF is really taking off thanks to increasing support for its work coming from all sections of the UK ambulance service! What a momentous year 2012 has been; a general feeling of shared pleasure at the celebration of the Queens Diamond Jubilee fuelled greatly by the recognition of her unstinting devotion to duty throughout those sixty years; the huge success of the Olympic and Paralympic Games re-enforced the widely held view that as a nation we know how to organise things. It also gave us an opportunity to prove that we are the best in the world at various events, both able–bodied and disabled, and now the news that a Royal heir is expected. All of these national events have had the effect of giving us something to smile about and to provide an alternative to thinking about the economic situation that is proving so hard to repair. Also we still have thousands of young men and women in our armed services overseas in constant danger of death and injury and a great number of people have had their homes severely damaged and their possessions ruined due to the recent flooding. What has all this got to do with the Ambulance Services Benevolent Fund? Well, I have to say that the Fund has had a good year in a number of ways. I get the feeling (no statistics to prove it) that there is a growing awareness of the Fund. This was particularly evident at the recent Emergency Services Show at Stoneleigh in Warwickshire. I do not believe that I am exaggerating when I say that hundreds of people visited our stand, so generously provided to us by David Brown the show director and Broden Media the

organisers. A great many of these visitors supported us by buying various badges and taking part in our raffle and a significant proportion of them also signed up to make regular donations to the Fund under the Give as You Earn Scheme. Kerry London the multi specialism insurance brokers reinforced their support for the Fund by presenting us with a cheque for £300 the proceeds of a fund raising scheme that they set up at the last show and a further £100+raised at this show. It was unfortunate that on the second day a heavy gale blew up and the giant marquee in which our stand was located had to be evacuated on safety grounds depriving us of the opportunity to meet many more people. The coincidence of my perception of a growing awareness of the Fund and the growing numbers of ASBF Champions in various services around the country is, I believe, significant. I take the view that, if someone that you know, respect and see on a regular basis is telling you about something and encouraging you to become involved in one way or another, it is much more likely that you will respond in a positive manner and I get the impression that this is the effect that our Champions are already having in their individual locations. In heartily applauding the efforts of the existing Champions I make no apologies for seeking to recruit more. We are a national charity (in fact the ONLY national ambulance service charity) we support serving and retired ambulance service personnel and their immediate families nationally

and we need to be represented nationally. I long for the day when every ambulance base has an ASBF Champion. I also long for the day that every Ambulance Service Chief Executive and all of his or her senior team members are ASBF Champions and are actively promoting support for the Fund throughout the service. Let’s finish this champion year with a flood of new ASBF Champions from all levels in the service. A

Merry Christmas and a Happy New Year to all. If you have any positive awareness ideas you’d like to share with the ASBF or if you’d like to become one of the growing number of ASBF Champions, helping us raise awareness and fundraise around the country, please get in touch with us at enquiries@asbf.co.uk

AMBULANCE SERVICES BENEVOLENT FUND. WILL YOU CHAMPION THE AMBULANCE SERVICES BENEVOLENT FUND IN 2013? Proud to be serving, proud to have served! Relieved to receive support when dealing with a personal crisis or period of hardship? Your support today will help the ASBF to provide that extra help when the unforseen has happened, whatever your role, whether serving or retired. This support comes at a price of course so we have to attract donations.To help with this we need volunteer representatives at all ambulance sites and localities to ensure staff are aware of our existence and to help raise funds so that we can continue being there for all the unsung heroes of Britain’s ambulance service who are asking for our help in their time of need. Remember, you may think that an unforseen personal crisis may never happen to you, but when it does, a period of hardship can be tough to handle.

WE NEED YOUR HELP TODAY! We need your support NOW to raise funds to develop our Care for the Carers programe. Can you help the ASBF by volunteering as a representatives to champion its work, raise awarness to colleagues about the charity and to help with the challenges of fundraising? To find out more please visit the ASBF Stand #E6. For further information about the ASBF please visit our website: www.asbf.co.uk Or email the Secretary Simon Fermor: enquiries@asbf.co.uk “AFTER OVER 26 YEARS THE AMBULANCE SERVICES BENEVOLENT FUND IS STILL CARING FOR THE CARERS BUT TOGETHER WE WILL MAKE THE DIFFERENCE!.” PATRON: SIMON WESTON OBE. REGISTERED CHARITY # 800434

Enter 70070 into the "to" box - Write in the code 'ASBF44' and then add the amount you want to donate which can be £1, £2, £3, £4, £5 or £10 - Your text might look like this 'ASBF44 £5' Press 'Send' - Congratulations, you've just donated to the ASBF...it's that simple! December 2012 | Ambulancetoday

