Covering the entire spectrum of the Emergency Services
April 2015
www.emergencyservicestimes.com
Volume 16 | 2
ESTCONTENTS | 1
IN EVERY ISSUE
18
COMMENT
3
NEWS
4
EVENTS
8
PEOPLE
45
PROFILE
46
COMPANY PROFILE
50 | 51
PRODUCTS
58
LAST WORDS
60
43
IN THIS ISSUE MEDICAL
13
Updates are on the way in 2016 for the ambulance service clinical guidelines, FERNO looks at what the future holds for ambulance design and patient transportation, lessons learnt from combat casualty care, the use of clingfilm in burn injury management and
40
British Red Cross eases the pressure on an overstretched NHS
ICT
32
PCCs give the green light to The Police ICT Company, all the latest on the Emergency Services Network contract, O2 discovers more about the voluntary sector during a Round Table discussion, Staffordshire Fire and Rescue Service develops a Risk Management
7
app to record Site Specific Risk Information, Met Police looks to expand a tablet trial and London s Air Ambulance and EE launch a new dispatch app
4
MENTAL HEALTH
48
Mental health charity Mind is urging emergency service organisations to register their interest in signing the Blue Light Time to Change pledge, which aims to support the mental health of staff and volunteers across police, fire, ambulance and search and rescue services in England. Plus, how public service providers around the country are working together to provide support before people reach crisis point
COLLABORATION
53
JESIP changes Programme to Principles and continues the drive towards increased collaboration between the emergency services, Greater Manchester Fire and Rescue Service s role within the region s
43
wider public service reform and intraoperability in the East of England moves a step closer
www.emergencyservicestimes.com
April 2015
2 | ESTA-Z
Companies Company Name
Page No
Company Name
Page No
Company Name
Page No
Company Name
Page No
Adrian Flux......................................................................................................4
Emergency Athlete......................................................................................51
LED Lenser ..................................................................................................58
RoSPA.............................................................................................................6
Airwave Solutions ........................................................................................32
Emergency Planning Society.....................................................................46
Leicestershire Fire and Rescue Service....................................................45
Royal Berkshire Fire and Rescue Service.................................................57
Ambition .......................................................................................................19
Emergency Services Collaboration Working Group..........................38, 57
Leicestershire Partnership NHS Trust.......................................................49
Royal Lifesaving Society................................................................................8
Arqiva ............................................................................................................32
The Emergency Services Show 2015.......................................................11
Leicestershire Police.............................................................................48, 49
Association of Air Ambulances.....................................................................7
Espar.............................................................................................................58
Life Connections 2015..................................................................................8
Association of Ambulance Chief Executives.............................................13
Essex Police .................................................................................................44
Local Government Association ..................................................................56
Association of Chief Police Officers...........................................................50
Excelerate Group.........................................................................................58
Lockheed Martin UK ...................................................................................32
Atkins ............................................................................................................32
Facebook......................................................................................................32
London Ambulance Service.................................................................38, 45
Babcock International....................................................................................6
FERNO UK...................................................................................................14
London Fire Brigade......................................................................................6
Bedfordshire Police .......................................................................................4
FLIR.................................................................................................................6
London's Air Ambulance.............................................................................43
Belfast City Council......................................................................................38
Freelance Surgical.......................................................................................29
Lowland Rescue ..........................................................................................35
Scottish Ambulance Service ..................................................................7, 44
Brake.............................................................................................................56
Gloucestershire Fire and Rescue Service.................................................35
Manchester City Council.............................................................................55
Scottish Fire and Rescue Service ..............................................................45
British APCO ................................................................................................38
Google ..........................................................................................................32
Met Police..................................................................................38, 43, 45, 50
Seed Software .............................................................................................40
British Burns Association............................................................................23
Greater Manchester Fire and Rescue Service...................................45, 54
Midlands Air Ambulance ...............................................................................4
Severe Burns Life Support Foundation.....................................................22
British Red Cross...............................................................................7, 29, 46
Greater Manchester Police.....................................................................6, 50
Mind ..........................................................................................................3, 48
Skills for Justice............................................................................................53
British Transport Police.........................................................................45, 46
H&H Medical................................................................................................19
Ministry of Defence........................................................................................4
British Transport Police Authority ..............................................................44
Hampshire Fire and Rescue Service.....................................................7, 57
Motorola Solutions UK................................................................................32
BT .................................................................................................................32
Hartlepool Borough Council.........................................................................7
Mott McDonald ............................................................................................32
Buckinghamshire Fire and Rescue Service................................................4
Hartlepool College.........................................................................................7
Mubaloo........................................................................................................43
Bull Products................................................................................................58
Her Majesty’s Inspectorate of Constabulary .............................................45
National Crime Agency...............................................................................45
Chief Fire Officers' Association ..............................................................8, 56
Hereford and Worcester Fire and Rescue Service.....................................4
National Police Air Support Service...........................................................38
Class Professional Publishing ....................................................................13
Hewlett Packard Enterprise Services UK .................................................32
National Search and Rescue Dog Association.........................................35
Cleveland Fire Brigade..................................................................................7
Highways Agency ........................................................................................38
NHS England..................................................................................................7
Terrafix ..........................................................................................................44
Cleveland Police.............................................................................................7
Home Office.......................................................................................4, 32, 44
Norfolk Fire and Rescue Service ...............................................................57
Tyne and Wear Fire and Rescue Service .....................................................6
College of Paramedics................................................................................11
Hov Pod ........................................................................................................58
Norfolk Police...............................................................................................57
TyTek Medical...............................................................................................19
College of Policing ................................................................................44, 50
Humberside Police......................................................................................45
North East Ambulance Service ....................................................................7
University Hospital South Manchester......................................................22
Definitive Event Policing .............................................................................50
Hutchinson 3................................................................................................32
Northrop Grumman ....................................................................................32
University of Worcester .................................................................................4
Department for Communities and Local Government ..............................6
IMServ Europe ...............................................................................................6
Northumbria Police........................................................................................6
Derriford Hospital ........................................................................................26
Independent Ambulance Association .......................................................21
O2 ...........................................................................................................32, 35
Dorset and Wiltshire Fire and Rescue Service .........................................45
Isle of Wight Fire and Rescue Service .........................................................7
Ortus Technology Ltd ....................................................................................4
Dorset Fire and Rescue Service ................................................................45
JESIP ......................................................................................................35, 53
PageOne.......................................................................................................38
Dräger .............................................................................................................4
John Dennis Coachbuilders..........................................................................4
Petzl...............................................................................................................58
Dyfed Powys Police .......................................................................................6
Kellogg Brown & Root.................................................................................32
Physio-Control.............................................................................................28
East Midlands Ambulance Service...............................................................7
Kent Fire and Rescue Service....................................................................57
Police ICT Company....................................................................................44
East of England Ambulance Service ...................................................19, 25
Kent Police ...................................................................................................57
Police Service of Northern Ireland.............................................................45
Wiltshire Police.............................................................................................45
East Sussex Fire and Rescue Service .......................................................40
King’s College Hospital ...............................................................................26
Primetech (UK) Ltd.....................................................................................35
Yorkshire Ambulance Service ....................................................................13
EE ...........................................................................................................32, 43
Lancashire Police.........................................................................................35
Rosenbauer UK..............................................................................................4
YPO...............................................................................................................50
Company Name
Company Name
Company Name
Royal National Lifeboat Institution................................................................8 Royal Navy....................................................................................................18 SafeGuard Clothing.....................................................................................60 Samsung.........................................................................................................6 Saviour Stretcher.........................................................................................28 Scania..............................................................................................................4
South East Coast Ambulance Service...................................................7, 25 South West Ambulance Service...................................................................6 SP Services ..................................................................................................27 St John Ambulance .....................................................................................25 Staffordshire Fire and Rescue Service..................................................6, 40 Suffolk Police ...............................................................................................57
Vodafone ................................................................................................32, 43 Volkswagen.....................................................................................................7 Welsh Ambulance Service ............................................................................4 West Midlands Police ..................................................................................45 West Sussex Fire and Rescue Service.........................................................4 Wiltshire Air Ambulance..............................................................................45
Advertisers Company Name
Page No
Page No
Page No
BOC Healthcare...........................................................................................20
FERNO UK..................................................................................................IFC
NAPFM.........................................................................................................52
British Red Cross .........................................................................................52
FLIR...............................................................................................................34
O2 ....................................................................................................................5
Class Professional Publishing ....................................................................12
Freelance Surgical.......................................................................................24
Ortus Technology Ltd............................................................................17, 33
The Emergency Services Show 2015.....................................................IBC
Getac UK ......................................................................................................39
Paramedico ..................................................................................................10
Espar.............................................................................................................10
Goliath Footwear (YDS Boots) ..................................................................16
Physio-Control.............................................................................................12
Excelerate Technology Limited............................................................30, 31
Lyon Equipment Limited ...............................................................................9
SP Services (UK) Ltd ..............................................................................OBC
EVAC .............................................................................................................10
MANX Telecom............................................................................................34
Strongs Plastic Products Ltd ......................................................................47
Page No
Terrafix ..........................................................................................................41
TyTek Medical...............................................................................................20
Vimpex Limited ............................................................................................39
Water-Jel.......................................................................................................24
www.emergencyservicestimes.com
WH Bence (Coachworks) Ltd...........................................................OFC, 42
YPO...............................................................................................................47
April 2015
ESTCOMMENT | 3
ISSN 1472-1090 Date: April 2015 Editor: David J. Holden MEng(Hons) Twitter: @999editor davidholden@brodenmedia.com
Scale of stress and mental health problems revealed in Mind survey Staff and volunteers in the emergency services have already been identified as at higher risk of developing a mental health problem, due to the unique set of difficulties these challenging roles present. However this data is the first to reveal the scale of the problem and the level of unmet need.
Advertisement Manager: David Brown davidbrown@brodenmedia.com Advertisement Sales: Carol Fox carolfox@brodenmedia.com Office & Events Manager: Lesley Stevenson lesleystevenson@brodenmedia.com
Major new programme
Marketing Manager: Emma Nicholls emmanicholls@brodenmedia.com Circulation: Christine Knoll admin@hpcpublishing.com Joint Managing Directors: David Brown David Holden Published by
Worrying data from the mental health charity Mind has found that nearly nine in 10 (87 percent) emergency services staff and volunteers surveyed have experienced stress, low mood and poor mental health at some point while working for the emergency services.
Online survey Robert Denholm House, Bletchingley Road Nutfield, Surrey RH1 4HW Tel: 01737 824010 Fax: 01737 824011 e-mail: davidbrown@brodenmedia.com www: brodenmedia.com Distribution: EMERGENCY SERVICES TIMES is free of charge to officers and managers who are buyers or specifiers actively involved in the procurement of equipment or services within the emergency response industry and based in the UK and Irish Republic. All other categories of reader are invited to subscribe at £130.00 to UK addresses and £165.00 overseas. Single copy price £25.00 including post and packing. The articles within Emergency Services Times are copyright and are the property of the publisher Broden Media Limited and cannot be reproduced in any media form without permission of the publisher. Application should be made in writing. Reprints of articles and advertisements are available, allow 28 days for delivery. PDF pages are available by email at £20.00 (+VAT) per page (€32.50, $33). Prices on application to the publisher. Printed by Manor Creative Tel: 01323 514400 Studio work by Friskywhiska Design Tel: 01947 811333 Mobile: 07976 917411 charlotte@friskywhiska.co.uk
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The online survey of over 3500 emergency services personnel also revealed that more than half (55 percent) had experienced mental health problems at some point. This is in sharp contrast to findings of the general workforce from the Chartered Institute of Personnel and Development (CIPD), December 2011, ‘Focus on mental health in the Workplace’, which revealed 26 percent of respondents had experienced a mental health problem – indicating that working in emergency services is associated with a greater risk of developing poor mental health. Despite the greater prevalence of mental health problems among emergency services personnel, Mind’s research indicates that they are less likely to take time off sick as a result. Just 43 percent of emergency service workers and volunteers surveyed said they have taken time off work due to poor mental health. The CIPD has found that this figure is much higher among the general workforce, with nearly three in five (57 percent) saying they had needed time off for poor mental health. This suggests that emergency service workers find it harder than other professions to say when they’re not at their best and keep coming to work regardless. It could be that personnel are fearful of talking about mental health at work or don’t believe their employers view mental health problems as valid reasons for sickness absence.
Mental health charity Mind has been awarded LIBOR funding to develop a major new programme of mental health support for emergency services staff and volunteers from police, fire, ambulance and search and rescue services across England. The Blue Light programme has been developed in consultation with emergency service staff and volunteers and will be delivered between April 2015 and March 2016, involving local Minds and professional bodies, employers, charities and unions that represent emergency services staff and volunteers. The Blue Light Programme focuses on four main areas: tackling stigma and discrimination; embedding workplace wellbeing; building resilience; and providing information and support.
Time to Change pledge
Mind is urging emergency services organisations to register their interest in signing the Blue Light Time to Change pledge – a commitment to develop meaningful action plans to support the wellbeing of their staff and volunteers. The action plans will follow the model developed by Time to Change, the anti-stigma campaign run by Mind and Rethink Mental Illness, but will be more tailored to the emergency services needs.
www.mind.org.uk/BlueLight Read more about Mind’s Blue Light Programme on page 48.
April 2015
4 | ESTNEWS Bedfordshire Police has received a coveted prize for the support it gives the armed services. Chief Constable Colette Paul attended the Ministry of Defence Employer Recognition Scheme Awards on 17 February where Lord-Lieutenant Helen Nellis presented her with a silver Defence Employer Recognition Scheme award signed by the Secretary for Defence and the Chief of the Defence Staff. www.safer-beds.org
A new turntable ladder supplied by Rosenbauer UK has gone on the run with Buckinghamshire Fire and Rescue Service at Great Holm Fire Station. The vehicle, a Metz L32A-XS turntable ladder on a Scania P320 chassis, is expected to be in service until 2030. It features include a 32m ladder, thermal imagery and a remote control function that can be operated by means of a built-in camera system. Camera images can also be directly relayed to a command vehicle as well as a remote support room. http://bucksfire.gov.uk
Hereford and Worcester Fire and Rescue Service has launched a new website. The new responsive site (www.hwfire.org.uk) was developed in partnership with students from The Worcester Business School’s Media Lab initiative, a student-led design and development lab working in conjunction with the University of Worcester to create web solutions for the local community and businesses. www.hwfire.org.uk
The Welsh Ambulance Service NHS Trust (WAST) has selected Ortus Technology Ltd’s DataPoint vehicle telematics solution for its mixed fleet following the conclusion of a competitive tender evaluation process. The five-year contract includes an option to extend for a further two years. www.ortus.co.uk
Specialist insurance broker Adrian Flux has launched a new, discounted scheme that more accurately reflects the safer driving records of ambulance, police and fire and rescue service drivers. The broker analysed data that showed 999 drivers cost insurers 20 percent less than all other occupations combined. As well as preferential rates, the new scheme provides blue light cover on request for emergency drivers responding to 999 calls in their own cars when off duty. The policy also provides cover for vehicles modified to fulfil certain emergency tasks, such as winches or tail-lifts. www.adrianflux.co.uk
www.emergencyservicestimes.com
Dräger device used for roadside drug testing Dräger has added to its portfolio of Home Office approved kit, after its drug detection equipment has been given the green light for roadside drug testing. As new drug drive legislation came into effect on 2 March, the fully automated Dräger DrugTest 5000 will be used by police forces around the UK, to test for cannabis and cocaine at the roadside – similar to the way drivers are breathalysed for alcohol. The new drug driving legislation means people caught driving under the influence of drugs will face harsher penalties including up to six months’ imprisonment, a £5000 fine and 12 months’ disqualification. The DrugTest 5000 underwent rigorous testing at the Home Office’s centre for applied science and technology (CAST), to confirm its accuracy. It has been designed for real time usage, with saliva samples able to be analysed immediately for results on the spot. The approval of this mobile device also means officers will no longer have to wait until they are at the police station to test drivers they suspect of being on drugs.
Policing Minister Mike Penning said, “This Government is determined to drive the menace of drug driving from our roads. Those who get behind the wheel while under the influence of drugs not only put their own lives at risk, but also those of innocent motorists and their passengers. “I’m delighted to have type approved the DT5000 for use by the police, which will allow them to more quickly test drivers for cocaine or cannabis – two of the most prevalent types of drugs detected among drug drivers.”
Charity reaches milestone with ‘darkness’ operations Thanks to the continued support and generosity of the public, Midlands Air Ambulance Charity has been able to extend its life saving service into the hours of darkness for the first time. Up until September 2014, the charity has been operational during 14 hours of daylight in the summer months and just 10 in the winter, with its three aircraft carrying out up to eight missions per day across the region. Now, thanks to generous donations from local individuals, communities and businesses, and the research into the extended demand for the service, the charity will be operational for a 14 hour day throughout the year, transporting patients between lit helipads to the area’s specialist trauma hospitals in the hours of darkness.
www.draeger.com
New ALP for West Sussex Fire and rescue operations at height have been boosted in West Sussex thanks to the introduction of a new Aerial Ladder Platform (ALP) into the West Sussex Fire and Rescue Service’s fleet. Based at Worthing Fire Station, the ALP is a Vema 32F Series. It is 4.4m
wide with a Scania P270 chassis and bodywork by John Dennis. Thanks to rear wheel steering and a smaller chassis and jacking system, the new ALP, which will now be in service until 2030, is more manoeuvrable than the old appliance it is replacing and can be used on narrower roads and in more confined spaces. The rescue cage is also a new design, enabling stretchers to be loaded more quickly and easily for casualty safety. The service’s Area Manager for Operations Adrian Murphy, said, “This is a real boost to our operational response. The new ALP is equipped to a high specification, can be used at a greater variety of incidents and is more economical to run than the old appliance. The feedback from the crews who have been training on it has been very positive. “In the past 12 months we’ve also invested in an all-wheel drive Unimog increasing our capacity to protect and respond during flooding, snow and other severe weather conditions. There are also plans in place to upgrade the service’s four-by-four fleet as well as introduce three new upgraded Scania Water Tender Ladders later in the year.”
Air Operations Manager Becky Tinsley commented that this latest, unique milestone was another step towards providing an operational service throughout the night. She said, “As well as providing crucial HEMS support throughout the day, being able to fly between lit hospital helipads within our extended operating hours throughout the year is significant for the Midlands Air Ambulance Charity. This has only been possible due to the tremendous support we receive from the public, and the hospitals that have provided lit helipad landing sites, but there is still a long way to go in improving the lit helipad network across the region. “Undertaking full air ambulance missions at night is part of our strategic plan but we cannot achieve this goal without further aircrew training, equipment and a more robust lit helipad network, which is why the continued support of the public is required, now more than ever.”
www.westsussex.gov.uk
www.midlandsairambulance.com
April 2015
6 | ESTNEWS London Fire Brigade (LFB) has unveiled its new £7m training centre in Park Royal. The purpose built complex, provided by the brigade’s training partner Babcock, will complement the brigade’s other dedicated training facility, which opened in Beckton last year. The centre, which covers 4000sqm and will run around 500 training courses a year, features a four storey zero-emission fire house, provides a tower for ladder and line rescue training as well as classroom facilities.