Out & About News If you want your service news here or on our ‘Rolling News’ website email us at: www.ambulancetoday.co.uk

Yorkshire Ambulance Service appoints new Associate Directors Yorkshire Ambulance Service NHS Trust has recently appointed two new associate directors. Shelagh O’Leary joined the Trust October 2012 as Associate Director of Organisational Effectiveness and Education while Graeme Jackson took up the position of Associate Director of Human Resources in August 2012. Prior to joining YAS, Shelagh was employed as Service Director (People and Development) for the National Policing Improvement Agency (NPIA) where she was responsible for the leadership, strategic direction and delivery of workforce strategy, training, education, professional development and assessment and selection services, amongst many other functions, for 43 police forces. Having held this role since 2007, Commenting upon her appointment, Shelagh said, “As a resident of Yorkshire, I’m very much looking forward to being a part of the Yorkshire Ambulance Service and helping to develop services for our patients and staff”. Graeme Jackson was previously employed as Head of Human

Resources for the Scottish Ambulance Service. In this role Graeme was responsible for leading a similar range of Human Resources-related functions for a comparably sized workforce and has the benefit of bringing with him an understanding and appreciation of the context of the ambulance service. Speaking about his appointment, Graeme said, “I’m am very excited about my new role with Yorkshire Ambulance Service and am looking forward to delivering our ambitious programme for transforming the HR function and the way that we empower and support our managers and staff”. Stephen Moir, Deputy Chief Executive at Yorkshire Ambulance Service said, “I am delighted to welcome both Shelagh and Graeme to the team and am looking forward to working closely with them to ensure that we enhance our approach to the leadership, management and development of our staff. As a consequence of their work and the teams that they lead, our patients will continue to receive high quality care. The wealth of experience and knowledge that they both bring will be a great asset to the Trust”.

(From left to right) Graeme Jackson, Associate Director of Human Resources, Shelagh O’Leary, Associate Director of Organisational Effectiveness and Education and Stephen Moir, Deputy Chief Executive of Yorkshire Ambulance Service.

Out & About News If you want your service news here or on our ‘Rolling News’ website email us at: www.ambulancetoday.co.uk

Last ASN conference superb success Nearly 100 people from as far away as Norway attended the final Ambulance Service Network conference in London last month to hear from speakers including urgent care minister Earl Howe, King’s Fund Senior Fellow Nigel Edwards and deputy NHS chief executive David Flory CBE. Following a warm welcome from ASN chair Heather Strawbridge, 96 delegates heard David Flory set out a high-level view about the challenges facing the urgent care sector, including ambulance services, in the future. Mr Flory told the conference that the public is right to set such high standards for its emergency care services, and that all parts of the sector must work together in order to meet the public’s expectations. Mr Flory told delegates, who came from ambulance trusts all over the UK, as well as from acute and community trusts, primary care and the voluntary sector, that the ambulance service has a strong track record of resilience in the face of challenge, and should take pride in what it has delivered in the past. But he warned that failure to transform the emergency and urgent care system would be dire for the wider NHS, given the partial return to huge pressures on the ambulance service in some

parts of England, which were the norm pre-QIPP. Former acting chief executive of the NHS Confederation and now senior fellow at The King’s Fund, Nigel Edwards gave delegates the benefit of his long experience of health policy, with a frank and entertaining presentation on how ongoing NHS reforms could impact on urgent care. Mr Edwards spoke about the need for real behaviour change within the NHS, saying that “if we only change the names on the doors, nothing different will actually happen”.

Nigel Edwards Drawing on his extensive knowledge and contacts, Mr Edwards explained that new clinical commissioning groups

(CCGs) seem keen to work with providers by developing strong, constructive relationships rather than implementing rigid processes. He emphasised that one big upside of ongoing NHS reforms is the fresh ideas and clinical focus which new commissioners can bring to the party. But he warned that some of the fundamental challenges facing the urgent care sector remain unchanged. “We must continue to improve the way we involve the primary care sector; we must continue to target frequent users of 999 services; and we must continue with service redesign,” he said. He challenged delegates to be brave enough to break out of existing service silos, and said that the only measures that should count are those relating to outcomes which are important to patients. Workshops and presentations covered innovations in technology, looking at telecare and telehealth and how they can benefit patients, as well as children’s urgent and emergency care, patient experience and the impact of public health on the urgent and emergency care sector. Sivakumar Anandaciva, benchmarking manager at the Foundation Trust Network, led a session exploring why patients end up in A&E, and Dr Alison Walker and Angela Harris from Yorkshire Ambulance Service, and medical director of South East Coast Trauma Systems

Iain McFadyen set out the differing perspectives clinicians can bring to the urgent and emergency care system. Earl Howe, the government minister responsible for urgent and unplanned care including ambulance services, rounded off the day with an address praising the ambulance service as one that ‘refuses to rest on its laurels’. The minister told delegates: “I believe that the quality of our ambulance service today has never been better, and the people who work in it are highly-skilled and impeccably professional.” Ambulance Service Network director Jo Webber said: “This was the last ever annual conference for the Ambulance Service Network, so it was great to see so many delegates attending, benefitting from high quality speakers and taking advantage of the opportunity to network and share thoughts and ideas with their peers from across the full range of urgent and emergency care services. We are not quite in a position to announce what will replace the ASN conference next year, as we are currently finalising the exact nature of the membership offer on how the NHS Confederation can best support the urgent and emergency care sector going forward. We will be ready to announce that in early in 2013, and Ambulance Today will be one of the first to know!”.

NEAS gives Winter a warm welcome! A leading figure from the North East region’s business community has been appointed chairman of the North East Ambulance Service (NEAS). Ashley Winter, former chairman and managing director of Patterson Motor Group, has taken over at the top of the ambulance service from Tony Dell, who is stepping down after eight years at the helm. Ashley said: “I am delighted to have been appointed to this important and high public profile role. “The North East Ambulance Service is one of the leading NHS Trusts in its sector in the UK and this is an exciting – and challenging - time to be leading an organisation as it introduces the new 111 number across the region over the next few months.” Ashley added: “I have a keen interest in employee and customer (user) satisfaction which are critical to NEAS success. The Board,

Governors and Members should also be significant assets to this process. Raising standards, training and equal opportunities are the bedrock for the sector and I can add value here.” The former Patterson Motor Group boss is well-known in business, charity and education circles as he has served as President of Tyne & Wear Chamber of Commerce, chair of Business Link Tyneside, Tyneside Training and Enterprise Council and led the transition to the Learning and Skills Council which he chaired in Tyne & Wear. He was awarded the OBE for Services to Businesses in the North East in 2003 and is currently chair of the Community Foundation Tyne & Wear and Northumberland and also the Tyne & Wear Enterprise Trust (Entrust); a director of Herbert Dove Trustees and a Trustee of the Charlotte Straker Project, a charitable nursing and residential home in Corbridge, Northumberland. Ashley is currently High Sheriff of

December 2012 | Ambulancetoday

Tyne and Wear until April 2013. NEAS chairman Tony Dell said: “It has been a privilege to be the Chair of NEAS and I have greatly enjoyed being at the head of such a caring organisation. I am also very pleased to see the reins being handed over to a businessman with so much experience. His previous focus on customer care bodes well for continuing our strong belief that patients have pride of place in our list of priorities.” The appointment of the chairman was made by the Council of Governors for the North East Ambulance Service NHS Foundation Trust. The council comprises 21 elected public governors, four elected staff governors and nine appointed governors representing local authorities, emergency services, health and voluntary agencies. Lead Governor Robert Alabaster said: “Tony Dell has done so much to build a successful Foundation Trust and supported the governors in the process during our first year. We wish

him all the very best in his retirement. “We are delighted to have made an appointment of an outstanding and high profile member of the North East community. Ashley’s appointment was endorsed by the whole Council and the governors look forward to working with him in taking the ambulance service forward.

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LAS appointment of new Non-Executive Directors The London Ambulance Service is pleased to announce that Nicholas Martin and John Jones have been appointed as non-executive directors of the Service. Nicholas Martin, who has 30 years’ experience of working in corporate finance, took up his post on 1 October, replacing Murzeline Parchment. Nicholas said: “It’s a great privilege to join the London Ambulance Service and a particular pleasure to do so shortly after their excellent

performance during the high profile events in London this summer. “I look forward to assisting in their progress to foundation trust status and maintaining and achieving world class standards of patient care.” John Jones has started as an associate non-executive director, and will take up his substantive role on 1 January 2013, replacing Brian Huckett. John, who has held a number of executive finance director roles in the NHS, said: “I’m delighted to join the London Ambulance Service at

this exciting time. As an associate director I’m more of an observer finding out about the Service before I take up my role formally in the new year.” As non-executive directors, they are members of the Trust Board which consists of a non-executive chairman, five executive and six nonexecutive directors. The nonexecutives have overall accountability for the strategic direction, performance and the safe operation of the Service. The Chairman of the London

Ambulance Service Richard Hunt said: “I’m pleased that both Nicholas and John are joining the board. They bring significant experience from their financial backgrounds. John also brings knowledge of a foundation trust process and Nicholas has wide commercial experience from the City. “I look forward to working with them as the Service completes its foundation trust application process and positions itself for the challenges of the next five years.”