Energy management solution reduces costs for GMP
www.london-fire.gov.uk
Some 500 frontline police officers in Dyfed Powys Police have been issued with smartphones, which allow them to carry out the majority of their everyday policing duties while out on patrol. This number will rise to 650 by April. The Samsung Galaxy Notebook 3 handheld devices have replaced the traditional pocket notebook and can be used for a range of duties including crime recording, police checks, road traffic collision recording, monitoring and on-street cannabis warnings. The introduction of handheld devices to the force is part of the strategy to be completely digital by 2016. www.dyfed-powys.police.uk
HRH The Princess Royal officially opened a cutting-edge Ambulance Special Operations Centre in Exeter (ASOC West) on 16 February. The new ASOC is part of the impressive £210m SkyPark scheme, and is the base for the South West Ambulance Service NHS Foundation Trust’s Exeter Hazardous Area Response Team (HART). www.swast.nhs.uk
FLIR has developed an easy-to-read informative booklet ‘Thermal Imaging for Firefighters: The Ultimate Guide’, which covers everything that firefighters need to know about thermal imaging cameras (TICs) for fire fighting applications. This free guidebook can be downloaded from the FLIR Systems website. www.flir.com/fire
Landlords will be required by law to install working smoke and carbon monoxide alarms in their properties, under measures announced by Housing Minister Brandon Lewis on 11 March 2015. The measure is expected to take effect from October 2015. \This is part of wider government moves to ensure there are sufficient measures in place to protect public safety, while at the same time avoiding regulation which would push up rents and restrict the supply of homes, limiting choice for tenants. www.gov.uk
www.emergencyservicestimes.com
Greater Manchester Police (GMP) is working with IMServ Europe, one of the UK’s largest independent energy management providers, to gain a better understanding of its energy usage, and further drive GMP’s passion to be more sustainable. Helen Wilson, Sustainability Officer at GMP, explains, “In the current economic climate there is a growing pressure across all police branches to reduce costs and carbon emissions. One of the
ways we are approaching this challenge is to understand our energy usage, thus allowing us to make informed decisions on how we can reduce energy consumption and ultimately lower our bills.” IMServ’s micro-BMS is specifically designed to enable companies or organisations to monitor, understand and control building energy consumption such as lighting, heating, air conditioning and boilers. This can be done remotely and automatically, without interference from local staff. Helen continues, “We installed IMServ’s micro-building management solutions (BMS) into one of our smaller buildings which houses part of the IT department. This building is too small to warrant installing a full BMS system, however we had limited control over its energy usage and were keen to assess any areas for potential cost savings.” Over a three-month pilot period, the micro-BMS service provided GMP with an energy saving of 70 percent, with a return on investment achieved well within that time frame. Considerable cost savings were achieved, which help towards the force’s ultimate goal of reducing its energy bill. Helen said, “IMServ has enabled us to install a BMS system where it would not have been possible otherwise. By doing so we have been able to investigate, and improve energy consumption in the building, contributing to our ultimate goal of reducing the cost of energy used by the GMP.” www.imserv.com
Staffordshire scoops two top awards Staffordshire Fire and Rescue Service is celebrating after scooping two top national awards. The service won the gold award for ‘Innovation’ and the bronze award for ‘Fire and Rescue Service Project of Year’ in the Improvement and Efficiency Social Enterprise Awards, which took place on 4 March at Church House, Westminster. It was the first time the service had entered the prestigious competition, which saw public sector organisations, councils and social enterprises across the country apply. Staffordshire Fire and Rescue Service was recognised for the ‘ST15’ misting branch, which forms the nozzle of a fire fighting hose. International company FireBug, which teamed up with the service in 2013 to develop and produce the tool, is selling the nozzle. It encapsulates science to use minimum water while achieving maximum results. It is the most water efficient nozzle on the market today and is approximately 65 percent more efficient than other comparative nozzles. www.staffordshirefire.gov.uk
Firefighters demonstrating the ST15 misting branch.
Emergency services drive to keep motorcyclists safer on the roads this summer Tyne and Wear Fire and Rescue Service (TWFRS) is teaming up with Northumbria Police’s Collision Investigation Unit and RoSPA (Royal Society for the Prevention of Accidents) to keep motorcyclists safer on the region’s roads. As the better weather approaches, motorcyclists will be getting back on their bikes and motorists will start to see more of them on the roads. This partnership is aimed at raising awareness to both groups to watch out for each other and stay as safe as possible on the roads. Area Manager Alan Robson, who is senior sponsor of the motorcycle section at Tyne and Wear Fire and Rescue Service, said, “I am delighted the service
is taking part in this initiative aimed at reducing the number of deaths and serious injuries we see on the roads.
The sessions on offer are completely free and will help motorcyclists to improve their driving, knowledge and skills which will help them to stay safer on the roads this summer.”
Combined efforts
(From L to R) John Ennis, RoSPA; Area Manager Alan Robson, TWFRS; PC Fraser Doherty Northumbria Police; Assistant Chief Fire Officer Chris Lowther, TWFRS; Crew Manager Stu Dobson, TWFRS; Firefighter Phil Waddell, TWFRS; and Watch Manager Dave Summers, TWFRS.
John Ennis, Chairman and Advanced Motorcycle Tutor of the local group of RoSPA Advance Drivers and Riders (RoADAR), said, “I am pleased to collaborate with the emergency services on road safety matters. Hopefully our combined efforts will help reduce deaths and serious injuries on our roads.” www.twfire.gov.uk
April 2015
ESTNEWS | 7
‘Active shooter’ exercise tests emergency services in the North East Exercise Sandpiper, one of the largest outdoor emergency exercises to have ever taken place in Cleveland, saw agencies come together over two days in January to test the response of police, ambulance and fire and rescue services in the event of an ‘active shooter’ scenario, where public safety is endangered by a gunman or gunmen. Although such incidents have recently been highlighted by events in Australia and France, Sandpiper was actually conceived over a year ago. Agencies such as Cleveland Police, Hartlepool Borough Council, North East Ambulance Service, Cleveland Fire Brigade, NHS England and British Red Cross were all involved in months of planning for the exercise, which was staged over three sites. The first was the Tesco store in Stockton, where an armed robbery goes wrong and the robbers injure several people with guns and vehicles while making a getaway. The second was at Wolviston, where the gang swap cars and burn out their original vehicle. The third and largest was at Hartlepool, as
the gang are spotted by automatic number plate recognition and pursued to ‘Sandpiper College’ on Hartlepool Marina, using their weapons and causing a significant motor accident before taking students and staff hostage. The fictional college was actually a disused retail outlet. A team of construction students from Hartlepool College, led by lecturers Andy Hetherington and Simon White, constructed a maze of rooms in which casualties, hostages and the gunmen would by placed to provide a realistic challenge to the police firearms and medical teams. A large number of college students and staff were also drafted in to play victims on the day, with College Production Arts Make-Up students providing a series of realistic make-ups to simulate a variety of wounds. The ‘hostages’ were supplemented by Amputees in Action actors, who are able to simulate lost limbs.
www.secamb.nhs.uk
After the exercise, Cleveland Police Chief Constable Jacqui Cheer said, “Part of this response is being prepared for a whole range of things – hence the exercise that took place. This has been a year in the planning and there are so many people to thank for getting it ready but I will pick out Hartlepool College for a special mention – thank you. Those of us away from force watched what was unfolding via social media and I was hugely impressed. Well done to everyone involved.” www.cleveland.police.uk
Cleveland services agree collaborative alliance Cleveland Police and Cleveland Fire Brigade have formed a groundbreaking collaborative alliance to explore opportunities to deliver savings by sharing buildings to house blue light teams. Police and Crime Commissioner Barry Coppinger, Acting Chief Constable Iain Spittal, Chief Fire Officer Ian Hayton and Fire Authority Vice Chair Jan Brunton signed a memorandum of understanding, which cements the commitment of both organisations to bring the most efficient and cost effective service to communities.
Talks between both police and fire brigade began last year, and while still in the early stages, the next phase will go further in exploring the viable options and cement plans for collaboration. Opportunities include both police and fire officers co-locating in stations in a bid to save thousands on the estates bill for both emergency services and a specialist training facility and exploration of a community hub at Queens Meadow Business Park in Hartlepool. Acting Chief Constable Iain Spittal said, “This alliance absolutely makes
sense as our officers don’t spend their time policing from behind a desk; their office is the streets of the communities they serve. If we can collaborate with our partners to reach our common goals of achieving savings and sharing resources, we can reduce the money we spend on buildings and invest it into our people. This alliance reaffirms the commitment of all involved to keep communities safe and protect people from harm.” www.cleveland.police.uk
‘One off’ ambulance hits the streets in Derbyshire A new concept ambulance is now operating in Derbyshire on behalf of the East Midlands Ambulance Service (EMAS). The Volkswagen Amarok am-
Photo: Steve Harrison, Paramedic Team Leader, EMAS.
www.emergencyservicestimes.com
bulance is designed to help paramedics get to patients in hard to reach places where 4x4 capability can be crucial. Steve Farnsworth, Head of Fleet Services at EMAS, said, “The vehicle has been purchased from monies donated to EMAS by former Derbyshire resident Dennis Hall. He sadly passed away but left a significant amount of money in his will. It was a generous donation for which we are very grateful. “We can safely say this is a ‘one off’ vehicle, which will be especially useful
South East Coast Ambulance Service NHS Foundation Trust (SECAmb) has been awarded the Freight Transport Association’s (FTA) Van Excellence Accreditation. SECAmb is only one of three ambulance trusts in the country to be awarded this market-leading accreditation, which looks to enhance standards of van operator compliance, celebrate operators who demonstrate excellence and represent the interests of the van industry.
in the challenging terrain and increasingly changeable weather conditions we often see in Derbyshire. It’s fully equipped and can easily get to places that normal ambulances would perhaps struggle to get to. “Staff who played a key role in the design stage are very impressed with the finished product, it’s certainly going to be a real boost to them and patients who may travel in it.” www.emas.nhs.uk
Hampshire Fire and Rescue Authority (HFRA) and Isle of Wight Fire and Rescue Service have agreed a partnership, which will now see Hampshire providing strategic leadership to the Isle of Wight. The partnership will formally begin on 1 April. Hampshire’s Chief Officer Dave Curry will take over leadership of the Isle of Wight, while the island’s three senior officers will be transferred to Hampshire's team, with the area and group manager maintaining a physical presence on the Island. www.hantsfire.gov.uk
The Association of Air Ambulances (AAA), which represents the majority of air ambulance operators in the UK, says a £5m donation from Libor fines will make a significant difference to patients across the UK. The funding was confirmed on 24 February 2015 at a meeting between UK Chancellor George Osborne and the AAA, whose charity will distribute the money among 20 local air ambulance charities. Each charity will receive £250,000 from the fund, which will contribute to a range of projects across the UK enhancing the lifesaving services provided by the local air ambulance charities. www.associationofair ambulances.co.uk
An additional £2m of Scottish Government funding is to be invested in the Scottish Ambulance Service (SAS) for 2015-16. The funding will be used to help the ambulance service deliver its refreshed strategy, Towards 2020: Taking Care to the Patient, which will support the overall vision for the health service to provide more care to patients at home or in the community and help to avoid unnecessary hospital admissions. To achieve this, more investment will be targeted at developing the clinical skills of the current ambulance service workforce as well creating new roles with enhanced skill sets. www.scottishambulance.com
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CFOA campaign focuses Diary dates on Cold Water Shock in 2015
The Chief Fire Officers’ Association (CFOA)’s first Drowning Prevention and Water Safety Week, which takes place from 13-19 April 2015, is aiming to raise awareness of the risk of Cold Water Shock when swimming in inland bodies of water. CFOA’s Water Safety Executive Board, led by Brigade Manager Dawn Whittaker, is working with other partners including the Royal Lifesaving Society (RLSS) and the Royal National Lifeboat Institution (RNLI) to coordinate campaign activity, working together to ensure more people are aware of the risks and statistics associated with water-related fatalities in the UK.
This campaign is particularly targeting young adults, aged 16-30, as this is the age group that saw the highest number of water related deaths in 2013. The campaign week will be focused on inland water sites – lakes, reservoirs, rivers and canals, as well as water-filled quarries. An important part of the week will be to ask young people to look after their friends – by not encouraging them to risk their life or putting them into danger – and by learning basic lifesaving skills, which could help in an emergency. CFOA is also asking fire and rescue services to support the RLSS’ Drowning Prevention Week from 20-28 June and the RNLI’s Respect the Water campaign in July. CFOA is also taking part in developing a National Drowning Prevention Strategy with partners who contribute to the National Water Safety Forum.
www.cfoa.org.uk
31 March – 1 April British APCO 2015 Manchester Central www.bapco.co.uk
14-16 April Rescue 3 Technical Rescue Conference Llangollen, North Wales www.rescue3europe.com
21-22 April Counter Terror Expo 2015 Olympia, London www.counterterrorexpo.com
21-22 April Ambition 2015 Olympia, London www.ambitionexpouk.com
For more information about CFOA’s Drowning Prevention and Water Safety Week please e-mail: rebecca.wallis@cfoa.org.uk
24 April Sky Tech Conference & Exhibition 2015 Business Design Centre, London www.skytechevent.com
More on offer at Life Connections 2015 Life Connections 2015, which takes place from 21-22 October at the Kettering Conference Centre, features a series of conferences and courses aimed at emergency medical professionals wishing to keep up to date with new technologies and maintain their CPD portfolios, at affordable delegate rates. Confirmed plans to date for the two-day event are highlighted below.
Meditech Global is running a Motorsport Medicine Workshop aimed at medics and rescue personnel involved with motorsport events. Speakers will include: FIA Doctors and active motorsport paramedics. Those interested in learning about or improving their role play and simulation facilitation skills are welcome to apply for a place on the ALSG The Practical Approach one-day course.
Thursday 22 October Wednesday 21 October The ATACC ‘Decoding the Future’ two-day conference aims to explore the very latest medical advances in the fields of resuscitation, trauma, anaesthesia and critical care. The Paramedic Practice Conference includes presentations including: Burns to the Integumentary System; Ebola Transport; The Pre-hospital Management of Traumatic Cardiac Arrest; and Intubation Without Traditional Laryngoscopy – Is this the future? The NAEMT Trauma First Responders course is a one-day continuing education course, which teaches the principles of Prehospital Trauma Life Support (PHTLS) to non-EMS practitioners. It helps them prepare to care for trauma patients while serving as part of a transport team or awaiting a transport provider. Medipro Training is running a Paediatric Workshop covering a general approach to paediatrics to include spotting a sick child, red flags pre-hospital and prehospital pain management.
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Thursday 22 October sees the second day of the ATACC Decoding the Future conference. Meditech Global will also be repeating its Motorsport Medicine CPD Workshop, with only 25 places are available. Speakers at the Resuscitation Today Conference will include Professor Sir Keith Porter, Jamie Todd and Mike Davis, who will be providing presentations on topics including Incorporating Non-Technical Skills in Life Support Teaching. The new Resus Guidelines will also be discussed. Thames Group is running a Cardiac Based Study Day on ECG Interpretation, while Alan R D Clarke MBE, Paramedic & Pre-Hospital Care Consultant, will be running an interactive workshop on the subject of Long QT Syndrome and other Cardiac Arhythmias. Medipro Training is running a one-day Minor Injuries Workshop, which will practical exercises. Check the website or call 01322 660434 for prices and availability of all conferences and courses at Life Connections 2015.
www.lifeconnections.uk.com
8-13 June Interschutz 2015 Hannover, Germany www.interschutz.de
9-10 June NAPFM The Emergency Fleet Exhibition The International Centre, Telford www.napfmevent.org.uk
23-27 August International Association of Women Police 53rd Annual Training Conference Motorpoint Arena, Cardiff www.iawp2015.org
15-18 September DSEI 2015 Excel, London www.dsei.co.uk
23-24 September The Emergency Services Show 2015 The NEC, Birmingham www.emergencyuk.com
21-22 October Life Connections 2015 Kettering Conference Centre www.lifeconnections.uk.com
27-30 October A+A 2015 Düsselfdorf, Germany www.aplusa.de
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ESTEVENTS | 11
Learning and development focus at The Emergency Services Show 2015 A new seminar theatre dedicated to training will feature at The Emergency Services Show 2015, which returns to the NEC in Birmingham from 23-24 September. Free to attend, the new seminars will be led by training centres, academies and universities who run specialist courses for emergency services personnel, and will expand the offering of free learning opportunities already available to visitors. The Emergency Services Show, a growing exhibition for frontline emergency responders, has already attracted many of the most respected training providers in the industry, including the Tactical Training Centre, NHS Ambulance Service First Aid Training consortia (NASFAT), Fire Training Group, PGI Training, University of St Andrews, Coventry University and London Metropolitan University. Organisers Broden Media, publishers of Emergency Services Times magazine, will also be running seminar programmes on multi-agency working and innovation (successfully launched at the 2014 event), as well as the popular College of Paramedics CPD Workshops. Meanwhile the indoor and outdoor exhibition will feature over 400 companies and organisations, some of which will run workshops and live demonstrations on their own stands.
Exhibitors include leading names in training, communications, IT, protective clothing and uniforms, vehicles and fleet, vehicle equipment, fire fighting equipment, search and rescue, extrication, first response, outsourcing, community safety, station facilities, water rescue and medical supplies.
Emergency Response Zone Aimed at developing relationships and partnerships between the emergency services, and between the emergency services and the voluntary sector, the Emergency Response Zone is a networking focus of the exhibition and will feature many new exhibitors this year, including Fire Brigades Union, Arson Prevention Forum, CFB Risk Management, South Western Ambulance Service NHS Foundation Trust and Road Safety GB Academy.
“Registration for free entry to the show is now open at www.emergencyuk.com” John Halfpenny, Policing Skills Trainer, West Mercia and Warwickshire Police, described last year’s show as, “An invaluable and enjoyable chance to network and appreciate the challenges, strengths and capabilities of partner agencies in the emergency services and support organisations or responders.” While Mark Atton, ERA Head of Defence, described the show as, “A great one stop shop for emergency services capability, intelligence and expertise.” With something new around every corner, The Emergency Services Show provides a unique opportunity for emergency responders to learn, network and progress their careers. It is also a showcase for the most innovative kit on the market and the very best examples of industry collaboration. “The exhibition halls will be buzzing with knowledge and expertise and we urge officers of all ranks, across all emergency services, to take full advantage,” says Event Director David Brown.
Free parking The NEC is physically linked to Birmingham International Station and Birmingham Airport and is directly accessible from the UK motorway network. Parking for visitors and exhibitors is free of charge. Now in its tenth year, The Emergency Services Show is aimed at anybody involved in emergency response, planning and recovery, including all blue light services, voluntary workers and service providers. To register for free entry to the exhibition nd access to the free seminar sessions please visit www.emergencyuk.com.
www.emergencyuk.com
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Feature heading
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ESTMEDICAL | 13
Updated ambulance service clinical guidelines on the way in 2016 The Association of Ambulance Chief Executives (AACE) provides ambulance services with a central organisation that supports, coordinates and implements nationally agreed policy. It also provides to the general public and other stakeholders, a central resource of information about NHS ambulance services. Having picked up many of the aspirations of its predecessor, the Ambulance Service Association, the primary focus of the AACE is the ongoing development of the statutory ambulance services across the UK and the improvement of patient care. Words: Steve Irving, Executive Officer, AACE. Providing standards for the clinical care that is delivered to patients in the prehospital setting is very challenging. The environment of care can be different for every patient and every incident attended. As all responders will know, Protocols, which are by nature proscriptive and limiting, are not always suitable for use ‘on the ground’. They are rigid statements that allow little of the flexibility that is required to deliver optimum care, in the right place, at the right time. Guidelines, however, are recognised to reduce unacceptable or undesirable variations in practice and provide a robust basis for providers to deliver the best care. They are tools designed to assist decision-making and allow patient needs to be considered as part of practice. Since the 1990s, the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) has produced guidance for ambulance clinicians. Through rapid developments in capabilities, especially the expansion of Paramedic’s scope of practice, these early publications have been radically developed to become our current set of guidance, the UK Ambulance Services Clinical Practice Guidelines 2013. Provided in a variety of formats, two publications complement each other – the full reference edition is supported by a ‘Pocket Book’ field guide. In addition to the printed books, digital editions are available to purchase for download onto iOS (iPad, iPod, iPhone) and Android devices.