Honour for behind the scenes heroes of the London Marathon Unsung volunteers from the nation’s leading first aid charity will be honoured at the House of Lords next month. The St John Ambulance Medical Logistics Unit (MLU) in London has been awarded the Voluntary Ambulance Service Team of the Year Award 2012 by the Ambulance Service Institute. The team whose behind the scenes efforts are crucial to the success of many of London’s biggest public events - including the London Marathon, Notting Hill Carnival and New Year’s Eve celebrations – will receive their award from Baroness Browning of Whimple at a ceremony on 13 November. The MLU is a volunteer unit of 15 members who operate from a warehouse in Bow, East London. One of the lesser known but hardest working units within St John Ambulance in London, the MLU supplies equipment, food and

logistical support for major public events and state occasions. They are a lynch pin of the vast first aid operations which the charity provide throughout the year – from the New Year celebrations to tennis at Wimbledon and concerts in Hyde Park. The London Marathon is one of the largest and most complex events for the MLU. This year the unit devoted more than 1,200 voluntary hours to the marathon which involved a total of 1,400 St John Ambulance volunteers, 55 treatment centres and 33 ambulances. The MLU provided equipment packs for all the treatment centres and equipped three large Intensive Treatment Units at the finish line. The ITUs were equipped with 15 hospital beds, 100 stretchers, monitoring equipment, drip and oxygen stands, Advanced Life Support trollies as well as various consumables such as bandages,

swabs and dressings. Andy Wapling, London St John Ambulance’s Deputy Assistant Commissioner (Logistics), who nominated the team for the award, said: ‘It’s awe inspiring to witness the time and dedication given by this small band of volunteers to ensuring that patients receive the best

possible care during some of the world’s biggest public events.’ ‘The team’s work is hugely demanding but often goes unseen. It’s nonetheless a vital element of St John Ambulance’s work which on so many occasions is quite literally the difference between life and death.’

World Class Cardiac Care for Essex & Herts Air Ambulance Trust Thanks to an appeal over the summer which raised over £14,000, the people of Essex and Hertfordshire are now benefiting from some of the highest standard pre-hospital cardiac care the World has to offer with new state of the art equipment on board the Essex & Herts Air Ambulances. Essex & Herts Air Ambulance Trust (EHAAT) recently took delivery of three brand new ZOLL® X Series™ Patient Monitors each worth £25,000 and is the first Helicopter Emergency Medical Service (HEMS) in the UK to use this new cutting edge technology in conjunction with ZOLL’s AutoPulse® mechanical CPR device during flight. Dr Gareth Grier, EHAAT Clinical Lead, explains: “At EHAAT we are delighted to have the new ZOLL X Series monitor as part of our essential set of equipment. The

monitor allows us to continue to safely provide life-saving treatments for the patients of Essex and Herts at the roadside such as the delivery of an anaesthetic, something normally only available in hospital. We chose this monitor as it will ensure that even during the harshest of conditions outside of hospital; we can easily watch the effect of our interventions on patients. We undertake treatments for the most critically injured of patients as soon as possible after an accident or severe illness, wherever this occurs. When someone’s heart has stopped, EHAAT provide cutting edge treatment which has been published in international medical journals. We aspire to take this treatment even further by using the X series monitor in conjunction with ZOLL’s AutoPulse device which uses a “Pass Through” feature with defibrillation. Using this feature,

electric shocks to the heart can be delivered at a specific time in a chest compression cycle, where the shocks will be at their most efficient in saving lives. EHAAT has already shown that working together with the Ambulance Service and first responder colleagues we can secure outcomes for our patients that are amongst the best in the UK.” The monitors are used in all medical and trauma cases, both adult and children, attended by the Essex & Herts Air Ambulances, enabling the Air Crew to continue providing cutting edge, life-saving interventions to the sick and injured of Essex and Hertfordshire whilst ensuring patient safety and care is kept to the forefront. The Charity is delighted that people and businesses responded to the appeal for the third monitor in such a positive way and generously sent in donations of support. A big

thank you to everyone that supported the appeal including Olympus KeyMed of Southend, IT Fleet of Colchester, Rotary Club of Brentwood a Becket and Freemasons from Colvin Lodge, Clacton-on-Sea.