Gold standard Now into its third reprint, these guidelines are considered the gold standard across the UK by the NHS ambulance services and a wide variety of other
organisations and care providers. AACE and Class Professional Publishing were delighted that both books were shortlisted and then ‘highly commended’ at the BMA Medical Book Awards in 2014. The challenge through 2015 is for AACE to support, through JRCALC, expert groups to research, evidence and write new guidance where required. Work has started on: Convulsions in Children; Sepsis; Mental Health and End of Life Care as well as updating C-Spine Care and Immobilisation along with the Head Trauma sections. In response to the increasing number of lower acuity patients seen by UK ambulance services a new section is being developed to offer guidance in meeting the clinical needs of this patient group. Mark Millins, Lead Paramedic for Clinical Development at Yorkshire Ambulance Service NHS Trust, is assisting AACE with coordinating this task. He said, “I am delighted to have recruited Paramedics on to each group who have the credentials and enthusiasm to produce high quality guidance based on current evidence. Under the direction of JRCALC chairmanship, each group will produce recommend draft text to go forward to NASMED for inclusion in the 2016 publication.”
“These guidelines are considered the gold standard across the UK by the NHS ambulance services.”
The full reference book and pocketbook were ‘highly commended’ at the BMA Medical Book Awards in 2014.
To support continuing professional development (CPD) for clinical staff, AACE were pleased to give access to the 2013 Guidelines for Richard Berry to support his online learning tool CPG: CPD, which can be tried out for free by going to http://cpgcpd.com. As Richard says, “CPG: CPD dovetails with that need to complement academic methods with a prehospital brain-training tool. It is suitable for those starting their career, those consolidating, and those in their middle and later years facing difficulties in the recall of information they used to find so easy!”
Updates available separately
The UK Ambulance Services Clinical Practice Guidelines 2013.
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AACE is committed to publishing the revisions and the new guidelines in the first quarter of 2016. There will be many care providers and students who will want to have the new version available to them in either print or electronic format but to assist those who own the 2013 edition and only require the updates, Class Professional and AACE are looking into providing standalone updates published separately in addition to a fully updated Pocket Book. The intellectual property rights (IPR) and copyright for these guidelines are held by AACE who are mindful to maintain their currency. All NHS ambulance trusts invested in their development and there is an obligation to ensure that investment is well managed. Because of that, the guidelines are not made freely available on the web but licensed versions can be made available to individuals or academic institutions for students to reference and use for their studies.
Clinical Guideline Apps… Looking forward to 2016 and beyond, technology and innovation will no doubt influence practice and the way we access and record information. AACE is keen that clinical guidance and aids to learning continue to be produced in formats best suited to the user and to promoting improved patient care. Expect news on the suite of Clinical Guideline Apps and the like in the near future…
http://aace.org.uk http://classprofessional.co.uk http://cpgcpd.com
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Identifying innovations in ambulance design and patient transportation What is the future of patient transportation? How will ambulances evolve to improve patient comfort, protect and empower paramedics, enhance clinical care and boost the efficiency and performance of ambulance fleet management? Words: Richard Smith, IPTS Programme Manager, FERNO UK. The overriding aim of innovations in ambulance design and performance is improved patient experiences and positive patient outcomes. New ambulances will seek to offer safer, faster patient-centred service and have the versatility to offer more in-transit clinical care. Ambulances work at the frontline of the NHS service and the reputation of the service is of paramount importance. The general public, the other emergency service partners and hospital-based medical practitioners and administrators must all have total confidence in the ambulance service. This is why rethinking the design and role of ambulances is a key concern for everyone working within the UK’s ambulance trusts.
Four areas of focus The scope for improving ambulance performance can be broadly split into four key areas. These are: 1. Paramedic welfare – lighter equipment, enhanced seating, better access to clinical apparatus, improved staff satisfaction, more protection from injuries caused by lifting, bending, stretching and sliding/falling (during transit). 2. Interior layout – a move towards modular design will mean ambulance interiors can be reconfigured and replenished quickly, creating a more ergonomic and efficient working environment. 3. Vehicle data and informatics – a new generation of vehicle intelligence will record and analyse data and provide both real time and cumulative information for paramedics, hospital staff, fleet operational managers and drivers. Benefits will include increased logistics efficiency, reduced fuel costs, lower carbon emissions and lower insurance premiums to name a few. 4. Patient experience – prevent delays with shorter ambulance-loading times, increase comfort prior to and during transit, quicker access to enhanced standards of clinical care, higher levels of medical care during transit. The first three areas offer a huge range of opportunities for practical improvements. The fourth area, the patient experience, which directly influences the broader healthcare objective of patient outcome, is largely determined by the aggregate of benefits derived from the first three areas.
1. Paramedic welfare Improvements in the in-transit seated positions of paramedics and doctors can be expected with the introduction of more flexible and ergonomic seating positions. Being able to comfortably reach both clinical and communications/administrative equipment will minimise injuries from stretching and stumbling and enable more productive activities during transit. The aim is for paramedics to be safely seated while intransit 100 percent of the time. Flexible seating and secure seatbelts will be designed to allow close
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A new generation of touch button operated trolleys will minimise injury risks, meaning, less bending and stretching for paramedics.
attendance to the patient, as and when necessary. An adjustable, fold-away laptop/tablet bar on an extending arm that is secured to the side wall of the ambulance will allow paramedics to send e-mails and update hospitals from the ambulance. Further innovations include incorporating vibrating pads into the paramedic’s seat, which are activated when the driver turns on the indicator before taking a left or right turn. This will forewarn the paramedic of the lateral movement and enable them to adjust/cease any patient care, which may be affected by the temporary movement.
Powered trolleys A new generation of touch button operated trolleys will minimise injury risks, meaning less bending and stretching for paramedics. Currently, every-day patient loading and unloading operations pose the risk of personal injury to emergency medical staff. This can and does result in injuries, which lead to lost workdays and, in the worst cases, career-ending, long-term injuries. Both the personal costs and the economic costs of replacing and training these individuals present an overwhelming case for eradicating the risk of injury caused by avoidable manual handling and lifting. The Department of Integrated Systems Engineering at Ohio State University in Columbus in 2013 completed extensive trolley ergonomics research. It measured and quantified the dramatic reduction in paramedics’ average and peak muscle activity when using an advanced powered auto-loading system. The new loading system removes the need for considerable manual handling and lifting.
Devices that mechanically lift and load patients into ambulances are likely to mark the end of A&E ambulance tail lifts and ramps. Currently it is common-place for paramedics to transport a patient on the carry chair and then to transfer them to the stretcher in the back of the vehicle, as it is easier to do this than use the stretcher and loading system, however, ergonomically, moving a patient from a carry chair to the trolley in the back of the vehicle creates its own risks. In comparison to self-loading powered trolleys, tail lifts are very slow, take up valuable internal space and present a safety risk to paramedics (push and pull injuries, trapped fingers etc). Tail lifts and ramps also add excessive weight to each vehicle, increase its carbon emissions and require expensive annual preventative service and maintenance. Therefore, the case for incorporating the use of a faster, safer and lighter integrated patient transportation and loading system is clear. A new generation of ‘self-loading’ system will rapidly speed up the loading and unloading process. This versatile and stable system should also quickly convert into a seat if the patient would benefit from this configuration. A built-in LED light system will automatically illuminate the area around the trolley system offering increased safety when attending patients while providing a visual warning to others nearby. This is also particularly important when lighting up the ground in front of the trolley during night-time loading. A further innovation is the automatic opening of ambulance rear doors as a patient transport device approaches. This will be activated by an intelligent signal sent between the trolley and ambulance vehicle. This is just one more measure designed to significantly reduce loading times and save lives by speeding up patient care.
April 2015
ESTMEDICAL | 15 2. Interior layout The terrorist strikes in New York (11 September 2001) and London (7 July 2005) provoked a re-think in ambulance design. Research sponsored by the US Government into trauma response prompted design teams to look for new industry standards. One area of investigation was military ambulances. We asked the question, ‘How does the military fill an ambulance vehicle space?’ Ambulances of the future will certainly be influenced by advances in mobile care in the military sector. In particular, a modular approach to ambulance interiors will become the norm. A series of wall-mounted brackets will allow interchangeable and modular equipment to be locked-in and removed as needed prior to the ambulance setting off to a destination. Although a number of standard configurations will be recommended, the ability to change the modular layout at short notice will greatly enhance the flexibility of ambulance crews to respond to a given situation and build in the equipment they need. For example, if a patient is known to need specialist equipment and intensive on-board care, the ambulance can be rapidly configured to meet these requirements before it leaves the base. In a very different scenario, the number of stretchers secured to the wall mounts can be increased to five if an ambulance’s designated role is simply to transport mass casualties over a relatively short distance.
“Ambulances of the future will certainly be influenced by advances in mobile care in the military sector.” Focus on ergonomics Interior design focuses on safety, ergonomics, intelligent, interoperable, reconfigurable, interchangeable, integration of equipment and data. iNTraxx and brackets sited within soft interior walls will allow cabinets and clinical apparatus to be securely installed and relocated quickly. Almost everything will be movable. Small storage boxes for consumables can be held onto the side of stretchers by the lock system in transit to ensure no movement or spillage from boxes or containers during transit. All large and small containers and equipment, including oxygen systems will be easily secured and interchangeable. All on board clinical apparatus, medical supplies, communications and administration devices need to be ergonomically optimised to allow the medic to respond to every situation that arises during patient transit. Even lighting within the ambulance cabin must respond to the needs of the paramedic and allow degrees of flexibility to enable the patient to receive the best care. As well as improving the quality and efficiency of patient care and team communications, a strategically designed modular interior will result in fewer injuries and strains for paramedics caused by bending and stretching.
Extending on board clinical care The Keogh Review, Transforming urgent and emergency care services in England, published in November 2013 proposed the need to, ‘Develop 999
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With many ambulance authorities facing an annual fuel bill of in excess of £6m, the use of vehicle informatics will play a substantial role in reducing costs as well as addressing important environmental issues by lowering carbon emissions.
“A pre-stocked and well-configured ambulance will ensure the patient receives the best possible treatment and care during transit.”
Richard Smith, IPTS Programme Manager, FERNO UK.
ambulances so they become mobile urgent treatment services, not just urgent transport services. We know that paramedics can now deliver treatments that would only have been done by doctors 10 years ago, whilst with the support of improved community services they can safely manage many more people at scene. This gives us both more options to treat people at home, and to travel further to reach specialist care. There are opportunities for extending paramedic training to better assess, prescribe for and manage patients with exacerbations of chronic illnesses and work more closely with GPs and community teams.’ Ambulances are a significant, long-term investment by NHS trusts that have varied and complex specifications. During an ambulance life (typically seven years), advances in medical equipment technology, can give rise to the need for costly modifications to ensure that the new equipment is secured safely in transit or, alternatively, where the cost of these modifications are inhibitive, delays in the provision of the enhanced technology, creating a two tiered provision of patient care within ambulance trusts. An increase in the variety and versatility of modular equipment in ambulances means that it is possible to be more responsive to these changes providing more immediate access to these essential, enhanced medical equipment or treatment pathways and advances in patient care. Extensive research and trialling must be undertaken to measure the impact and advantages of more doctors travelling in A&E ambulances on selected call outs. This process will be data driven and the recorded efficiencies must also be evaluated in the context of alleviating the huge pressure on the overextended A&E departments in UK hospitals.
3. Vehicle data and informatics Vehicle informatics will include real-time information on stock levels of consumables and accurate records of vehicle performance – including fuel consumption, satellite tracking, daily mileage and service records. This data will enable detailed analysis of vehicle performance, and the efficiency of fleet logistics, interteam communication, partner coordination and driver performance.
The addition of vehicle informatics is inevitable and essential. It is to be welcomed because its primary objective is to optimise the use of assets and improve the efficiency of patient care delivery. It will yield clear information on all aspects of an ambulance’s clinical and mechanical performance; highlighting maintenance issues early and identifying areas where changes in processes and behaviours would benefit service delivery. One of the outcomes will be an increase in the amount of accurate data relating to driver performance. This should be seen as a method of educating all drivers in best practice and elevating their subsequent performance, rather than placing excessive pressure on individuals. The data could lead to the identification and rewarding of elite drivers who consistently ensure their vehicle achieves the best possible performance.
Operational advances Ambulance fleet management can be expected to achieve new levels of sophistication and find new ways to measure and assess operational performance. Meaningful comparisons can be made between ambulances, similar fleets and regions. Best practice can be benchmarked and quickly disseminated to team leaders to ensure overall standards are continually rising and incremental efficiencies and savings can be introduced. The use of on board clinical equipment, communications devices and case document management systems will also be expected to improve when better data is available to all parties and the working environment for paramedics is enhanced. Studies carried out by the Helen Hamlyn Design Centre on behalf of the NHS and the Keogh Review have shown that typically 40 percent of Emergency Admissions are patients who do not need to be admitted to hospital. More sophisticated data and new industry benchmarks will enable more at scene (treat and discharge) or in-transit diagnosis and decision-making. Technologies which coordinate ambulance crews with hospitals and other emergency service partners continue to evolve at great speed. We can rely on our partners in this fast-moving sector to integrate increasingly efficient data and communication platforms into ambulances in the near future.Extensive research and trialling must be undertaken to measure the impact and advantages of the availability of advanced level diagnostic equipment and providing ‘at-scene’ access to doctors or consultants advice through technology. This process will be data driven
April 2015
16 | ESTMEDICAL and the recorded efficiencies must be evaluated in the context of alleviating the huge pressure on the over-extended A&E departments in UK hospitals.
In its broadest sense, more data allows better decisions, better operational performance and better patient experience.
Capturing data
4. Patient experience
Data captured will include journey logs, speed, duration, fuel consumption, reversing, blue light use, engine on and off, temperature control, tyre condition, broadband and radio dialogue and video recordings. Secure ‘real time’ information will be stored on cloudbased platforms and this allows customised and flexible reporting systems to be set up. Extensive research is going into seamlessly integrating data capture and communication devices within the fabric of the ambulance. The new technology will also be designed to integrate with and enhance UK current control systems. The ambulance dashboard will continue to house a range of familiar LED warning lights driven by the vehicle’s ECU. The vehicle diagnostics will include battery, tyre pressures, oil levels etc. In addition, a GPS system will record the real time location, provide remote vehicle diagnostics and theft protection of equipment. The theft protection monitoring equipment will alert the driver if the ambulance is about to leave the scene without vital equipment, including stretchers, chairs and defibrillators. Engines which turn off when idling will cut fuel consumption by 20 percent and contribute to a considerable overall improvement in the ECO performance of the ambulance. Many of these changes will be data driven and best practice carbon reducing benchmarks will be introduced and refined based on real usage.
Improving all aspects of the ‘patient journey’ from the emergency scene to hospital is at the heart of the new developments discussed in this article. We take a holistic view of the ‘journey’ and this goes beyond ambulance design to cover all equipment, activities, procedures and communications that combine to safely treat and transfer the patient.
www.emergencyservicestimes.com
“Extensive research is going into seamlessly integrating data capture and communication devices within the fabric of the ambulance.” Specific measures to increase speed, efficiency, quality and safety in these areas will contribute both directly and indirectly to improved patient outcomes. For example, an improved seating position for the paramedic within the ambulance will raise the standard of patient care administered. A faster transfer on a trolley that can cope with stairs and obstacles will mean a shorter hospital admission time for a critical patient –
A new generation of ‘self-loading’ system should also quickly convert into a seat if the patient would benefit from this configuration.
which could be life-saving. A pre-stocked and wellconfigured ambulance will ensure the patient receives the best possible treatment and care during transit. And finally, optimised logistics planning will also shorten transit times.
The future is closer than you think Many of the innovations discussed in this article are in the advanced stages of development and we believe most will be integrated into UK ambulances in some form in the next two to five years. What is certain is that advances in both materials and technology will continue to make ambulances and their equipment lighter, smarter, safer, more efficient and, where appropriate, faster.
www.ferno.co.uk
April 2015
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Lessons learnt from a decade of combat casualty care The conflicts of the last decade have ensured that the UK Defence Medical Services have been busy in support of combat operations in Iraq (2003-9) and Afghanistan (2006-14). Many lessons have been learnt in this time – some old, and some new – and many are transferrable to civilian emergency care. Words: Surgeon Captain J E Smith, Royal Navy Consultant in Emergency Medicine & Defence Professor of Emergency Medicine, Academic Department of Military Emergency Medicine, Medical Directorate (Research and Academia), RCDM, Birmingham. It is recognised that for a given severity of injury, mortality has decreased over the last 10 years in patients presenting to military medical treatment facilities [1]; in other words, patients are now surviving who previously would have succumbed to their injuries. This has been illustrated by the number of clinically and mathematically unexpected survivors returning to the UK [2-4]. However, no single innovation has resulted in this improvement in survival. Many factors have contributed, and some of these will be described in this article.
“It is likely that the whole trauma system, encompassing care at point of injury all the way through to rehabilitation, is responsible for the improved survival in military trauma patients.” Once again, we have learnt that haemorrhage is the major cause of death on the battlefield. To mitigate this, a change in emphasis of the rationale of the way combat casualties are assessed and treated, and novel methods of haemorrhage control, has been adopted. The traditional approach of assessment of Airway, Breathing, Circulation (ABC) has been changed to reflect the priority that should be given to stopping the bleeding in someone losing blood onto the battlefield. This has resulted in <C>ABC (where <C> represents control of life-threatening haemorrhage), a paradigm that is taught to military personnel from first aid (and buddy aid) through to advanced resuscitation. This is reflected in guidance issued to all deployed medical units – the Clinical Guidelines for Operations [5]. It is likely that the whole trauma system, encompassing care at point of injury all the way through to rehabilitation, is responsible for the improved survival in military trauma patients.
threatening haemorrhage. The Combat Application Tourniquet (CAT) is much easier to use than the previously issued rubber tourniquets, and has undoubtedly saved lives in patients injured predominantly by explosion [6]. Novel haemostatic agents are employed when there is ongoing haemorrhage not easily controlled by a tourniquet, and are particularly useful in patients with junctional wounds (such as those in the groin or axillae) [7].
Intra-osseous devices Treating patients with severe blood loss requires access to the circulation, to facilitate infusion of drugs and blood products. However, this is often the patient group in whom it is most difficult to secure intravenous access. Infusion into the bone is not a new concept – indeed it has been around since the 1920s – but it fell out of favour until the last decade of military experience. Gaining intra-osseous access is a relatively simple procedure that can be life saving. Indeed, anaesthetic drugs, blood products and analgesic agents can all be administered through an intra-osseous needle, and these are rapidly delivered into the central circulation [8, 9].
Physician-paramedic teams The physician-paramedic teams deploying as part of the Medical Emergency Response Team (MERT) have brought critical care interventions forward from the emergency department onto the battlefield. This concept was borne out of the civilian physicianparamedic teams employed as part of Helicopter Emergency Medicine Services (HEMS), and earlier incident response teams that deployed in other operational theatres. The capability ensures that rapid sequence induction of anaesthesia and intubation (RSI), advanced analgesic techniques, delivery of blood and blood products, and emergency thoracotomy can all be performed earlier in the patient pathway than could be achieved by a traditional retrieval model.
Haemorrhage control The management of a patient with life threatening bleeding involves haemorrhage control, and replacement of lost blood products. Haemorrhage from a limb can often be controlled by direct pressure and elevation, but if this is ineffective, a tourniquet should be used in the context of life-
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An ambulance waits alongside a Chinook helicopter at Camp Bastion, Afghanistan. The Medical Emergency Response Team (MERT) consisted of a consultant in emergency medicine or anaesthesia, an emergency nurse and two paramedics. In addition four Royal Air Force Regiment gunners provide armed protection when they land and leave the helicopter to collect the casualty.
A battlefield first aid exercise involving troops from 7th Parachute Regiment Royal Horse Artillery.
Training The training that military medical teams undergo before deployment is tailored to meet the requirements of the specific deployment. Some of the training requirements are generic, and include core military and medical skills; these are supplemented by formative and summative team training opportunities during a hospital exercise (HOSPEX) [10] and the Military Operational Surgical Training (MOST) course where resuscitation and surgical teams work together during cadaveric and simulation training serials to rehearse common scenarios.
Conclusion Combat casualty care has come a long way in the last decade. However, there is still a long way to go if we are to maintain the momentum of excellent standards of trauma care as we enter a period of contingency operations.
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References 1. Penn-Barwell JG, Roberts SA, Bishop JRB, Midwinter MJ. Improved survival in UK combat casualties from Iraq and Afghanistan: 2003-2012. J Trauma 2015 in press. 2. NAO. Treating injury and illness arising on military operations: report by the Comptroller and Auditor General. London, UK: National Audit Office; 2010: 10 Feb 2010. 3. Russell RJ, Hodgetts TJ, McLeod J et al. The role of trauma scoring in developing trauma clinical governance in the Defence Medical Services. Philos Trans R Soc B 2011; 366: 171-91. 4. Hettiaratchy S, Tai N, Mahoney P, Hodgetts T. UK's NHS trauma systems: lessons from military experience. Lancet 2010; 376: 149-51. 5. JDP 4-03.1 Clinical Guidelines for Operations. Development, Concepts & Doctrine Centre (DCDC) 2010. 6. Brodie S, Hodgetts T, Ollerton J et al. Tourniquet use in combat trauma: UK military experience. J R Army Med Corps 2007; 153: 310-3. 7. Smith AH, Laird C, Porter K, Bloch M. Haemostatic dressings in prehospital care. Emerg Med J 2013; 30: 784-9. 8. Lewis P, Wright C. Saving the critically injured trauma patient: a retrospective analysis of 1000 uses of intraosseous access. Emerg Med J 2014 in press. 9. Barnard EBG, Moy RJ, Kehoe A et al. Rapid sequence induction of anaesthesia via the intraosseous route: a prospective observational study. Emerg Med J 2014 in press. 10. Davies TJ, Nadin MN, McArthur DJ et al. Hospex 2008. J R Army Med Corps 2008; 154: 195-201.
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ESTMEDICAL | 19
American manufacturer has Ambition to save more lives A Cincinnati-based manufacturer of emergency medical equipment is heading to the UK to showcase its range of innovative military inspired life-saving products. TyTek Medical produces compact, pre-hospital emergency medical supplies for trauma care. The company is venturing overseas to launch a new product at Ambition 2015. TyTek Medical will be exhibiting an advanced Thoracic Valved Decompression Needle (TVDN) at Ambition, which takes place at London’s Olympia from 21-22 April. TVDN is a reliable solution for treating a tension pneumothorax injury, or sucking chest wound, one of the leading causes of death in combat. Current methods for treating this injury include the application of a plastic seal over the chest wound to inserting a needle catheter into the chest to drain air out of the chest and relieve pressure. However, successful application of a pneumothorax needle has proven difficult to achieve in combat situations. The TVDN was inspired by an idea considered by the US based Tactical Combat Casualty Care committee and developed with TyTek Medical’s partners at H&H Medical who worked with the US Department of Defense during a robust testing and evaluation phase.
“Our prehospital emergency medical supplies allow first responders to stabilise critical patients until they can be safely transported or until further medical assistance arrives.” Platinum 10 minutes Statistics indicate that most battlefield deaths occur within the first 10 minutes of wounding. Therefore to survive injury in combat every second counts. Medical
The success of TyTek Medical’s product range in combat zones has led to demand from non-military first responders in: search and rescue, fire and rescue, ski patrol, remote/wilderness EMS, tactical and EMS teams.
Major trauma packs
planners in the military now refer to the time immediately after injury as the platinum 10 minutes, rather than the golden hour that used to be referred to. Prehospital trauma care in the military has undergone an unprecedented transformation and advancements have been made in trauma care to adapt to current needs and to reflect the 10-minute window. Almost 90 percent of service men and women who die from combat wounds do so before they arrive at a medical treatment facility, highlighting the importance of emergency battlefield trauma care. TyTek Medical’s Managing Director Chris Tyler said, “TVDN offers better efficiency, safety and important physical features. It has a veress safety tip to reduce the risk of puncturing internal organs when inserted. It also includes a visible cap head to monitor air or blood leaving the chest and a one-way valve has been added to the top of the needle to ensure that the air being drawn out of the injured chest does not draw back in. Lastly, a luer lock cap allows for an active drawing or elimination of air or blood from the chest.” The TVDN will be packed in a hard shell case built for the demanding military environment. TyTek Medical’s emergency products were designed and engineered specifically for use in the current Middle East conflicts to meet Tactical Combat Casualty Care (TCCC) guidelines.
The call for potentially life-saving products has global reach. In England, the East of England Ambulance Trust (EEAST) recently announced its intention to improve standards of care, by investing £12m in the installation of a new range of medical devices including major trauma packs in all emergency ambulances and rapid response cars by 2016. On the other side of the world cyclone season has reached Australia’s Northern Territory and trauma skills workshops are preparing health workers in the remote Top End, where a category four storm hit four remote Aboriginal communities in February. First responders are refreshing their skills in case of another natural disaster or major road accident, workshopping how to get people out of crashed vehicles, to splint fractures, relieve pain, reduce bleeding and insert chest tubes.
Stabilise critical patients Chris concluded, “Our product range works in a variety of trauma care situations. For prehospital emergency care providers our compact medical supplies effectively deal with chest decompression through to haemorrhage control. They can be used on a small scale, eg a critical injury on a ski slope or a road traffic collision, through to a mass casualty incident or even a terrorist attack. Ultimately our prehospital emergency medical supplies allow first responders to stabilise critical patients until they can be safely transported or until further medical assistance arrives.”
Confined space rescue TyTek Medical will also feature its emergency rescue extraction device XTricate. It is designed for use in confined space rescue scenarios allowing both vertical and horizontal lifting and support. The innovation has been rated highest in its category for strength – independently tested to carry over 1000lbs (over 450kg) in weight. TyTek Medical will be exhibiting on Stand 2-E7 at Ambition 2015. The Thoracic Valved Decompression Needle (TVDN).
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www.TyTekMedical.com
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Feature heading
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April 2015
ESTMEDICAL | 21
Independent Ambulance Association ready to continue the Blue Light Fight The Blue Light Fight is the name given by the Independent Ambulance Association (IAA), the country’s largest representative body for providers, to its campaign to stop the unintended consequences of legislation being rushed into law. It is at the very heart of what motivates IAA members: the need to save lives. Words: Penny Bustin, Director of Communications at the IAA. The Government’s Deregulation Bill was planned as a catch-all device to tweak all sorts of tricky bits of law – from apprenticeships to rules governing sellers of knitting yarn, from exempting Sikhs from wearing crash helmets to the erection of statues in London, which were not working as intended.
Alarm bells But the unintended consequences of what they were proposing in Section 36 had alarm bells ringing in our heads – if not, in future, on our members’ vehicles. ‘Road traffic legislation: use of vehicles in emergency response by NHS’. It was the last two words in that sentence that threatened what our members have been doing every day for more than 30 years – saving lives. The precise wording about the use of speed exemptions and the use of blue lights on a vehicle in an emergency said, ‘for the purpose of providing a response to an emergency at the request of an NHS ambulance service’. Thousands of patient journeys are done each day by independent providers for NHS hospitals, not at the request of an NHS ambulance service. In Bristol one IAA member is contracted by Intensive Care medical teams at Bristol Children’s Hospital to retrieve critically ill babies and children from across the South West and Wales under emergency conditions. In Cambridge, Addenbrookes Hospital has contracted out blue light services to another IAA member. “The NHS ambulance service does not hold a monopoly on the transport of the sick and injured,” said Event Paramedics and IAA Director Rick Player. “The Care Quality Commission regulates this and that lawfully includes private providers. Many private ambulance companies are contracted directly to hospitals through Clinical Commissioning Groups (CCGs) to provide High Dependency and Critical Care (blue light) ambulance transport for inter-hospital transfers. “This is not at the ‘request of an NHS Ambulance Trust’. That means thousands of emergency journeys each year would have to be re-tasked to the already-stretched NHS ambulance service, putting countless patients at risk, and jeopardising the future of private companies that are relied upon to ease the burden on the system.”
Event coverage The other area of service that was threatened by the Bill’s wording was the event world, in which our members specialise each and every day across the country. Public and private sporting and social events like cycle races, marathons, air shows, music festivals, equestrian events and town festivals rely on independent or voluntary medical cover. Indeed, most cannot get a licence to operate without first detailing who is providing emergency services. NHS ambulance trusts cannot possibly provide cover to all these events
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and do not have appropriate vehicles, such as 4x4 or motorcycle units, which suit the circumstances. The proposed legislation could mean a competitor or spectator at an event could not get fast treatment as a rapid response vehicle (RRV) couldn’t get to the patient on a public highway using blue lights or driving at speed or transport them if needed to hospital. One IAA member covering a cycle event took four minutes using an RRV to get to a badly injured competitor who had come off on a downhill straight at 30-40mph. An NHS ambulance was called at the same time: it took 40 minutes to arrive. Another IAA member has dealt with a cardiac arrest at a half marathon, a stabbing which penetrated the heart, and several heart attacks. After initial treatment by their paramedics who reached them by RRV the patients were rapidly transported to hospital. Without the ability to use driving exemptions on public highways they would have had to wait for an NHS ambulance to travel to an unfamiliar event site through crowds of spectators. That would have presented an immediate threat to time-critical patients. And it would have added further stress to already-stretched NHS ambulance services.
Police request Another IAA member runs a night-time service at weekends in four large cities at the request of local police. He responds to incidents at pubs and clubs before the NHS using RRVs. He couldn’t get to the scene, or if faced with a seriously injured patient, could not rapidly get them to hospital without using driving exemptions. For more than 30 years independent and voluntary ambulance service providers have used such exemptions based on need, not on which organisation happens to operate the vehicle. Organisers in the event and festival world were similarly aghast when we alerted them to the situation. Time was against us. The Deregulation Bill by now was at Report stage in the Lords. IAA Director Rick Player found he had a great ally in the organiser of the Secret Garden Festival in Cambridgeshire that his firm has covered for years. The owner of the land on which the festival is held sits in the Lords. He put down his suitcase on his way to the airport and contacted fellow peers. We started an online petition, got members to lobby their MPs and engaged in direct dialogue with the Bill’s sponsoring MP Cabinet Minister Oliver Letwin via Twitter and email. The noise worked. We were invited to a meeting with senior advisers from the Department of Health and the Department for Transport. They were able to clarify that ambulances, vehicles, whoever operates them, which are designed or adapted to carry a semi-recumbent patient, can continue to use driving exemptions. Great news.
But they clearly had little understanding of the nature of the modern event world. Why not just send an ambulance? This was the response to our concerns about the issues of covering events without being able to use blue lights. RRVs are cheaper, quicker and often mean bikes/motorbikes/4x4s or quads, which are vital in off-road events. It became clear that nothing would be changed. The Bill could not and would not be stopped in its rapid progress to the statute book before the General Election. So RRVs can operate on private land. But they cannot venture off site using blue lights or driving at speed to rescue an injured competitor or spectator. By excluding both private and voluntary providers, the IAA claims this equates to stealth legislation to stop a lawful activity. IAA chairman James Barnes, who attended the meeting at the DoH, said, “It’s very disappointing that they are not willing to put an amendment forward even at this late stage. But they were keen to understand our concerns. They have promised to work with us after the election. “We will continue to push Parliament and other relevant agencies to amend the Bill. We are prepared to engage with both health and transport departments to achieve this goal,” he said.
Life saving dossier The IAA is now preparing a comprehensive dossier of members’ experiences of situations in which lives could have been lost if RRVs had not been able to gain rapid access to injured patients using blue light exemptions. This will be presented to the Whitehall advisers. “The examples we outlined from work at events had real impact. It was obviously an area they didn’t know about or understand,” said James. “We will get more examples to them. We have their ear now – and we are going to use it. No other ambulance body has been invited into such a meeting – or been asked to go back. The Blue Light Fight goes on. Lives depend on it.” The hope is that members have to rely on historic situations for the dossier’s examples. Not an upcoming verdict from a coroner’s court.
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April 2015
22 | ESTMEDICAL
The clear facts: the use of clingfilm with burn injury in the prehospital setting The use of polyvinyl chloride film (clingfilm) in the prehospital setting continues to generate considerable confusion among emergency medical and rescue practitioners responding to burn injured patients. This article provides an overview of the clinically evidenced pathway for the potential use of clingfilm as advocated by leading international emergency burn care and trauma associations. Words: Patrick M Bourke, a Director and Educator with the Severe Burns Life Support Foundation (SBLS) & Ken W Dunn, a FRCS, Burn Centre, University Hospital South Manchester (UK). Serious burn injuries are devastating events that leave patients with long term physical and psychological challenges that are recognised by paramedics worldwide as one of the most horrific and challenging injuries known to the emergency medical and rescue services. [1] Burn injured patients who enter the in-hospital management pathway, are extremely expensive for their local health care system to repair and support, as they progress through the burn care system towards repatriation with their families, hopefully with a positive re-introduction into civilian life. At the time of incident, a burn-injured patient may be severely stressed, possibly going into shock (depending on the source and severity of the burn injury), in considerable pain (both physical and psychological). Their current method of assisted cooling by family, friends or members of the public may not be the most efficient or effective (more than likely the case with children and the elderly), as their burn injuries continue to damage their integumentary structure. All of the above will continue until the arrival of medical assistance on scene, when they expect from this moment onward, everything is going to get better.
Confusion among responders Responding to burn patients within the pre-hospital setting, ‘Stop the burning process, cool the burn injury, assess and then cover’ is the recommended management procedure included in the standard trauma protocol pathway, endorsed by international burn associations throughout the world, and is clearly referenced and evidenced in current burn injury protocol training manuals and clinical research papers. Typical questions from emergency medical and rescue practitioners responding to burn injured patients include: Do I put clingfilm on first? Do I put it on after? Do I put one layer on top of the other? Do I wrap it around the burn injury and how many times? Do I use strips? Can I layer the strips? Will it stay on if it is windy? Will it stay on if I wrap the patient in warm blankets? Can I use it on the head and face? Can I use it on the groin region? How do I use it for hand burns? What happens if it shrinks onto the burn injury? Further comments include: This is how we were told to do it; I have never been trained on its use; and we were told to use it because it is cheaper and will save money for the ambulance service etc.
1987: early research The use of clingfilm gained early research exposure in the 1987 paper ‘Plasticised polyvinylchloride as a temporary dressing for burns’ [2]. In the research
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Patrick M Bourke, a Director and Educator with the Severe Burns Life Support Foundation (SBLS).
abstract, authors G Wilson FRCS and G French, Senior House Officer from the Burns Unit, City Hospital, Nottingham, state, ‘Plasticised polyvinylchloride film has been used in this burns unit for a long time for dressings before the ward round, before surgery, and when the burned patient is transferred from the casualty department to the burns unit. Plasticised polyvinylchloride film is easy to use, safe, and causes no pain. Most importantly, in the present financial climate, it is cheap’. The research details the use of plasticised polyvinyl chloride in three circumstances: 1. For the ward round: this burns unit has a policy of dressing all burns except those on the face. When a wound is to be viewed on the doctors’ round there may be some delay before it is seen, particularly if there are several dressings for the nurses to take down. A sheet of polyvinylchloride film is wrapped around the wound and sealed to itself. [2] 2. Before operation: if a burns dressing has been inspected on the morning of surgery or if the dressings are particularly offensive and the patient is to be bathed before the operation the wound is wrapped in polyvinyl chloride and left undisturbed until the patient is anaesthetised. [2] 3. Transfer of burns patients: for the past 12 months the burns of patients who have been transferred from the region’s casualty departments have been dressed with plasticised polyvinylchloride. [2]
2004: well referenced research A well referenced clinical research paper from 2004 by K Allison and K Porter is, ‘Consensus on the prehospital approach to burns patient management’ [3]. It specifically mentions that the use of polyvinyl chloride film (clingfilm) is for potential use after the burn injury has been effectively cooled:
Stop the burning process: The burning process should be stopped/extinguished and the patient should be removed from the burning source etc .[3] Cool the burn wound: There is often confusion over this process and how long it should last for. It is suggested that the ambulance service despatcher will advise the ‘999’ caller to cool the burn area for up to 10 minutes. Cool running tap water is sufficient and ice cold water should not be used etc .[3] Dressings: these are important to help the patient’s pain control and to keep the burnt area clean. The burnt area should be covered with a cellophane type wrap clingfilm, remembering the possible constricting effect of wrapping; smaller pieces are perhaps better than circumferential sheet. The patient should be wrapped up in blankets or a duvet etc .[3] [NB This paper is quoted as a reference support document [ref#771] to the current UK Ambulance Services (JRCALC) Guidelines V1.2 2013]
2007: burns and scalds in primary care The ‘Management of Burns and Scalds in Primary Care’ manual (2007) [5] published by the New Zealand Guideline Group and endorsed by the Australian and New Zealand Burn Association (ANZBA) (also referenced by the Joint Royal Colleges Ambulance Liaison Committee JRCALC Guidelines V1.2 2013 [ref#757]), dedicates a complete page to the use of Polyvinyl Chloride Film (clingfilm) for use with burn injuries. Chapter 2: First Aid, begins with the internationally recognised burn injury pathway of stopping the burning process and cooling, which is supported with evidential statements covering almost three pages. This in turn leads on to initial coverings after the cooling process is complete. The manual’s ‘Polyvinyl chloride film (clingfilm) Recommendations’ are outlined here: Following cooling, polyvinyl chloride (PVC) film may be used as a temporary cover prior to hospital assessment. It should be applied by persons knowledgeable in its use. PVC film should be layered onto the wound and not applied circumferentially around a limb. The manual highlights, however, that ‘PVC film should not be used as a substitute for a dressing product’. The statement ‘It should be applied by persons knowledgeable in its use’ raises a further issue – if you are currently being encouraged to employ the use of polyvinyl chloride film (clingfilm) for immediate emergency burn management in the pre-hospital setting, are you trained on its correct use and timing to ensure best possible outcome for your burn patient?
April 2015
ESTMEDICAL | 23 Association alliance Two of the world’s most renowned burn care associations, the Australian and New Zealand Burn Association (ANZBA) and the British Burn Association (BBA) formed an alliance to advance the standards of burn care in their respective regions, by sharing a common understanding and teaching through their internationally recognised burn course, the ‘Emergency Management of Severe Burns UK Course Pre Reading’ (EMSB) [4], which is taught throughout the UK. This emergency burn course is considered one of the very best available to educate Emergency Department (ED) nurses and doctors onward into theatre. Under chapter 7, Management of the burn wound, ‘First Aid’, it is clear that the recommended pathway is concurrent with international thinking, ie stop the burning process, cooling the burn surface and then into early management. In preparation for transport the patient may need a dressing on the burn wound. Depending on the time between injury and transport and the expected time taken during the transport process, it may be necessary to apply something more than simply wrapping the area in a clean cloth. Plastic clingfilm can be used and is particularly useful in children because it limits evaporation and, hence, heat loss.