HEMS Pilot Nicky Smith, HEMS Doctor Adam Chesters and HEMS Paramedic Erica Ley showcasing the new life-saving equipment

December 2012 | Ambulancetoday

Out & About News If you want your service news here or on our ‘Rolling News’ website email us at: www.ambulancetoday.co.uk

South Western Ambulance Service picks up two ASI awards South Western Ambulance Service NHS Foundation Trust (SWASFT) has collected two national accolades from the Ambulance Service Institute (ASI) at an awards ceremony held on Tuesday, November 13th, at the House of Lords, London. The Trust was successful in winning the innovations category award and was also acknowledged for the contribution made by its staff during the tragic M5 collision last year. Innovations Category Award The innovations category award was received for the Trust’s use of tranexamic acid, a drug that can reduce the risk of death from bleeding in trauma incidents. In December last year, in partnership with the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for the South West Peninsula (PenCLAHRC), the Trust was the first ambulance service in the country to introduce tranexamic acid on all of its vehicles. Tranexamic acid is a drug commonly used in operating theatres and in trauma incidents in the armed forces. In simple terms, the drug inhibits the breaking down of blood clots, a process which can worsen bleeding in situations such as major trauma. The internationally recognised CRASH study demonstrated that, if used within three hours of the accident, tranexamic acid can reduce the risk of death from bleeding by as much as 30 per cent.The drug will undoubtedly save many lives across the South West each year. Professor Stuart Logan from the University of

Exeter Medical School, and who is also director of PenCLAHRC, commented: “There is often a delay of years between evidence being published and its use in practice, but this is a great example of what the NHS at its best can do and we are delighted that the project has won the Innovations award.The South West is lucky in having an Ambulance Trust with a really innovative approach, a commitment to evidence-based practice and a close partnership with the acute trusts and with our research teams. We are delighted that our strong local partnership resulted in this being the first region to get this effective intervention into widespread use.” Statistics show that since the introduction of the drug, the Trust has administered the life saving intervention to 74 patients across the South West. The number of patients receiving the medicine continues to increase significantly month on month. Recognition for Trust staff involved in the tragic M5 accident in Somerset in November 2011 On Friday November 4th 2011 seven people died with many more sustaining serious injuries during one of the UK’s worst motorway disasters on the M5 in Somerset. The Trust was alerted to the incident at 20:22pm and ambulances arrived at the scene within five minutes. SWASFT committed 42 vehicles and almost 60 personnel, including three doctors and many off duty staff who reported for work to help at the scene of the incident. Staff on duty in the clinical hub that night were instrumental in managing the situation and ensured that patients at the scene were treated with the right care in the right place and at the right time.

Adrian South, Deputy Director of Clinical Care for SWASFT, is pictured receiving the innovations award. He is pictured with (from left to right) Maria Robison, Dr Priyamvada Paudyal (from PenCLARHC) and Hayley Bayley

A volunteer with the service also scooped the award in the special incident category. Dr James Hickman is a volunteer with the Somerset Accident Voluntary Emergency Service (SAVES) and also attended the ceremony. SAVES is a network of doctors specially trained to deal with emergencies outside of the hospital at the request of the ambulance service. Dr Hickman claimed the Special Incident Category Award for his ongoing voluntary work with SWASFT, including attending the tragic crash on the M5. Ken Wenman, Chief Executive of SWASFT, said he was delighted with the awards and added: “I am pleased that the Trust has been recognised for its innovation and the part our staff played in managing the tragic incident on the M5 in Somerset in November 2011. “SWASFT is a forward thinking organisation and I believe our use of tranexamic acid in the field has demonstrated this. “As we all know, our staff are at the heart of everything that we do and during the M5 crash many of them went over and above the call of duty. Staff in the clinical hub that night were instrumental in making sure we responded with the right care in the right place and at the right time.”

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East of England Ambulance Service Mourns Peter Kendall On Wednesday, November 21, family, friends, and work colleagues past and present, from around the Country, gathered to pay their respects to Peter Kendall, who recently passed away at his Bedfordshire home.

Peter was given a full ambulance service funeral which took place at St Peter de Merton Church in Bedford. A blaze of green uniforms lined the streets near to and outside the church to form a guard of honour. Ambulance service colleagues from all over the country and representatives from all blue light services, voluntary services, local authorities and NHS partners, paid their respects at a very moving service.The procession arrived at the

church after travelling from the Trust’s Bedford Office, was led by two ambulance motorcycle out riders and a vintage ambulance vehicle which Peter had actually crewed when he started in the ambulance service. Peter’s lengthy career spanned over 48 years ago and he worked in various roles and starting in Worcester in the 1960s and 70s, before moving to head of the control room in Hereford and Kent. He is mostly known for his role within the resilience and emergency preparedness team whist being based at the Bedford Office. Since 2008 and up until his unexpected death, Peter was seconded to the Department of Health’s Emergency Preparedness Division in London, as an Ambulance Adviser to the National Ambulance Resilience Unit (NARU. Steven Moore, deputy head of resilience and special operations, who read at Peters service said: “Peter was my manager for five years and during this time I worked closely with him on a number of projects, during which time I learnt a huge amount from his vast array of experience which he had gathered during a life time of dedication to working in the ambulance service and specifically in the field of emergency planning.”