“The use of polyvinylchloride film (clingfilm) does have a supportive role in burn injury management – just not in the immediate phase of emergency burn care.” The Victorian Adult Burns Service, Alfred Hospital Melbourne Australia and the Royal Children’s Hospital Melbourne Australia [9] perform first aid for burns as per the ANZBA Guidelines and indicate after cooling, cover the wound with a sterile dressing, use clean plastic film wrap if no dressings are available. They advocate, ‘Cover the burn: Where the surface is blistered and/or raw, the wound should be covered with a dressing. In the absence of any wound dressings, cover the wound with plastic film wrap or clean cloth to keep the burn wound clean until definitive management can occur. Plastic film wrap is a suitable dressing for patients being transferred to the burn service within six hours. Avoid wrapping affected area circumferentially with plastic film wrap as this can have a tourniquet effect as oedema worsens’.
2009: BMJ article In 2009 The British Medical Journal (BMJ) published a further article ‘Emergency and early management of burns and scalds’ [6] written by three eminent authors: Stuart Enoch, University Hospital of South Manchester, Manchester (UK); Amit Roshan, Cambridge University Hospital, Cambridge (UK); and Mamta Shah, Central Manchester and Manchester Childrens Hospital, Manchester (UK). In this article, under the heading ‘How should major burns be managed?’, the authors reference ‘Box 3’, indicating a consensus summary on first aid
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management (prehospital care) for burns. The article also shows that the recommended pathway for immediate emergency burn care management is to stop the burning process, cool the burn injury, and then after cooling, cover if required, with clingfilm. In the interest of their patients, emergency medical practitioners around the world strive to be the very best in their chosen field of emergency medicine. To maintain these standards, they must continue to study and up-skill regularly with the best available resources of teaching and learning. There are numerous recognised advanced trauma and paramedic manuals published by international authors who continue to excel in their field of emergency medicine. ‘Trauma Care’ by Greaves, Porter and Garner (2009) [7], is one such manual being referenced by paramedics and advanced clinicians on a regular basis to further their skill set. In Chapter 20, the same pathway is advocated: safety, stop the burning process, cooling followed by covering/dressing. ‘At the point of injury, the burning process should be stopped as quickly as possible by removing the patient from the source, smothering, ‘drop and roll’ or irrigation. The wound should be cooled, ideally under running water for 10-20 minutes. This acts as an analgesic and decreases the inflammatory reaction associated with the injury. Clingfilm is ideal as a non-stick, temporary dressing prior to transfer’.
2014 – current international burn care protocols Globally, current recommended burn management protocols remain the same. In Wounds International [8], an online practice-based journal for clinicians worldwide, it is shown, under the top 10 tips on the management of burn wounds; Tip number 5 Dressing Selection for Burn Wounds: The following dressings should be considered when managing burns: ‘Use clingfilm if transferring to a burns unit as a temporary dressing. It should be remembered that clingfilm should be only one layer thick and never used on face burns’. On the NHS UK [10] online advisory website, under ‘Treating burns and scalds’, the following pathway is recommended: stop the burning process, remove any clothing and jewellery, cool the burn, keep the patient warm, and followed by; cover the burn with clingfilm. On the NHS Direct Wales [11] advisory website under ‘Burns and Scalds’ a similar pathway is advocated: immediately get the person away from the heat source, cool the burn, remove any clothing and jewellery, make sure the patient is kept warm, and cover the burn by placing a layer of clingfilm over it. The use of clingfilm for burns as directed by the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) 2013 guidelines (V1.2) [12] in the management pathway of a Burn Injured Patient in the Prehospital setting lays out 16 steps for the correct pathway of burn injured patient management, which include: step 5 – cool/irrigate the burn with copious amounts of water for a maximum of 20 minutes… Gel based dressings may be used but water treatment is preferred; and step 7 – Dress the burn – use small sheets of clingfilm – do not wrap around limbs but layer the film. In the absence of clingfilm use a wet nonadherent dressing. NB do not apply creams/ointments; they interfere with the assessment process. Highlighting again the recommendation that clingfilm may be used after the burn injury has been cooled. Within the same manual [12], under Update Analysis (xxvii); the duration of irrigation of burns with water has changed to 20-30 minutes; irrigation can be undertaken up to three hours post injury. Water gel dressings are advocated in absence of water for irrigation.
The papers, training manual references and clinical practice guidelines (CPG) referenced in this document show clearly the recommended clinically evidenced pathway for the use of polyvinyl chloride film (clingfilm), should it be required, for the secondary management of burn wounds and onward transfer to a higher clinical intervention, and suggest that polyvinyl chloride film (clingfilm) should not be used as a substitute for a dressing product.
Considerations Once this confusion has been addressed, and the correct clinical pathway evidenced to the satisfaction of all, the following concerns, relating the use of clingfilm in the immediate stage for emergency burn management should also be considered: • Were the burn injuries sufficiently cooled prior to application of the clingfilm strips (running cool clean water for a minimum period of 20-30 mins)? • Did you use single strips only as directed or accidentally wrap it circumferentially? • Has the clingfilm strip location tape been applied over an area of burnt tissue, and is it constrictive? • Did you remember to dispose of the first 10-20cm (4-8in)? • Is your roll CE approved as a medical device for use on potential open wounds? • Is it being stored correctly according to manufacturer’s guidelines? • Does it have an expiry date? • Have you been trained in its correct use?
Conclusion The application of polyvinyl chloride film (clingfilm) onto a hot burn injury should be supported by clinically evidenced documentation for it to be implemented as an emergency treatment protocol for burns in the prehospital setting. To date after many months of research, it has not been possible to locate any clinically evidenced training manual, research paper or International Burn Association advocating the use of polyvinyl chloride film (clingfilm) for the immediate emergency management of a hot burn injury in the prehospital setting, irrespective of location on the human body or age group. References 1. Severe Burn Injury- Prehospital Paramedic Response- If it goes wrong. Patrick Bourke, Ken W Dunn. Journal of Paramedic Practice Vol 5 #10 October 2013 2. Plasticised polyvinylchloride as a temporary dressing for burns. Hospital Topics. G. Wilson FRCS Registrar Plastic Surgery Unit and G. French MB, CHB, Senior House Officer. Burns Unit, City Hospital, Nottingham (UK). British Medical Journal Vol 294 February 1987. 3. Consensus on the prehospital approach to burns patient management. PRE HOSPITAL CARE K Allison. K Porter. Emergency Medical Journal 112-114. 21: 2004 4. Emergency Management of Severe Burns (EMSB) COURSE MANUAL UK version for the BBA Australia and New Zealand Burn Association Ltd 1996. 5. Management of Burns and Scalds in Primary Care. EVIDENCE BASED BEST PRACTICE GUIDELINE. New Zealand Guideline Group June 2007. 6. Emergency and Early Management of Burns and scalds. CLINICAL REVIEW. Stuart Enoch, University Hospital of South Manchester, Manchester (UK). Amit Roshan, Cambridge University Hospital, Cambridge (UK). Mamta Shah, Central Manchester and Manchester Childrens Hospital, Manchester (UK). British Medical Journal 2009. 7. Trauma Care Manual (second edition) on behalf of Trauma Care. Ian Greaves, Keith Porter and Jeff Garner 2009 8. Wounds International, Ten Top Tips on the management of burn wounds. On-line practice based journal for clinicians worldwide. Vol 5 Issue 1 February 2014. Mc Robert J. Stiles K. www.woundsinternational.com/pdf/content_11259.pdf 9. Burns Management Guidelines. Victorian Adult Burns Service at the Alfred and the Royal Childrens Hospital, Melbourne, Australia 2014. www.vicburns.org.au 10. NHS (UK) Burns and Scalds – Treatment On-line advisory clinical site for advice on treating burns and scalds 2014. http://www.nhs.uk/Conditions/Burns-and-scalds/Pages/Treatment.aspx 11. NHS (Wales UK) Burns and Scalds Introduction On-line advisory clinical site for advice on treating burns and scalds 2014. http://www.nhsdirect.wales.nhs.uk/encyclopaedia/b/article/burnsandscalds/ 12. JRCALC - Joint Royal Colleges Ambulance Liaison Committee. NHS Association of Ambulance Chief Executives. UK Ambulance Services and the University of Warwick. Clinical Practice Guidelines 2013 V1.2 (latest edition).
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Patient care: in and out of hours You have to really love your job to want to do more of it out of hours for no money. But that is exactly the sort of passion held by East of England Ambulance Service Senior Locality Manager Jason Gillingham. During his working hours, Jason manages a team of 150 staff in the Ipswich area and is sent out to major incidents as a paramedic. Out of hours he’s a St John Ambulance (SJA) volunteer. “Short of being a Premier League footballer, being a paramedic is the best job in the world,” says Jason. “I joined SJA when I was eight years old. My father was also in the ambulance service, and an SJA volunteer, as were my aunt and uncle, cousins and now my son. Out of the 150 staff I now manage, around 20 have been or are currently in SJA. Being an SJA volunteer really helps as a stepping stone into the ambulance service. You can gain instructor and management qualifications and experience. “For me the roles are quite different. When I’m working I’m managing all those staff and a multi-million budget, as well as treating patients. With SJA I just get to treat patients. And I still love doing that.”
on the stairs. The homeowners immediately called 999, and when they realised Donnie wasn’t breathing one of the family members began cardiopulmonary resuscitation (CPR).
“Short of being a Premier League footballer, being a paramedic is the best job in the world.”
Community First Responders SJA is the country’s leading first aid charity, and aims to provide and train people in first aid in order to ensure no one dies when first aid could have saved them. Much of this work runs in tandem with the emergency services, including the Community First Responder (CFR) schemes. The Surrey CFR is a partnership between SJA and the South East Coast Ambulance Service (SECAmb). CFRs carry AEDs and oxygen and are trained to respond to 999 calls, providing emergency first aid until the ambulance arrives. They operate from their homes or workplaces and are dispatched at the same time as an ambulance via ambulance control. The CFR is likely to arrive first as they are only sent to calls in their immediate vicinity. CFR and SJA volunteer Tessa Weaver knows only too well how this speedy response can be a lifesaver. She was called to help Donnie McFee, a 62-year-old furniture removal man from Oban who was busy doing removals at a house in Godalming when he collapsed
Tessa was at the scene within around three minutes. She was able to use an Automated External Defibrillator (AED) to deliver an electric shock to his heart. Paramedics from the SECAmb closely followed and continued CPR. They were able to stabilise Donnie and take him to the Royal Surrey County Hospital, Guildford, where he was fitted with a pacemaker. Tessa said, “Donnie’s case is a perfect example of how we’re able to save lives in local communities through great team working between St John Ambulance’s volunteer CFRs and the NHS ambulance service.”
Cycle Response Units Speed is also of the essence with the St John Ambulance Cycle Response Units (CRUs). These specially trained first aiders on wheels are deployed at events where getting an ambulance to a patient in need could prove tricky. The new CRU in Hull now has five volunteers and two specially equipped bikes, each carrying AEDs and
Jason Gillingham, Senior Locality Manager, East of England Ambulance Service.
oxygen as well as the regular first aid kit. The volunteers are not only trained in first aid but also in cycling techniques enabling them to swiftly negotiate the crowds and terrain at big events such as the Freedom Festival and Hull SkyRide. Unit Manager Luke Singleton, who also works as a critical care nurse, knows from experience what difference a bike makes. When he was called to the rescue of a runner who had collapsed at the end of the Humber bridge during the Half Marathon, it took him less than two minutes to reach him. “With the other runners blocking the way, it would have taken 15 to 20 minutes to get to him on foot. On my bike, it took me 90 seconds. The bike made a difference for that man, who I’m delighted to say made a full recovery.”
Major incident support Of course none of this service would be possible without diligent practice, and St John Ambulance volunteers also regularly play a part in major incident response scenarios staged all over the country. Volunteers were last summer part of a 60-strong team including Coastguard and Broads Authority staff taking part in a complex training exercise at Burgh Castle in Norfolk. The scenario – two boats colliding after the captain of one of them suffered a stroke – demanded first aid for roleplay casualties on the boats, dry land and in the water. Tony Curd, St John Ambulance’s District Manager, said, “The meticulous planning that went into the exercise from all three organisations has meant that we have had a superb scenario to deal with. Our first aiders showed that they truly possess the skills to be the difference between life and death.”
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CFR and SJA volunteer Tessa Weaver with patient Donnie McFee.
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April 2015
26 | ESTMEDICAL
Maritime In-Transit Care: prehospital and critical care transfers Words: Gareth Bott, Emergency Department, Derriford Hospital, Plymouth; Joe Barnard, Sickbay, HMS Nelson, Portsmouth & Kate Prior, Department of Anaesthetics, King’s College Hospital, London. Fight against Ebola
Photo: Ministry of Defence.
During the Afghanistan conflict, the British Military learnt valuable lessons in healthcare. One success was the development of a bespoke capability to provide a Medical Emergency Response Team who could begin advanced pre-hospital care in a Chinook helicopter en route from point of wounding to the hospital at Camp Bastion. This forward emergency capability allowed a greater level of care than had previously been available to troops on the ground and contributed to the number of unexpected survivors. With the draw down from Afghanistan, a need was identified to develop smaller and more flexible teams to provide a comparable level of care in multiple different environments using different modes of transport. The Maritime In-Transit Care (MITC) team has been developed to provide the Royal Navy and Royal Marines with a prehospital and critical care transfer capability that can be utilised during operations to close the gap from point of wounding to provision of damage control surgery and resuscitation and critical care support; this can be delivered by air, on land or at sea. In addition to retrieving casualties from point of wounding or illness, MITC can also provide critical care transfers from forward medical facilities to a higher level of care (Tactical Medevac).
“The MITC team provides 24/7 trauma care to a population at risk of over 1000 people, including both military personnel and non-military UK aid workers in Sierra Leone to help combat Ebola.” www.emergencyservicestimes.com
Currently deployed on Op GRITROCK, the UK response to the fight against Ebola, the MITC team are based on board the Primary Casualty Receiving Facility on RFA ARGUS, stationed just off the coast of Sierra Leone. At present, the team consists of a consultant anaesthetist, an emergency nurse and a Royal Navy Medical Assistant. The team members have all done multiple operational tours previously and have completed prehospital and military training prior to the deployment, including relevant courses and Helicopter Underwater Escape Training (also known as the dunker). The MITC team provides 24/7 trauma care to a population at risk of over 1000 people, including both military personnel and non-military UK aid workers in Sierra Leone to help combat Ebola. The nature of the operation dictates that vast distances need to be covered by the MITC team. At the furthest point from the ship, a MITC retrieval can take up to two hours, meaning that the team needs to be well equipped for all eventualities and aware that there are only minimal resources available on the ground. On Op GRITROCK, the main mode of transport has been a Merlin HM Mark 2 Helicopter from 820 Naval Air Squadron, RNAS Culdrose, who maintain an aircraft at 30 minutes’ readiness (Alert 30) during the day and at 60 minutes’ readiness (Alert 60) during silent hours. Their primary tasking is usually anti-submarine warfare, but the aircrew have embraced their new roles of providing a heavy lift capability and a Helicopter Emergency Medical Service. The Merlin can carry two critically ill or injured patients and there is enough space
Photo: Ministry of Defence.
to be able to provide advanced interventions, eg emergency anaesthesia in flight. 539 Assault Group Royal Marines from Plymouth provide support for the MITC in the form of fast boats and landing craft as an alternative way of transporting patients. All of these variables make the already taxing environment of prehospital emergency care even more challenging.
www.mod.uk
Photo: Ministry of Defence.
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SP ready for further success SP Services has been delivering quality products at affordable prices for over 25 years, supplying everything you need in an emergency, from a single pack of plasters to the latest defibrillators and ECGs. 2015 is already proving to be an exciting year for the company, with an imminent Open Day and Business Awards nomination, and with new product ranges now available, SP’s success looks set to continue. SP Services will once again be opening its doors for an Open Day, which takes place this year on Friday 17 April, on the eve of the Trauma Care Conference in Telford. SP’s Open Day is an event not to be missed, with behind the scenes tours of Bastion House headquarters, exclusive on the day discounts on a wide range of products and a chance to see the company’s latest innovations. In order to secure your free place at this fantastic event, please register by completing the short form at www.spservices.co.uk/SPOpenDay2015.
The Donway range of vacuum mattress and traction splints is new for 2015.
‘Business of the Year’ Managing Director Steve Bray and the team at SP Services have been shortlisted for the ‘Business of the Year’ award at the Shropshire Star Excellence in Business Awards. The winners will be announced at the awards ceremony on 23 April, which takes place at Hanger 1 of RAF Cosford. Steve Bray said, “To be shortlisted as a finalist in the Business of the Year Category is incredible news. When we selected Telford as our logistics hub and headquarters we did so as Telford is situated in the heart of England, allowing us to service our customers across the country and internationally. When we moved to Bastion House in 2012 it was a £2m investment from SP Services and it was our intention to spend as much of the budget as possible with locally based companies and SMEs to help boost the Shropshire economy. We are looking forward to the awards evening and meeting the other finalists. Best of luck to all that have made it through to the final.” Tracerlite boots have earned an enviable reputation among the blue light services.
You can stay up to date with the awards and the presentation night with SP Services on www.facebook.com/SPServices and www.twitter.com/SPServicesUK.
Affordable quality Not only does SP Services stock market-leading medical products, the company also provides many sought after industry renowned brands, such as Parabag, Donway and Tracerlite. Parabag are one of the most popular specialist equipment bags produced by SP Services, covering key equipment requirements for first responders and paramedics. The new Parabag range, available from Spring 2015 has been completely redesigned around functionality and modern materials to ensure these quality products continue to be a gold standard within the specialist equipment baggage market. Developed with the latest Blood Borne Pathogen (BBP) resistant fabric, which is designed with the Parabag consumer and infection control in mind, the bags are robust and easy to maintain in a hardwearing environment. The new features include rapid fix handles, robust access zips and fluid resistant coating to ensure it is both functional and durable. Reinforced stitches, anti-slip under cushion pads mean that these bags are designed to stand the test of time. Available in a range of colours, models and sizes so that you can find the right bag to meet your professions needs.
New Donway range Another innovation for 2015 is the new Donway range of vacuum mattress and traction splints. Building on the signature quality and versatility of existing Donway products the new vacuum mattress has a V-shaped body design that optimises the vacuum mattress capabilities, while at the same time drawing on enhanced internal chamber technology for superior stability throughout,
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ensuring that immobilisation is achieved for a rescue or evacuation scenario. The mattress and splint are easy to store and transport meaning they are a fantastic addition to any rescue and evacuation kit. Quick and easy to apply and secure, the colour-coded straps ensures rapid securing of the patient. The vacuum mattress and splint add to the range of quality Donway emergency rescue equipment on the market.
“To be shortlisted as a finalist in the Business of the Year Category is incredible news.” Essential footwear Tracerlite boots have earned an enviable reputation among the ambulance, blue light, security, health and safety services for being able to perform in the toughest environments, providing quality lightweight workwear that is built to last. It’s this pedigree of a tough, well designed boot, combined with essential comfort and a true eco build that makes Tracerlite footwear essential for any professional whatever the environment. Tracerlite boots are made with function and fit in mind and to the lightest possible weight specification while featuring an array of features, including: ultralightweight; SRC compliant for anti-slip properties (other brands are SRA only); water resistant or water proof; multi directional toe traction; heel anchor zone; anti slip zone sole; ladder grip zone; composite safety toe; easy access side zips; thermal slip resistant outsole; composite shank midsole; and all models are compliant to the European Eco Label requirements.
New catalogue The new SP Services catalogue is out now, request your free copy via the website or call SP on 01952 288 999 or e-mail: sales@spservices.co.uk.
www.spservices.co.uk
April 2015
28 | ESTMEDICAL
Physio-Control marks 60th anniversary
Members of the University of Washington Husky marching band help celebrate the 60th anniversary of Physio-Control. Opening company meetings and events with a marching band is a long-time Physio tradition started by Hunter Simpson (President from 1966 to 1986).