Chief executive officer, Hayden Newton, who spoke of Peter’s lengthy career at his funeral said: “Peter joined the ambulance service 48 years ago, originally starting out as a control room manager in Worcestershire before making his way to the East of England. Most will remember Peter from his days in the emergency preparedness team in Bedfordshire and Hertfordshire, where his commitment, hard work and extensive knowledge really came into their own. Peter was recently seconded to the Department of Health, where I know his expertise was highly valued and appreciated. Respected for his work not just locally, but nationally as well, Peter was a long standing friend and colleague

to so many of us and will be very sorely missed. Mike Shanahan, Deputy Director of NARU and Mr Kendall’s immediate line manager, said: “Peter was first and foremost a real gentleman and always found the time to talk to anyone wanting to speak to him. Peter’s passion was the ambulance service and he gave many, many hours of his own time to that end. Peter was one of the longest serving members of staff in the UK ambulance service and news of his passing away has shocked us all, including many in the wider NHS and Government departments. We would like to extend our heartfelt condolences to his family and we will all miss Peter immensely.”

North West Ambulance’s Head of Service Celebrates Queen’s Ambulance Medal with Royals Peter Mulcahy, North West Ambulance Service’s Head of Service for Cumbria and Lancashire, received his Queen’s Ambulance Medal at Buckingham Palace, on Friday 19 October. Earlier this year Peter Mulcahy was shortlisted for the prestigious Queen’s Ambulance Medal; awarded to individuals who have shown exemplary dedication to their role, and demonstrated outstanding ability, merit and conduct to their vocation. One thousand people were named in the Queen’s Birthday Honours List 2012, and Peter was just one of five individuals to have been nominated for the prestigious Queens Ambulance Medal, across the whole of the UK and Northern Ireland. Peter commented: “Friday was a fantastic experience, and one I never dreamed of happening. I am so proud that after 34 years’ service I have received such an award – and going to Buckingham Palace was an unexpected bonus! “I consider it an honour, not only on a personal level, but also for

NWAS. It’s recognition for my profession. As well as thanking the wider NWAS team, I would also specifically like to thank my teams in Cumbria and Lancashire for their support.” Peter’s role within NWAS is Head of Sector for Cumbria and Lancashire, this is an expansive area that totals 71% of the Trust’s 3000 mile footprint. Within his time in this appointment, Peter has acted as a lead-role in three separate major incidents in Cumbria’s recent history. The first was the major floods in Cumbria in 2000, where hundreds of local residents had to be relocated for a number of days. The second in May 2010 when a coach carrying school children rolled over as a result of a road traffic collision. And thirdly, the Whitehaven shootings on 2 June 2010, where 12 people were killed and 45 injured. In each of these very different and challenging incidents Peter demonstrated very clear and strong leadership. Peter was seen by staff and the community as a figurehead and focal point ensuring multi-agency and media briefings

were carried out (mainly by himself) and that the staff involved were fully supported during and after each event with single or group counselling. Peter acted well above and beyond what was required of him portraying a professional and strong leader at all times. Mary Whyham, Trust Chair, added: “The NWAS Trust Board is

delighted that Peter has been recognised in the Queen’s Birthday Honours. His commitment to the work of the ambulance service and in particular, to the people and patients of Cumbria and Lancashire is outstanding – His award of the Queen’s Ambulance Medal for distinguished service is well deserved.”

Left to right: Agnes (Peter’s Mother-In-Law), Peter Mulcahy, Jeanette Mulcahy (Peter’s Wife), Kevin Mulcahy (Peter’s Brother) December 2012 | Ambulancetoday

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SCAS wins Large Public Sector Fleet of the Year South Central Ambulance Service NHS Foundation Trust (SCAS) has won the award for Large Public Sector Fleet of the Year at the Fleet News Fleet Van Awards 2012 presented in London on 5 December. Now in their fifth year, the Fleet Van Awards are the benchmark awards for the light commercial vehicle industry, with trophies for manufacturers, fleet operators and suppliers. The fleet awards focus on safety, awarding trophies to those van operators that display an obsession for keeping their drivers safe and their vehicles accident-free.