It all started when Dr Karl William Edmark, a 30-year-old surgeon, in 1954, was finishing his residency at the Lahey Clinic in Boston, Massachusetts. Seeing so many patients die on the operating table from cardiac arrest disturbed Edmark. At the time, there wasn’t any sort of electronic monitoring device to help doctors detect when a patient’s heart had stopped, so he set about
finding an electronic solution that would alert doctors to heart failure. This marked the beginning of Physio-Control. Dr Karl William Edmark, developed a device that sent a direct current (DC) electric shock through the heart to terminate ventricular fibrillation. This first DC defibrillator became the prototype for medical devices used by emergency medical services and hospitals around the world. Ten years later Physio-Control dramatically changed the face of emergency medical care forever with the introduction of the first portable defibrillator/monitor.
clear and its goal is simple, ‘To manufacture emergency response tools of the highest quality to help clinicians and emergency responders, anywhere in the world, through the toughest kind of emergencies’. Physio-Control was established in 1955 in Seattle and moved to its corporate headquarters in Redmond, Washington in 1974, where it continued to lead in the development, manufacture, sale and service of external defibrillator/monitors. Now the company has over 1300 team members across 16 countries, operating in over 100 countries.
Anniversary celebrations Building on success The company continues to build on this early success. Working in partnership with emergency medical services, nurses, doctors and medical researchers, Physio-Control vigorously pursues new technologies for incorporation into its family of products. Today, its products are designed to work together to give emergency caregivers, in the hospital or on the street, more control of a critical event. The company’s path is
On 7 February 2015, Physio-Control celebrated its 60th anniversary with an open house event in Redmond that saw over 1000 team members, retirees, family and friends of the company coming from as far away as New Zealand to attend the event, including the first team member hired by the company.
www.physio-control.com www.checkoutthefuture.co.uk
Saviour the ‘Swiss Army knives’ of stretchers The Saviour Stretcher range has been enhanced to be the solution for all pre-hospital arenas.
The majority of stretchers on the market today are still heavy, rigid devices that are difficult to store, deploy and repack. With the ever-increasing pressures of clinical governance and the need for effective disinfection and decontamination, many stretchers end up impossible to effectively clean and therefore become, in reality, single use. Designed by Paul Savage OBE, in conjunction with the manufacturer, the Saviour Stretcher range – the Saviour Tactical and the Saviour Technical – is set to change that.
but acts, if required, as a pelvic splint. The stretcher is x-ray translucent and CT friendly yet the design allows the patient’s chest to be accessed easily for CPR, defibrillation, IO insertion or respiratory assessment. When evacuating the patient using the Saviour, the patient can be dragged by a single operative using the integral drag harnesses, carried by two or four operatives using the soft carry handles, vertically or horizontally hauled from the 200kg rated eyelets (horizontal haul – Saviour Technical only) or even floated out of the scene, as the stretcher is neutrally buoyant. This means it is suitable for confined space rescue, water rescue, vertical and horizontal line rescues, mass casualty rescue and vehicle, air or boat transport. As all materials are resistant to salt water and sand, it works in even the harshest environments. It fits in all basket stretchers so there’s no need to remove from the Saviour for onwards patient transport.
A new standard Designed initially for the maritime SAR world, the Saviour Stretcher range has been enhanced to be the solution for all pre-hospital arenas. The stretchers are light, weighing in at less than 5kg, and they roll up and store in a small shoulder carry or rucksack bag. Once deployed and laid flat, the patient is placed onto the Saviour and it is formed around them using the colour coded fastening straps and head hugger system. Not only does the double skin around the spine and the strapping system make for a securely packaged patient,
Cost effective The Saviour takes seconds to restow into its carry bag. Decontamination is simple and effective as the stretcher has been manufactured from sympathetic materials with this in mind. However, should a strap be soiled beyond salvation, every single part of the Saviour is easily available as a spare part, meaning that this becomes a very cost effective, multi-use device. So next time you are designing a vehicle, kitting out an ambulance or carrying a heavy stretcher over a distance to a scene and wondering why you carry a variety of stretchers for a variety of roles, think how much simpler life will be when you only need to carry one that is small, light and highly effective.
The Saviour Technical stretcher.
saviourstretcher@gmail.com The Saviour takes seconds to restow into its carry bag.
www.emergencyservicestimes.com
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ESTMEDICAL | 29
Red Cross eases pressure on overstretched NHS Emergency hospital admissions have risen by nearly 30 percent over the past 10 years and overstretched A&E departments have made headlines with at least 14 hospitals declaring a ‘major incident’. The British Red Cross has been utilising its 30 years of experience to work alongside NHS colleagues, helping struggling A&E departments cope with the increased demand. Fully trained Red Cross volunteers are currently supporting 13 ambulance services by transporting patients to medical appointments and providing extra ambulances during busy periods. In addition, dedicated volunteers are working in over 20 A&E departments across the UK assisting hospitals with high patient volumes and delayed discharges.
Support service in Swansea In one Swansea hospital, Red Cross has set up a support service in the building to care for worried patients and keep their families informed as they wait. Becky Gammon, Senior Nurse at Swansea, said, “The Red Cross are a great comfort to patients and complement our staff well. Their work is right at the heart of our efforts to ease pressure on the department and ensure patients can be seen in a timely manner according to greatest clinical need.”
Longer term care
The Red Cross also plays a vital role in helping patients return home safely and when appropriate, arranging for their continued care elsewhere to prevent unnecessary hospital admissions. Volunteers regularly take patients home and ensure everything is OK for them; checking they have enough food in the fridge, and everything else they need. Volunteers will then follow-up on their recovery, arranging longer term care if needed. This unique support gives doctors and nurses the confidence to discharge vulnerable patients, safe in the knowledge that the Red Cross will be there for them.
Across the UK, Red Cross runs more than 100 ‘home from hospital’ schemes, which help vulnerable patients cope when they return home after a long stay in hospital. By running essential errands like collecting prescriptions, as well as offering companionship at a difficult time, volunteers help build people’s confidence and allow them to get back to their daily routines. The charity also runs a mobility aid service, loaning people wheelchairs, commodes and other equipment so they can better cope at home. Juliet Mountford, Director of UK Service Development at British Red Cross, said, “We recognise the huge pressures the NHS is under, and feel strongly that the voluntary sector needs to play a role in reducing these pressures and provide much-needed support to people in crisis. “Our services offer short term practical and emotional support and can save the NHS and social care up to £8m every year.” “We want to support hard-working and essential NHS staff, and are proud to see the people we support being more able to manage their daily activities, and have improved feelings of wellbeing and better coping skills.”
www.redcross.org.uk
The new LTS-D – safe in routine and emergency Nothing is more fundamental to the practice of general anaesthesia than the maintenance of a clear upper airway. The Laryngeal Tube is used as an alternative for mask ventilation or as a non-invasive device for airway management in the event of failed or unnecessary endotracheal intubation. Introduced in 1999 the Laryngeal Tube has become an important part of the prehospital environment. Since its launch the device has been continuously developed and clinically adjusted to ensure best possible patient safety. This leads to more than 16 million clinical insertions of the Laryngeal Tube in 97 countries. As the sole UK distributer for VBM, Freelance Surgical has announced that VBM is bringing to the market a new range of single use Laryngeal Tubes with gastric access: The new LTS-D.
www.emergencyservicestimes.com
As a second generation supraglottic airway device, the new LTS-D complies with the latest recommendations of international guidelines. It incorporates a ventilation tube as well as a drain tube to allow control of both airway and gastric tracts. It is free from phthalates, does not contain latex and is supplied sterile for single use.
Improved features The design of the new LTS-D is based on clinical studies and user feedback and incorporates many improved features, including: new ventilation section for optimal tidal volumes; new ramp for ease of insertion and free space in hypopharynx; new cuffs for effective sealing at low pressure (< 60 cmH2O); new curvature and softer material for successful insertion in difficult scenarios; large gastric access channel (up to 18 FR) to prevent risk of regurgitation and aspiration; and available in all sizes for all patients. The new LTS-D is intuitive to use, which reduces training times.
When using the device, precise cuff pressure monitoring should be applied as with all supraglottic airway devices. VBM recommends adjusting the cuff pressure to the ‘just-airtight-seal’ leakage pressure, to a maximum of 60 cmH2O. Freelance Surgical supplies a comprehensive range of pre-hospital products, including the Quicktrach II – cuffed cricothyroidotomy device, Pocket Introducer, Rescuefix ET Tube Holder and Inflatable Pelvic Sling.
www.freelance-surgical.co.uk
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ESN – a fast approaching decision? The Emergency Services Network (ESN) is being procured by the UK Home Office for the police, fire and rescue, and ambulance services in England, Scotland and Wales. This new communications service will ultimately replace the existing Airwave service. The award of complex service contracts will follow the election of the next government. As the decision approaches, shortlisted suppliers are consolidating and withdrawing from competition as tough negotiations take place. Words: Guy Kenyon, Kenyon Consulting The previous TETRA based emergency communications system, designed, built, owned and operated by Airwave Solutions Ltd, has been running since 2000 and must be replaced, at the latest, by 2020. The ESN is scheduled to gradually take over service from 2017 onwards and will be based upon the LTE/ 4G networks being built out now by the mobile network operators (MNOs). Mobile Services provision is one of the initial four lots being competed and this is one of the key areas where consolidation of suppliers is most apparent. Of the five suppliers originally shortlisted, EE is now being bought by BT and Hutchison 3 has agreed to buy Telefonica O2. These potential changes of ownership upset existing infrastructure sharing arrangements so Vodafone is now encouraging 3 to join the Vodafone/O2 joint venture (JV) Cornerstone, while EE may gain significant benefit from easier access to the BT Openreach division while losing 3 from its MBNL JV.
Increased coverage As the ESN decisions approach, it is also apparent that the tough coverage requirements are receiving significant attention from the MNOs. EE’s recent news of plans for coverage extension by drones and balloons to provide coverage to 90 percent of the UK’s 245,000 miles of roads is a significant step forward by a mobile network operator and reduced the need for the Lot 4 Extension Services. In January, Lot 4 was duly withdrawn from competition with only one
bidder – Arqiva. It should also be noted that Google and Facebook, through the Internet.org JV, are both looking to provide extended wireless broadband coverage through their own use of satellites, drones and balloons. In addition to coverage, significant MNO service enhancements will be required in functionality as well as availability, security, resilience and reliability. Key additional functions required are press to talk operation, group and emergency call and direct mode operation (mobile to mobile) when out of coverage. These items are all being brought into LTE/4G via the 3GPP standardisation process under the collective heading of Group Communications System Enablers (GCSE) delivered in Release 12 and Release 13.
“In addition to coverage, significant MNO service enhancements will be required in functionality as well as availability, security, resilience and reliability.” Service availability improvements will be required at the weakest point in service provision – the base station. With experience from delivering Airwave, Northrop Grumman added resilience to both base station backhaul and power supplies for the New York City Broadband Wireless Network (NYCWIN) through
dualled backhaul provision (fibre and microwave) and 24 hour battery back up at all sites. Whether the MNOs will provide additional resilience measures at switching centres remains to be seen. The User Services Provider (Lot 2) is a challenging and continuing role that will require a supplier that has an existing service provision capability to handle, potentially, interaction with in excess of 300,000 users across up to 400 user organisations. Two bidders remain in competition for this service contract – Motorola Solutions UK and Hewlett Packard Enterprise Services UK. It is considered most likely that the transition Delivery Partner (Lot 1) will be a large organisation such as a systems integrator, finance or engineering consultancy but will there be sufficient income in the role over a finite term to interest suppliers? This will undoubtedly be a high profile programme, which is potentially to be replicated wherever existing TETRA based systems are to be replaced but is there a business case under the multiple lot model? There remain four bidders for this contract – Atkins, Kellogg Brown & Root, Lockheed Martin UK and Mott McDonald.
ESN App Store In March, an ESN Supplier Event is being arranged to encourage SMEs to contribute to the development of what is hoped to be an ESN App Store modelled on the current Government CloudStore/ Digital Marketplace. Last December, the Labour Party came out against the ESMCP on safety and timescale grounds. If Labour is elected in May, will the programme continue?
www.gov.uk
Airwave looks to the future Following the announcement that it was no longer in the running for Lot 2 of the Emergency Services Network (ESN), Airwave Solutions released the following statement from Chief Operating Officer John Lewis. “We can confirm that Airwave has not been downselected for the Emergency Services Mobile Communications Programme (ESMCP). This was confirmed late on 10 February 2015. “Despite this outcome, we can reassure our 300,000 emergency services and public safety customers around Great Britain that we remain totally committed to continuing to deliver a mission-critical communications service with many contracts in place until at least 2020. “We have built and honed our world leading service over the past 15 years in
www.emergencyservicestimes.com
response to a need for a national, interoperable, secure and resilient service. Our network covers 99% of Great Britain’s landmass including 100% of roads and remote areas such as the Highlands and Islands; it is encrypted and protected against hacking; it allows interoperability with all three emergency services to communicate with each other when they need to; and is able to withstand major incidents such as flooding and power outages – the Airwave Service remains operational when other networks fail. Every six minutes across Great Britain, a member of the emergency services relies on Airwave’s emergency push-to-talk button to summon urgent assistance. “Our plan is to continue to deliver new capabilities to our public safety customers including mobile data and application services, both now and well into the future.” http://airwavesolutions.co.uk
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www.emergencyservicestimes.com
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Meeting the operational needs of the wider emergency services network To better understand more about the challenges faced by voluntary emergency service partners and how technology might improve and enhance the life saving work these organisations deliver, O2 recently hosted a Round Table discussion, ‘Community Safety in a Digital World’, held at the company’s UK headquarters in central London. From the public’s perspective, the response to an emergency comes in the form of blue lights – the police, fire and rescue or ambulance service, sometimes all three, respond as required. In truth, as we know within the emergency services sector, the scope of response to an emergency reaches far wider – with numerous partner agencies, many of them voluntary, ensuring the response to an emergency is cohesive, coordinated and collaborative.
ESN contract O2’s technology and services are used by 27 police forces, 11 fire and rescue services and four ambulance trusts, as well as organisations such as Network Rail, Transport for London and a number of central and local Government bodies. The company is one of two finalists at negotiation stage for Lot 3 of the pan-Government, multi-agency contract for the new Emergency Services Network (ESN) contract, which will provide the next generation integrated critical voice and broadband data services for the emergency services.
Enhance operational effectiveness ‘Community Safety in a Digital World’ perfectly sums up O2’s approach to working with the UK’s emergency services. For the blue light sector, the company provides the infrastructure and communications network, described by Managing Director of Public Sector Business at O2 Billy D’Arcy as ‘the plumbing’. O2 is placing equal importance, however, on improving its understanding of how the technology used on its network might be utilised to enhance the operational effectiveness of emergency responders, in particular the voluntary agencies that support the emergency services.
“Being able to use our skills, technology and innovation means we can help to provide community safety in a digital world.” To achieve this aim, O2’s Round Table meeting saw representatives from organisations including the National Search and Rescue Dog Association (NSARDA), Community First Responders (CFR) and Lowland Rescue share their operational needs with IT, social media and PR experts from O2. Some challenges highlighted were common to all agencies: improved network coverage and real-time mobile data on the technical side, to managing rotas,
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Artist Joel Cooper was on hand to record the conversations at O2’s Round Table discussion.
raising funds and increased brand awareness on the practical side. Other needs were more specific – location tracking of rescue dogs (NSARDA) and electronic patient records (CFRs), for example. With needs highlighted, the collective whirr of expert minds around the table was almost audible. The ideas that followed included practical solutions that could provide immediate assistance, to technical solutions to assist fundraising, such as the use of contactless payment systems for receiving donations. There was an obvious desire from all O2 staff present to deliver something beneficial from the day’s discussions.
Deeper engagement Chloe Jeffs, Head of Communications & Marketing for Emergency Services at O2, said, “The easy option for O2 would be to hand over a cheque to each of the organisations but we need to have a deeper level of engagement with them. “Now we need to turn these ideas into tangible assets for these individuals, whether that’s help with their social media, their marketing or technology. We’re going to take the insight that we’ve heard today and we’re going to turn it into something real.” Tangible assistance from O2 has already been provided to some voluntary emergency services partners, in the form of professional branding, on websites and advertising, as well as equipment donations such as an aerial drone and camera (and the training to use them) to the National Search and Rescue Dog Association (NSARDA).
Sharing expertise and innovation Former Deputy Chief Constable for Lancashire Police Chris Weigh, who now works as an Advisor to O2, chaired the Round Table discussion. He said, “Here at O2, we believe sharing our expertise and innovation is a great way to support the volunteer organisations who are on the front line every day supporting the wider emergency services. Opening up the possibilities of technology to these volunteers to use isn’t just important; it really could make the difference between life and death.” Billy Darcy, who hosted the session, said, “It was a privilege to meet people who volunteer their time and expertise to help others when they most need help. This country has an army of dedicated people who give up their time to be there for each of us in an emergency – you never know when you or your loved ones will need their help. Being able to use our skills, technology and innovation means we can help to provide community safety in a digital world. These special partnerships make me feel very proud to work for O2.” Contracts for the Emergency Services Network are expected to be announced in the early autumn. O2 now understands that the network of emergency services and their volunteer partners spreads far and wide and the Round Table discussions made it abundantly clear how passionately the company feels about the blue light sector. O2 is obviously looking for a long-term relationship, not just a quick fling.
news.o2.co.uk/O2ESN For more information go to news.o2.co.uk and visit the Emergency Services pages
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Primetech delivers modular incident ground communications ‘in a box’ The launch of Primetech’s innovative MultiNet Comms range of portable, self-supporting incident ground communications solutions answers a real need among emergency services for more flexible, high capacity incident ground communications, helping them improve their response to major public safety threats. Words: Henry Walker, a Director of Primetech (UK) Ltd. Primetech’s new range will also complement and build on a number of the company’s other unique technologies and flexible, agile platforms, such as its Resilient Communications Trailer, which the company has developed for improving emergency communications. These are all highly relevant to all UK emergency services.
Integrated systems UK mobile satellite broadband and communications developer and integrator Primetech has, over the past decade, built a growing reputation for developing and implementing advanced communications solutions. It supplies Ka-band mobile satellite broadband and other integrated communications systems, such as High Definition video and incident ground WiFi, to emergency services on a wide variety of platforms, from large and small Incident Command Units to more mobile Resilient Communications Trailers and fast, flexible vehicles such as the Mitsubishi Trojan and Land Rovers. Now, with the launch of its new MultiNet Comms family of modular, integrated incident ground communications solutions, combining video, voice and internet access over 2.4 and 5.8 MHz WiFi via a mesh network and 3G/4G, the company has made another major leap forward, demonstrating once again its commitment to supplying UK emergency services with some of the world’s most advanced operational communications systems. In the past, poor communications and organisational problems have often been the causes of ineffective multi-agency emergency management response. The consequences of such mistakes, involving many people’s lives, incomes and property, can often be catastrophic and linger on for decades.
rugged waterproof ‘boxes’. The range has been developed in response to requests from emergency services for communications solutions that are not dependent on being housed in Incident Command Units, of whatever size.
are light, powerful and capable of easy recharging; and they are all capable of linking together to form high bandwidth networks across incident grounds. Delivering different types of capability depending on incident requirements, they are all designed to be resilient and easy to use.
Building on successes During the Somerset flooding in 2014, for example, there were areas in which emergency services needed to operate – village ‘islands’ cut off by flooding, for example – that could not be reached by ICU vehicles. Primetech had already created a first prototype of a portable communications unit for Gloucestershire Fire and Rescue Service that worked very well. The new Primetech MultiNet Comms range builds on this achievement. There are a number of different units within the MultiNet Comms family, but all units have certain features in common; they are all highly portable and self-supporting, featuring lithium polymer batteries that
MultiNet units available The units within the Primetech MultiNet family include: Incident Ground Extender Nodes – these feature 2.4 and 5.8 MHz WiFi communications linked by a COFDM mesh network and can be located throughout an incident ground. They are capable of receiving and transmitting imagery, data, internet access and voice communications from the wide range of devices that are now deployed across an incident ground, including smartphones and ruggedised laptops featuring command and control systems such as VectorCommand’s Command Support System.
Operational Communications and Shared Situational Awareness Two key issues highlighted throughout the recent Joint Emergency Services Interoperability Programme (JESIP) were Operational Communications and Shared Situational Awareness, areas where in the past there have been problems. To support improved single and multi-agency communications interoperability Primetech has developed its new MultiNet Comms family of portable, battery-powered communications devices, housed in Peli cases. Covering mobile satellite broadband communications, UAV live imagery feeds, body-worn, tripod and other ground based imagery, life signs monitoring devices, plus COFDM-supported wide area WiFi and 3G/4G communications, the MultiNet Comms units are powered by light, powerful batteries and housed in
www.emergencyservicestimes.com
The highly portable and self supporting Primetech MultiNet Comms range has been developed in response to requests from emergency services for incident ground communications solutions that are not dependent on being housed in Incident Command Units, of whatever size.
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“Primetech’s innovative MultiNet Comms range of self contained incident ground communications solutions will help answer a real need among emergency services for better, more powerful and portable incident ground communications.” Command Master/Primary Nodes – these are used for receiving feeds from the various Incident Ground Extender Nodes located around an incident ground. The onboard, powerful multi-network router automatically connects to any available data network. Military spec encryption allows incident ground data to be securely transferred to the headquarters. Within the node is a ruggedised computer acting as the site server. Additional briefing screens can be added depending on requirements. E-mail, photographs and audio, live video feeds from body-worn, tripod, UAV and other cameras are transmitted back to the Command Master/Primary Nodes, facilitating multi-agency command headquarters at incident ground level. This video, voice and incident information can then be passed on through the multiagency communications hierarchies. The nodes can also be used to receive data from life-signs monitoring equipment worn by emergency personnel, such as HART ambulance staff, operating in hazardous environments. Command teams can add as many Incident Ground Extender Nodes as they need to cover incident ground areas. Battery charge lasts for about 24 hours, and can be supplemented with additional, swappable charged battery packs.
The Primetech MultiNet Comms modules are housed in Peli cases, providing mobile satellite broadband communications support for UAV live imagery, body-worn, tripod and other ground-based imagery feeds, plus wide area 2.4 and 5.5 GHz COFDM supported WiFi, 3G/4G and private cellular network communications. They can also support life signs monitoring, and are powered by light, powerful batteries and swappable back-up battery packs.
Private Cellular Network nodes – these are used for creating resilient mobile communications networks around incident grounds. Satellite unit – this is a waterproof ruggedised Peli case-housed unit linked to a C-Com Fly-75 satellite dish. It is battery powered and fully portable, linking the Command Master/Primary Node by high speed Ka mobile satellite broadband on to other command levels in the network.
The Primetech MultiNet Comms range will continue to evolve as new technologies are introduced and to support improved public safety and the protection of emergency service personnel, especially those who work in hazardous environments.
www.primetech.co.uk
Primetech selected as Europe s first C-Com Authorised Service Centre Primetech has been selected by C-Com Satellite Systems Inc of Canada as its first European Authorised Service Centre. Authorised Service Centres must meet a number of very strict requirements. They must have at least 12 months minimum proven experience supporting and installing iNetVu satellite systems. They are also required to maintain a comprehensive local inventory of spare parts, and staff must have completed iNetVu training courses. With over 10 years of support for C-Com satellite systems in the UK and throughout Europe, Primetech has fulfilled these criteria many times over.
www.emergencyservicestimes.com
Drew Klein, Director, International Business Development for C-Com, said, Primetech is one of the most established and successful C-COM partners in Europe, and we are proud to offer them the iNetVu Service Centre designation. This first European Authorised Service Centre is a long time coming. All C-COM customers in the United Kingdom, and throughout the continent of Europe, will benefit from having a local integrator with the expertise and quality of support that Primetech offers.
April 2015
38 | ESTICT
MAIT increases cross-flow of information between agencies British APCO is a small, not-for-profit association that looks after the interests of people who work in the public safety sector and use communications technology. Experience tells us that operational ‘users’ often end up with technology that’s not fit for purpose. If this doesn’t ring true – then read no further! Words: Sue Lampard, President, British APCO. British APCO brings together users, the ICT community and the commercial sector to act as a conduit for sharing knowledge and information. As these three groups often find it hard to understand the others’ perspective, the value we add is to sit in the middle and translate. The association is also working in a number of areas to drive public safety technology into the 21st Century. One of these areas is ‘MAIT’ (Multi-Agency Incident Transfer).
“British APCO was asked to develop a technical standard, which would enable any public safety agency in the UK to exchange information electronically with any other.” Electronic incident transfer If you work in a control room or call handling centre, you’ll be acutely aware of the time it can take to ask another agency for help. Whether it’s calling the local authority for a non-urgent housing issue, or during an emergency requiring several agencies, cross-flow of information is critical to business. The traditional way of telling a caller to contact a different agency doesn’t deliver great customer service, and certainly isn’t an efficient way to work. In an emergency, time is critical,
but most call handlers still have to pick up a phone to pass details to the other responders. There has been some development of electronic incident transfer. DEIT (Direct Electronic Incident Transfer) already links the Highways Agency and the National Police Air Support Service to every police force. Other ad hoc DEIT links, such as between the Met Police and London Ambulance Service also exist. 111 call centres transfer incidents to Ambulance Emergency Operating Centres, but use different technology. Connections are made ‘point to point’ (P2P) between each organisation. So with no common technical standard and a lack of coordinated approach there is a growing quagmire of complexity.
Proof of concept During 2013, a successful proof of concept was run in Wales, where agencies used the DEIT connection, but instead of using P2P, there was a single connection to a central ‘hub’. The scheme proved so successful (and was especially appreciated by call handlers), it has since continued to grow, bringing many more agencies on board. British APCO was asked to develop a technical standard, which would enable any public safety agency in the UK to exchange information electronically with any other. As many agencies were already using the DEIT standard, we based our approach on this technology. We re-named it to describe better what it will deliver – so DEIT died and became MAIT! DEIT was owned by a commercial company, so the new MAIT standard needed to become government owned and open for anyone to use. Version 1 of the standard has been completed and is going through the formal process of becoming a Government Open Standard (see www.mait.org.uk).
Meaningful interoperability It all sounds very positive – but there’s always a down
side. The MAIT ‘vision’ (with a subtle change from ‘Incident’ to ‘Information’) is to allow truly meaningful interoperability between agencies. In theory, the police officer on the street could receive information from the fire and rescue service; the paramedic from Environment Agency etc. At the moment, MAIT only caters for basic information such as caller details, incident location and basic medical questions. The technology bit is relatively simple. The challenge is what information should be shared – or can be shared? Who is allowed to receive the information? Protocols must be developed to allow appropriate information sharing – and this has to be driven by the users. We will work towards Version 2 by talking to people who are using MAIT and finding out what information they’d like to share and the barriers that exist. Often it’s deep-routed culture that prevents such progress and this needs to be challenged.
Potential cost savings The other issue is that MAIT has no formal governance or funding. It’s being driven by a very committed team who are all doing the work on top of very busy day jobs. Originally it was a JESIP ‘deliverable’, but was dropped. In spite of being approached several times, for inexplicable reasons they were unable to embrace it as part of the programme. The current Emergency Services Collaboration Working Group (information via http://publicservicetransformation.org/) has thankfully recognised the significance of MAIT in terms of the contribution it will make to interoperability and the potential cost savings. We have their formal support, but wait to see if the group will be funded to continue to exist post-election. In the meantime, British APCO and the core MAIT team will continue to bang the drum to deliver MAIT. If you’re interested in getting involved please contact us via the website.
www.bapco.org.uk www.mait.org.uk
Emergency planners select Connect Belfast City Council has recently selected PageOne’s Connect messaging solution to form a key part of its emergency communications strategy. Connect, PageOne’s secure cloud-based messaging solution, offers a range of services that allows clients to communicate quickly and efficiently, all in real-time. The solution is easy to use and allows a large number of people to receive and send messages via PageOne’s robust platform. David Neill, Emergency Coordination Officer at
www.emergencyservicestimes.com
Belfast City Council, said, “The environment we work in can often be high-pressured and fast-paced, which means we needed a flexible, but resilient solution, to support our communications. We also needed a system that was user-friendly and cost effective. Following a competitive process, we chose PageOne’s Connect solution to deliver priority communications via SMS and e-mail. “Acquiring PageOne’s services through the UK Government’s Public Services Network (PSN)
Framework Agreement gave us peace of mind that we were getting value for money.” Nigel Gray, Director at PageOne Communications, said, “Our messaging technology is designed to provide clients with the resilience required for critical communications – this is why organisations such as Belfast City Council trust our technology to help keep their staff informed and use it to direct emergency response.”
www.pageone.co.uk/services/connect
April 2015
ESTADVERTORIAL | 39
Docked and loaded Words: Peter Molyneux, President of Getac UK. Rugged mobile devices form vital support equipment for emergency services personnel, providing them with unparalleled access to critical data out in the field that can make a difference in saving lives. These devices will typically be transported inside a vehicle such as a fire appliance, an ambulance or a police car – vehicles that are likely to have to make evasive manoeuvres on the road. Therefore, any mobile device inside will need to be able to withstand the rigours of the journey, and be able to survive drops and vibrations. These robust units are also expected to fulfil a variety of functions, including acting as a vehicle’s Mobile Data Terminal (MDT). A fully rugged tablet or notebook can therefore offer dual functionality, both as an in-vehicle MDT or as a portable device that can be taken directly to the scene of an incident to offer communication and data support right at the critical location.
Dual functionality Understanding how emergency services personnel make use of this dual functionality has been critical to how Getac has developed rugged mobile solutions for the sector. Getac is the only supplier on the market that can provide an 11.6in, fully rugged device in the form of the V110 notebook and F110 tablet. The larger screen size is essential for those using the device as an MDT within their vehicle. Any passenger in a vehicle will know how challenging it can be to use a smaller screen such as a smartphone or even a conventional tablet while the vehicle is vibrating and moving – a challenge amplified when the vehicle is being driven under ‘emergency’ conditions. Getac also works closely with software suppliers for the emergency services to ensure the device is easy to use at every level with an appropriate user interface – for instance, avoiding interfaces that require users to touch extremely small icons, a task which would be next to impossible on a smaller screen. The F110 and V110 are also MIL-STD-810G and IP65 rated, meaning they incorporate military-grade ruggedisation without compromise on performance. This means operatives can have complete confidence in their equipment.
Integrate with existing technologies However, the device itself is only part of the story. Getac has also worked closely with key providers to develop docking solutions to make the most of high-tech equipment already present on vehicles such as ambulances and fire appliances, to perfectly integrate the rugged technology with existing capabilities. Emergency services vehicles are designed for robust communications and it therefore should be natural to expect those to be complemented with rugged computing. As a result, Getac offers a complete solution, from device, to dock, to dock fitting. That provides everything an emergency service operation requires to use the very latest in mobile technology, perfectly integrated with their existing hardware. Getac understands exactly how critical the docking station fitting can be – after all, it is being fitted to a complex vehicle where mistakes or errors can mean life or death – so it can work with emergency services teams to provide reassurance. For the emergency services information is power, but unless that information is easily accessible at all times on a device built to survive the rigours of the field, that power is diminished. Getac’s complete device and dock solution means emergency service personnel can be supported every step of the way.
www.getac.co.uk If you would like to discuss any aspect of your rugged computing solution requirements, call 01952 207 221, e-mail: Sales-Getac-UK@getac.com or visit www.getac.co.uk
www.emergencyservicestimes.com
April 2015
40 | ESTICT
Mobile app improves flow of risk critical information Staffordshire Fire and Rescue Service is embracing the use of mobile technology with an app that can provide risk critical information to crews attending incidents. The app, named Risk Management, is the service’s PORIS (provision of operational risk information system), used by firefighters to record Site Specific Risk Information (SSRI) about non domestic buildings and outdoor risks such as water, wildfires and outdoor storage areas. The information recorded is then available to crews via mobile data terminals (MDTs) on appliances if they are then required to attend an incident at one of the properties entered onto the system. The type of information recorded includes storage of chemicals and explosives, building layouts and locations of hydrants/other water sources. Staffordshire’s Deputy Chief Executive/Executive Director Becci Bryant said, “Historically we had a number of SSRIs for high risk premises in the county. These SSRIs were printed onto laminated sheets and kept in a folder on whichever pump covered that particular patch. The big downfall of this was that crews from outside the station ground didn’t have access to that information, despite the fact that they could still be sent to an incident there.
“We’re confident that this could soon be the system of choice for those organisations looking to improve their provision of risk information.” “With the introduction of MDTs we were able to address this, however there was still the issue of producing the documents in the first place, which involved a lot of duplication and a delay from the visit, to the information becoming available. The crews would hand-write the information during their visit, administrative assistants would then input the data electronically it would then be the responsibility of the station manager to approve. From the initial visit to the information becoming available on the MDTs the process could take weeks or in some cases months due to other work demands.”
The app allows firefighters to conduct a visit to a building and, while there, fill in a number of questions, using pre-populated fields, onto a tablet device.
www.emergencyservicestimes.com
Embracing mobile technology In 2013 the service started to investigate how it could address this issue, keen to embrace the latest mobile technologies. Firefighter Dave Atkinson was seconded to the project to allow his 24 years of operational experience to be utilised. Kelvin Knapper, who has over 35 years’ experience, operationally and in fire safety, led the project. Becci Bryant continued, “We were aware that technology was key to this project however we were conscious that we needed the input of our crews in order to deliver a solution that fully met their needs. By seconding Dave to work on the project the idea was for him to be the link between the operational crews, our ICT team and the company we selected to progress this for us.” In September 2013 discussions commenced with Seed Software, a not-for-profit organisation linked to the Computer Science faculty at Hull University. Seed Software welcomed the opportunity and by December 2013 a proof of concept was given the go-ahead by the service. Seed Software Manager Chris Preece said, “The team working on the project spent a day with crews in order to gain first-hand experience of what the risk visits involved. We then adopted a modern approach to software development called Scrum, which is an agile methodology, which meant the service could review the development at each and every stage.” In April 2014, the service started testing the software and by October 2014 it was been rolled out to all wholetime crews. The app allows firefighters to conduct a visit to a building and, while there, fill in a number of questions, using pre-populated fields, onto a tablet device. This information automatically saves to the tablet, and is replicated onto a desktop version of the software. Once submitted for approval a draft version is also automatically uploaded onto the service’s fleet of MDTs.
Incident commanders can start preparing dynamic risk assessments before even arriving at the incident.
An invaluable tool The new app has been positively received by firefighters, demonstrated by the fact there are already over 2500 entries on the system. Watch Manager Jason Richards said, “We’ve welcomed the app as it is a massive improvement on the previous system. The biggest advantage is that as soon as the data is submitted it is available in a draft version on the MDTs. Previously you had to wait for the information to be input electronically and then approved. Now though, the information is immediately available and even in its draft format it is more beneficial than going to an incident with outdated information or even none at all. “The information displayed on the MDT is in a userfriendly, colour coded format providing a brief overview of each section so you just select the section you need to view without having to scroll through the whole form. It is proving to be an invaluable tool and has meant as an incident commander I can start preparing my dynamic risk assessment before even arriving at the incident.” Becci Bryant continued, “It’s been really exciting working with Seed Software and what is fantastic about this partnership is that we are giving university students real life work experience that will undoubtedly enhance their future employment prospects.
System of choice
“The biggest advantage is that as soon as the data is submitted it is available in a draft version on the MDTs. ”
“The app was recognised during a recent peer review visit by East Sussex Fire and Rescue Service and we have already received interest from other fire services – we’re confident that this could soon be the system of choice for those organisations looking to improve their provision of risk information.” Chris Preece added, “We’re pleased to have produced a quality, working solution in a short time frame that has saved resource and minimised risk for Staffordshire Fire and Rescue Service. We are already working with them on some new apps and we look forward to developing our positive working relationship further.”
www.staffordshirefire.gov.uk
April 2015
ESTICT | 43
Met Police looks to extend tablet trial The Metropolitan Police Service (MPS) is transforming frontline policing by equipping officers with mobile devices (tablets) and specially developed apps. In support of this, Vodafone UK has provided iPad minis, 4G connectivity and secure device management in the first instance. The trial aims to reduce paperwork and to give frontline officers access to vital information on the move – meaning they can spend more time on the beat reducing crime and supporting victims, ultimately keeping London safer. The current trial using the tablets provided by Vodafone began last summer and 500 frontline officers are now using the devices. The Met is now looking at an extension of the trial.
Through the Met’s own specially developed apps and a super-fast Vodafone 4G connection, officers are able to securely access and update systems and databases from wherever they are. This means officers no longer need to return to the station to complete paperwork, allowing them to be more visible on London’s streets. Crucially, for the public, it means frontline officers can collect electronic witness statements and digital signatures at a crime scene, meaning victims of crime no longer need to attend the station at a later time.
Security is paramount Security of data and devices is paramount. Vodafone worked closely with the Met to provide a level of security for the devices and connectivity that met the necessary,
stringent security measures and operational requirements. “There is a huge opportunity for technology to transform policing, and this trial with Vodafone UK is a fantastic example of the Met making the best use of technology to deliver services to the public in new and innovative ways,” said Superintendent Adrian Hutchinson, Head of Mobility Planning for the Metropolitan Police Service. “We want officers out on the beat, not stuck in the station filling out paperwork or sat at a computer. Working with Vodafone UK to deliver phase one of the project, we’ve already had a great response from officers who have used the devices, and we are confident that the project will help them to be more visible to the public and ultimately deliver a better service to Londoners.” The project is part of the MPS’s Total Technology strategy (2014 to 2017), which sets the direction for an unprecedented transformation in its use of technology. Through one element of this strategy, improving police mobility, the MPS aims to cut crime, increase efficiency and increase public confidence.
www.vodafone.com
Life-saving app launched by London’s Air Ambulance and EE Forefront of innovation
A new mobile app and EE’s 4G network are helping London’s Air Ambulance save lives by reducing the time it takes to dispatch the charity’s advanced trauma teams by up to two minutes. Developed by mobile app developer Mubaloo and EE, the app increases emergency dispatch efficiency by automatically providing London’s Air Ambulance trauma teams with incident information via EE 4G to help them reach patients quicker than ever before.
4G tablets The app, which runs on 4G tablets, has reduced the time it takes for London’s Air Ambulance to dispatch trauma teams, with rapid response cars now being dispatched in as little as 10 seconds with all crucial incident and navigation data in hand. Details of the incident are now transmitted directly over 4G to trauma teams via the app, including incident
EE LAA app first of its kind app is optimised to run on EE’s 4G network and could help save the lives of hundreds of critically injured patients each year.
www.emergencyservicestimes.com
EE LAA app cuts time it takes for London’s Air Ambulance advanced trauma teams to be dispatched via air or road by up to two minutes.
information, navigation details with real-time flight and route data, allowing doctors and paramedics to focus on getting to the patients as quickly and safely as possible. The creation of the customised app by Mubaloo is the latest development of a long running relationship between London’s Air Ambulance and EE. The two companies have been working together for 18 months, developing new ways of using 4G to boost efficiencies and helping to save the lives of Londoners and visitors to the capital. Dr Gareth Grier, London’s Air Ambulance, said, “Out of the 5000 emergency calls that are received by the London Ambulance Service every day, we typically see six patients whose injuries are so critical that they need additional specialist treatment on-scene before they get to hospital. Even reducing the time we take to get to our patients by 10 seconds could, in some instances, mean the difference between life and death.”