Commenting on SCAS’ award the judges said: ‘SCAS continues to be one of the safest ‘blue light’ fleets in the country due to its relentless focus on driver culture and on minimising accidents. It applies best practice in all operational areas and shares its ideas with other trusts. SCAS is innovative and classleading.’ Rick Stillman, Head of Fleet for South Central Ambulance Service NHS Foundation Trust said: ‘Winning the Large Public Sector Fleet of the Year Award at the Fleet Van Awards 2012 is a reflection of the work and dedication of our staff in Support Services and testimony to the progress your

local ambulance service is making in our quest for excellence. ‘There is still a lot of work to be done and improvements to be made, but this award, following on from the trust winning the Fleet Safety Champion of the Year Award

and receiving Van Excellence accreditation in 2011, clearly demonstrates that we are heading in the right direction. ‘I would like to thank friends and colleagues for their continued support and hard work.’

Richard Kersley,Team Leader Vehicle Commissioning Unit for South Central Ambulance Service NHS Foundation Trust (SCAS) pictured receiving the Fleet Van Award for Large Public Sector Fleet of the Year from Ian Smith, Sales Director FMG.

SECAmb paramedic receives top medal from the Queen A long-serving South East Coast Ambulance Service NHS Foundation Trust (SECAmb) paramedic has attended Buckingham Palace to be presented with a Queen’s Ambulance Service medal. Dave Fletcher, received his medal from the Queen on Friday (9 November) after being named in this year’s Queen’s Birthday Honours list. He attended the special investiture ceremony with his family and is among the first to receive the medal, with this being the first year it has been awarded. Dave who served as a paramedic for more than 36 years was nominated for his commitment and pioneering work on resuscitation at SECAmb which led to the introduction of a new resuscitation technique, Protocol C, across the Trust.

The compressions-only CPR, supported by early defibrillation, has hugely improved outcomes for patients across SECAmb’s region of Sussex, Surrey and Kent. Dave worked closely throughout his career with Consultant Cardiologist Professor Douglas Chamberlain to improve out-ofhospital resuscitation survival rates across SECAmb’s region and from early on in his career acquired a reputation as one of best pre-hospital

clinicians. Speaking after the investiture he said: “It was an honour and with much pride that I received the award from the Queen on behalf of the ambulance service.The occasion was simply amazing and my family and I would like to have the day again so we can take it all in! “The award really must go to all my SECAmb colleagues whose hard work and dedication has resulted in such a significant increase in the number of patients who now survive out-of-hospital cardiac arrest. It is the clinicians at the sharp end, the teams in the control rooms and the community responders that make the difference. I gave them guidance, they did the work. “It also would not have been possible without my SECAmb Chief Executive Paul Sutton and Medical Adviser Professor Douglas

Chamberlain who gave me the opportunity and freedom to make changes to the system. “My personal reward, over my 38 years in the service has been to be part of a team that gives a life back to families and friends. Only those that have saved a life can appreciate fully the pleasure and satisfaction that this brings.That, above all, was my reward.” SECAmb Chief Executive Paul Sutton said: “Dave is extremely deserving of this recognition and award. I’m very proud that South East Coast Ambulance Service was represented at Buckingham Palace in front of the Queen and I would like to thank him both on behalf of SECAmb and personally for his dedication and commitment over such a successful career. He is the perfect recipient of this newlyestablished medal.”.”

Products & Suppliers News

The new Guidelines are coming! The long awaited new edition of the UK Ambulance Services Clinical Practice Guidelines 2013 will soon be available. Since 2006, when the last edition was published, there have been important changes to ambulance practice and an enormous amount of work has gone into the production of these comprehensive guidelines. The Joint Royal Colleges Ambulance Liaison Committee Guidelines sub Group and their network of expert contributors have been working tirelessly to

ensure that all new information has been passed to the editorial team and AACE have tasked their clinical leads NASMeD (National Ambulance Service Medical Directors) to review the material prior to printing. This work is designed to ensure that this wide ranging document is directly relevant to Paramedic practice and draws on the wealth of experience and clinical expertise available to today’s ambulance service. Major changes to this edition mean that there is new guidance on minor illness in children, pelvic, trauma, intravascular fluid therapy,

December 2012 | Ambulancetoday

obstetrics and gynaecological emergencies and others. All NHS Ambulance Trusts have placed bulk orders and further copies will be available through retailers such as BoundTree Medical, Amazon and SP services. Acknowledging that this 500 page book is going to be quite a sizeable document, AACE & the publishers are busy cramming the really important ‘how much, where and when’ facts into a pocket sized reference guide – hopefully available at about the same time.

Going forward, the challenge for AACE is to ensure that once the publication is released, updates on best practice can be provided in a timely manner to ensure that up to date clinical guidance is maintained. An important part of the updating process will be to ensure that regular feedback is sought from the paramedic profession and a wide range of stakeholder organisations including the College of Paramedics and the Air Ambulance Association. The new guidelines will be published by Class Professional Publishing and will be available in early Spring 2013. More details can be found at: www.classprofessional.co.uk

Products & Suppliers News

Another thriving year for the Emergency Services Show The Emergency Services Show 2012 celebrates another highly successful year, as a record number of visitors attended the unique show at Stoneleigh Park,Warwickshire. An astounding 5,289 visitors attended the show representing an 18% increase from the previous year with just under 600 visitors coming back the second day to take in everything on display.The show promoted multi-agency collaboration by bringing together everyone involved in an emergency, attracting the leading buyers of emergency equipment and services. The significant increase in numbers indicated that, even during the

current poor economic climate, the emergency services are still committed to improving public safety with new innovations and services. Even the inclement weather conditions didn’t deter visitors who battled their way through wind and rain to see the extensive range of products and services on show. Over 400 exhibitors displayed their products and services during the event of which 100 were new to the Show. Several exhibitors demonstrated live, including the Road Haulage Association, who re-enacted a road traffic collision recovery.The Emergency Planning Society held a CBRN Decontamination Workshop, which was designed to help local

authority staff improve their knowledge and ability to deal with decontamination incidents. New to the show this year was the Joint Emergency Services Interoperability Programmes (JESIP) National Interoperability Summit. The summit brought together leaders and strategic managers from UK Cat 1 & 2 responders to the first ever high profile national summit addressing this critically important topic.Topics covered included, an overview of JESIP and discussion on the external challenges from the worlds of law, academia and the military. Commenting on the JESIP National Interoperability Summit, Roy Whilsher, Chair of JESIP Strategic Board said: “I am very pleased that we had such an excellent conference and interesting range of speakers to help the official launch of the Joint Emergency Services Interoperability Programme (JESIP). My aim was threefold, to demonstrate the commitment of government and the three emergency services to this exciting initiative, to raise awareness of JESIP and to provide some challenge from the speakers to everyone involved. He continued by saying: “There has been previous interoperability programmes but this one feels

different with cross department government support and a real commitment to make a difference, I do not think there has ever been a better time to launch JESIP. I was very pleased with the Summit, I am enthused by the commitment of all involved, but the hard work starts now. We need to take the emergency services, all their governing authorities and partners with us to ensure we achieve the goals we have set ourselves.” David Brown, Event Director commented: “We are thrilled to have seen such a significant increase in the number of visitors to the event this year, especially taking into consideration the appalling weather conditions the UK faced over the two days of the show.” “The show is continuing to grow year upon year, and we are very much looking forward to planning next year’s event, as the UK’s leading multi-agency show, which is reflected in another year of record attendance.” The Emergency Services Show will return to Stoneleigh Park in 2013.You can keep up to date with show news throughout the year at www.emergencyuk.com

Six Ambulance Services in the Netherlands are using Optima Predict™ to further improve service delivery in an ever-changing environment As a leader in innovative technology, Optima has been chosen by Axira in the Netherlands to help the group’s six ambulance services improve response targets and patient care. With the healthcare system in the Netherlands under enormous pressure to review existing ways of working, six ambulance services in different regions of the country have formed a collaboration to allow collective purchasing, training and on-going support of technology and other resources. Axira is a cooperation some of the country’s most

innovative ambulance services and the group has chosen Optima’s unique modelling and simulation technology, Optima Predict, to assist with current operational challenges. UMCG Ambulancezorg is part of the Axira group. Jaap Hatenboer, Manager of Policy and Innovation at UMCG explained ‘Hospitals in the Netherlands are having to close emergency departments and merge facilities. The landscape we are working in seems to be changing constantly and our service needs to be able to react quickly and efficiently to those developments. Optima Predict allows us not

only to accurately understand our current situation and processes but also allows us to run different scenarios to see the effect that this might have on our response times. In just 15 minutes, we can model any proposed scenario to see what we would need to do to react to this and crucially, what the price tag would be.’ Axira is also using Optima Predict to help improve response times and meet performance targets in certain regions. Whilst one of the group’s ambulance services is striving for a 1% increase in meeting A1 call targets, another is having to fully examine and re-model its service delivery to improve overall performance. Jaap Hatenboer commented ‘Optima Predict is being employed on a national basis to address very local issues. It gives us decision support tools which are used in the back office but the results are clearly being shown in the front office and on the frontline.’ The Optima Corporation works with Emergency Services across the globe. For more information on The Optima Corporation and its product suite, please call +44 1189 036602, email info@theoptimacorporation.com or visit www.theoptimacorporation.com December 2012 | Ambulancetoday

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