EE and Mubaloo have developed the app for London’s Air Ambulance by studying and understanding the dispatch process in detail, including reviewing how data from 999 calls is processed, the on board requirements of the helicopter response team and the navigation challenges faced by the London’s Air Ambulance road response teams.. The app is the first of its kind in the world and further cements the reputation of London’s Air Ambulance as a leader at the forefront of innovation in prehospital medicine.
www.londonsairambulance.co.uk
EE LAA app increases emergency dispatch efficiency by automatically providing London’s Air Ambulance trauma teams with incident information via EE 4G.
April 2015
44 | ESTICT
Police ICT Company gets green light Police and Crime Commissioners (PCCs) across England and Wales have recently given their seal of approval to establish a national Police ICT Company for the first time. The move could realise savings in excess of £150m per year on the current total police IT spend of approximately £1bn, as well as help improve crucial information flow between criminal justice agencies. The Police ICT Company will be owned by Police and Crime Commissioners, but membership will be open to other policing governance bodies, as well as other public bodies and agencies with an interest in securing efficient and effective police services. Its main aim is simple: unlock savings by supporting forces to make the best use of technology and to deliver truly joined-up policing.
“We want to ensure that technology can support the delivery of efficient and effective policing.” National systems and services The savings will come from various areas – some can be achieved relatively quickly and others over a longer timescale, but they involve rationalising technologies, improving procurement and enabling business change. The company will ultimately provide a platform for the coordination and commissioning of national systems and services. APCC Chairman and Essex Police and Crime Commissioner Nick Alston has led this work, together with Stephen Greenhalgh (Deputy Mayor for Policing and Crime, London), Alun Michael (South Wales PCC), Martin Surl (Gloucestershire PCC) and Millie Banerjee
(Chair of the British Transport Police Authority). The PCCs formed a Board to review the requirements before putting their proposal to their general meeting in early February. Nick said, “The national Police ICT Company will create a much more commercially driven and strategic approach, supporting forces as they acquire and make the best possible use of technology. This is not about imposing a ‘one size fits all’ solution, but rather an agreed approach, which will enable the efficient development of new systems, in particular ensuring the effective flow of information between forces. It’s also essential that information can be shared not only with criminal justice agencies but also those other local partners with whom the police work to keep people safe. “Nationally, more than a billion pounds is spent on police IT every year and some companies are selling the same products many times to different police forces. This is inefficient and expensive. More importantly, opportunities to share information effectively are being missed. Criminals do not respect police boundaries, and police technology must enable critical information to flow seamlessly from force to force. “PCCs are bringing a clearer focus to the challenge and I am therefore delighted to be driving this work forward with my colleagues. This is long-term work. We want to ensure that technology can support the delivery of efficient and effective policing. The establishment of the company is a major step and I look forward to it becoming operational.” Although the company is not yet operational, the final plans for launching the company are nearing completion. Recruitment of key staff is now underway, ready to start
work as soon after the end of April as possible. If an application to the Home Office Innovation Fund is successful, the costs of establishing the company will be met by that funding. If the Innovation Fund bid is unsuccessful, Police and Crime Commissioners have agreed that the costs will be borne by those PCCs wishing to join the company. A vote by PCCs on 3 February confirmed that PCCs believe, given the scale of the savings that can be achieved longer term, this is a prudent investment.
Greater collaboration Company functions will include providing an overarching IT strategy to help law enforcement agencies and other partners work together effectively through the use of technology; commissioning the delivery of national police ICT requirements; enabling greater collaboration, integration and harmonisation between ICT systems; securing value for money; providing a centre of knowledge and expertise in relation to ICT; encouraging innovation, supporting the delivery of digital capabilities and identifying opportunities for collaboration and shared learning.
Open to other agencies Members of the Police ICT Board include the three PCCs, British Transport Police Authority, Deputy Mayor for Policing and Crime in London, the Cambridgeshire and Durham chief constables, the Home Office and the College of Policing. Membership of the company is open to other agencies with an interest in efficient and effective police services.
http://apccs.police.uk
Terrafix Aggregator pushes mobile data boundaries Terrafix continues its pedigree of developing advanced and innovative technologies, which help to meet the growing mobile data needs of its customers. Designed, developed and manufactured by Terrafix, the Terrafix Aggregator (T.AGG) is a vehicle based communications management hub with integrated GPS. It accesses up to four cellular networks for broadband data communications plus an option to interface to any other communications system such as satellite or point to point radio, supplying optimal data aggregation, coverage and bandwidth in the most challenging environments. Coupled with built-in dual Wi-Fi and Bluetooth, the T.AGG will provide a powerful facility to stream high data dependant applications to any mobile device. Remote working is becoming a normal and expected part of any business. This has always been the case in the emergency services but the geography and mobile communications architecture have been limiting factors.
www.emergencyservicestimes.com
Using the T.AGG to provide a diverse and optimised data path opens the door to the visions of the user communities making ideas a reality; ideas such as Telehealth, mobile consulting rooms, PNC, ANPR checks, video streaming, distance experts used in mission critical situations are all now possible. The applications for a remote guaranteed broadband facility are limitless.
Telehealth programme In January 2015 Terrafix successfully secured a contract with the Scottish Ambulance Service to provide the T.AGG as part of a full mobile data vehicle hardware replacement. It is the first step in Scottish Ambulance Service’s Telehealth programme and their strategic framework, ‘Towards 2020: Taking Care to the Patient’ (see page 7). The Terrafix solution procured will utilise the T.AGG for all in-vehicle communications with two Getac T800s, one for use in the front of the vehicle for mobilisation and routing and the other is positioned in
the rear of the vehicle, but remains portable to be utilised as a method of recording Electronic Patient Report Forms. Terrafix is now looking at potential markets around the world where the communications infrastructure is limited and where a T.AGG will offer a way of broadening a customer’s footprint by providing a resilient, diverse and secure mobile broadband facility.
http://terrafix.co.uk
April 2015
ESTPEOPLE | 45
Wiltshire Air Ambulance appoints new HEMS pilot Matt Wilcock has taken up his first posting as a Helicopter Emergency Medical Service (HEMS) pilot at Wiltshire Air Ambulance (WAA). Matt has made the switch to HEMS work after 17 years in the military where he flew a range of helicopters. Matt completed his training on Wiltshire Air Ambulance’s new helicopter, the Bell 429, at Fairoaks, Surrey, and began flying the air ambulance earlier this month.
Wiltshire Pilot Matt Wilcock.
Matt said, “The public support for Wiltshire Air Ambulance is great. When we have landed at locations to attend an incident local people have offered their help, such as driving our paramedics from the helicopter to the scene. “I like the role and challenge of flying an air ambulance. It’s unique in what it does in civilian flying and I can bring my 17 years of experience in the military, including night flying. “The Bell 429 is a very stable, fast and comfortable aircraft. It’s got really good cabin space in the back for the paramedics to treat patients and the avionics on board allow us to do our job really well.” Matt will be leading the training on using Night Vision Goggles (NVG) for the pilots and paramedics at WAA to enable the air ambulance to fly at night. Heli Charter employs the Wiltshire Air Ambulance pilots and WAA leases the Bell 429 from Heli Charter under a 10-year contract. www.wiltshireairambulance.co.uk
www.emergencyservicestimes.com
Combined Dorset & Wiltshire FRS announces new Chief
Darran Gunter.
Following a comprehensive selection process involving members from both Dorset and Wiltshire and Swindon fire authorities together with independent specialist advisers, CFO Darran Gunter of Dorset Fire and Rescue Service has been appointed as CFO Designate for the new Dorset and Wiltshire Fire and Rescue Service and will be the substantive CFO following the establishment of a new combined service on 1 April 2016. Cllr Chris Devine, Chairman of Wiltshire and Swindon Combined Fire Authority, and Cllr Rebecca Knox, Chairman of Dorset Fire Authority, said, “Darran will continue working closely with elected members on the joint
committee overseeing the combination, and staff in both Wiltshire and Dorset fire and rescue services to create a new organisation, its vision, and its future strategies and priorities. “We are very grateful to Simon RouthJones, Chief Fire Officer of Wiltshire FRS, who has been instrumental in the combination strategy and we would like to thank him for all he has done in getting the project to this stage. He will continue to work with Darran to support the process to its conclusion. “We look forward to continuing our work with Darran, Simon and both fire and rescue services to build and develop a new, unified and successful fire authority.” Darran said, “Our combination is by far the most complex and challenging change programme that both services have embarked on. We are determined to protect and, where possible, strengthen frontline services and I feel privileged and very proud to work with two such fire and rescue services. I am extremely grateful for the continued support from Simon Routh-Jones of Wiltshire and the professional team of members and staff from both services.” www.dorsetfire.co.uk
London ambulance tutor wins international award The work of a London Ambulance Service tutor has been recognised with an international award. Rachel Phillips joined the service in 2002 as a medical technician and spent six years on the road treating patients before becoming a tutor and teaching new recruits. Rachel, from Rochester in
Rachel Phillips, London Ambulance Service.
Kent, recently attended the JEMS Games in the US city of Baltimore, to collect the prestigious innovator award. She is the first British person to receive the award in the seven years they have been running. Ambulance Operations Manager Steph Adams, who nominated Rachel, said, “Rachel is entirely flexible and will adapt her schedule to work around others, providing additional training where necessary. Her friendly, approachable nature means staff feel confident enough to admit their mistakes, leading to an environment which is clinically focused, keen on development and generally much safer.” Rachel said, “I’m really humbled and very excited to receive this award. I really enjoy my job and it’s fantastic to know I’m inspiring other people and improving patient safety. I love the variety of my job and being in a position where I can clinically guide and support staff.” www.londonambulance.nhs.uk
Peter O’Reilly, who is currently Assistant County Fire Officer and Director of Prevention and Protection at Greater Manchester Fire and Rescue Service (GMFRS), will take up the post of County Fire Officer and Chief Executive in June following the retirement of long-serving Chief Steve McGuirk. http://manchesterfire.gov.uk
Stephen Otter has been reappointed as one of Her Majesty’s Inspectors of Constabulary (HMIC). Mr Otter was originally appointed in March 2012 and has responsibility for a number of forces and agencies including the Metropolitan Police Service, the British Transport Police and the National Crime Agency. He leads the inspectorate’s work on counter terrorism policing, organised crime and the Strategic Policing Requirement. www.gov.uk
Current Deputy Richard Chandler will be appointed as the Leicestershire Fire and Rescue Service’s new Chief Fire and Rescue Officer from 1 May 2015 following the retirement of Chief Fire and Rescue Officer Dave Webb. www.leicestershire-fire.gov.uk
Two top police officers have announced their retirements. Chief Constable Pat Geenty will retire from Wiltshire Police this May. Mr Geenty joined Wiltshire Police in July 2009 and was appointed substantive Chief Constable of the force in May 2012. Assistant Chief Constable Alistair Finlay is to retire from the Police Service of Northern Ireland (PSNI) after completing almost 33 years service to policing. www.wiltshire.police.uk www.psni.police.uk
Humberside Police has appointed Garry Forsyth to the post of Deputy Chief Constable. Garry is currently Assistant Chief Constable of West Midlands Police and it is hoped he will be able to take up his new post early in the summer. www.humberside.police.uk
The Scottish Fire and Rescue Service (SFRS) has appointed John Miller as Head of Service Delivery for the East of Scotland. As the new Deputy Assistant Chief Officer, John will oversee the Local Senior Officers (LSOs) who work with individual local authorities and community partners to maintain dedicated local fire and rescue services across the area. www.firescotland.gov.uk
April 2015
46 | ESTPROFILE
EPS looks for the next generation of emergency planners Membership of the Emergency Planning Society (EPS), the professional association for emergency responders, has halved since 2010, reflecting the level of job losses in Emergency Planning Units around the country, mainly in local government and the NHS. But confidence is returning and the EPS is gearing up for a year of activity, as we undertake a new drive to push up membership. Words: Tony Thompson, Chair, Emergency Planning Society. As the new Chair of the EPS I am fully aware that our organisation has been through a very difficult patch but the work of my predecessors over the past two years has shown that we are beginning to turn around. We want to keep this momentum going, and have already begun planning events and activities to attract the new generation of emergency planners. At our most recent meeting the Board of Directors of the EPS heard that for the first time since 2008, the organisation’s finances are back in the black. Financially it may only be a small amount, but it demonstrates we are now moving back in the right direction. I must pay tribute to my predecessors – in particular the former Chair Helen Hinds – for the work they have done in pulling the organisation around.
“The EPS is gearing up for a year of activity.” Building the EPS Work is now underway on events and actions to build the EPS. The EPS magazine has returned to printed format, to be distributed quarterly to the society’s 1300 members. I think it important that our members get a physical update of EPS activity through their letterbox on a regular basis. We will, however, continue to provide an
electronic version so that members can access the information across multiple platforms.
Great networking The EPS will be at The Emergency Services Show this September, positioned in the Emergency Response Zone. The Emergency Services Show is an important event for us as it is our key target audience. At last year’s event over 30 people came to our stand to express interest in joining. But it’s a great networking event for us too. A national workshop on Humanitarian Assistance is being held at Alexandra Palace in London on 26 March, with a further one planned for October. This is the first in a series of conferences and workshops at which the EPS’s ‘Professional Working Groups’, which specialise in different areas from CBRN to Near Earth Objects, aim to engage not just our own membership but also the profession generally. For example, our next workshop on Humanitarian Assistance will discuss concerns that this area is not being centrally coordinated at a national level. But there are indications from central government that this will change, and the aim of this national workshop is to contribute to the process with input from key practitioners in this sector. We are also looking to develop a Cities policy group.
National conference We have already announced the dates for the EPS national conference, which will be held from 29-30 September at the Emergency Planning College
Tony Thompson takes over at the EPS from former Chair Helen Hinds.
in Easingwold, Yorkshire. This location will help strengthen our new links with the college – we have our head office there. In preparation for the event, we will be issuing a ‘call for papers’ to invite ideas for speakers and topics – ideas can be sent to info@the-eps.org. We already have some ideas, but we want to make sure all our members have an opportunity to contribute. Things are on the move. Beside Resilience, we also have a regular newsletter for members called ‘m/f’ – ‘more follows’: and that will certainly be the case for 2015.
www.the-eps.org
EPS appoints new Chair Tony Thompson, a former British Transport Police Superintendent, has been appointed the new chair of the Emergency Planning Society (EPS). Tony began his career in the RAF before joining the British Transport Police (BTP) where he served for 32 years, a period that covered the series of train disasters from Clapham Junction through to Potters Bar. On leaving BTP he was the Government’s Regional Resilience Director for the South West Region for two years, and went on to become the Head of UK Emergency Response and Resilience for the British Red Cross. In recent years he has been working as a consultant, mainly in the United Arab Emirates.
But it is much more than that. It is all about people who need our help when faced with often the most extreme, distressing and life-changing situations that they have ever encountered. The role of many of those who have joined the EPS, and those who will do so in the future, is to make a real difference to our professional response to helping such people. My role is to help the EPS make that difference. “My immediate thought on being told that I had been appointed was of great excitement, mixed with the recognition of the huge responsibility that I will be taking on. The recent austerity measures have taken their toll on our profession, but we are moving forward and will continue the revitalisation of the EPS for the next generation of emergency managers, both in the public and private sectors.”
Tony said, “Emergency planning is sometimes seen by those who are not directly involved in the profession, as a concept or framework for dealing with emergencies.
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April 2015
48 | ESTMENTAL HEATH
Mental health charity Mind is supporting stressed out staff According to a recent survey by Mind, nearly nine in 10 (87 percent) emergency service personnel have experienced stress, low mood and poor mental health at some point while working for the emergency services. Our online survey of over 3500 emergency services staff and volunteers (representing 1.5 percent of the entire workforce) also found that more than half (55 percent) had experienced mental health problems at some point. Words: Emma Mamo, Head of Workplace Wellbeing at Mind, the mental health charity. These worrying statistics are far higher than we’d expect – CIPD figures reveal just over one in four (26 percent) of the general workforce had experienced a mental health problem – and adds to the growing body of evidence that suggests emergency services personnel have an elevated risk of experiencing poor mental health. But despite the high prevalence of mental health problems, staff and volunteers are actually less likely to take time off sick due to a mental health problem. Our survey also found that more than half (55 percent) of emergency service personnel said they have never taken time off work due to poor mental health. This is compared to 43 percent of the general work force (CIPD), which suggests that emergency service workers find it harder than other professions to say when they’re not at their best and keep coming to work regardless. This could be because personnel are fearful of talking about mental health at work or think that employers don’t view mental health problems as a valid reason for sickness absence.
“We hope to make workplace wellbeing an important every day part of all workplaces.” A workplace taboo Nowhere is mental health more of a taboo than in the workplace. A study by Mind and YouGov last October found that 95 percent of workers who had taken time off sick because of stress gave their employer a different reason for their absence, such as a headache. Only five percent said they were stressed. But if your employer isn’t aware of the difficulties you’re facing, it’s hard for them to help and things can get worse. We all have mental health just as we all have physical health, so why is it so difficult to talk about? We know that concerns about fitness to practice can prevent people speaking out, but this is the first step in accessing the support needed to stay well, recover, and continue vital work serving our communities. There is much more that must be done to promote a positive culture around mental health within the emergency services so that staff and volunteers feel comfortable seeking support. The beginning of March saw the launch of the Blue Light programme, which Mind is delivering between April 2015 and March 2016 to support the mental health of staff and volunteers across police, fire,
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ambulance and search and rescue services in England. The programme has been developed in consultation with emergency service staff and volunteers, involving local Minds and professional bodies, employers, charities and unions.
Workplace wellbeing Given the taboo surrounding mental health, one of the main aims of the programme is to tackle stigma and discrimination at an organisational level. We hope to make workplace wellbeing an important every day part of all workplaces by providing a bespoke mental health training programme for managers, staff and volunteers. Another crucial part of the programme is trying out new ways to build the mental health resilience of emergency service personnel, to aid recovery when they witness traumatic situations. Our research also showed a high demand for more information and support about mental health, so we are developing a mental health information service just for emergency service personnel, as well as their family and friends. Paul Farmer, Chief Executive of Mind, said, “Not only are many of our blue light personnel struggling with their mental health, but they’re less likely to seek support or have time off sick than the general workforce. The programme we’ll be delivering over the next year aims to ensure that the estimated quarter of a million people working and volunteering within police, ambulance, fire and search and rescue divisions are able to talk openly about their mental health and access the support they need to stay well, recover and continue doing the vital and challenging roles they do serving the community. “Since Mind was awarded the funding and we have begun work on the project, we have been really encouraged by the response from everyone we have spoken to. There is a clear consensus that this is an issue that needs tackling and it’s clear that the will is there to address it.”
Sign the pledge Mind is urging emergency service organisations to register their interest in signing the Blue Light Time to Change pledge. Signing the pledge shows a commitment to developing a meaningful action plan that will support the wellbeing of their staff and volunteers. Simon Cole, Chief Constable at Leicestershire Police, said, “Signing the pledge is a public statement of Leicestershire Police’s commitment to improve the way we deal with issues relating to mental health and wellbeing. It will empower our officers and staff to talk about mental health and wellbeing confidently and to respond to both colleagues and the public appropriately.” Effectively managing workplace mental health is critical to both the mental health of employees and volunteers and to the wider mental health of the people and communities they serve every day.
www.mind.org.uk/BlueLight Find out more information about the programme, by e-mailing: bluelight@mind.org.uk. Mind has a confidential information and support line, Mind Infoline, available on 0300 123 3393 (lines open 9am - 6pm, Monday – Friday)
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Information sharing to improve outcomes for people in mental health crisis National bodies involved in health, policing, social care, housing, local government and the third sector, in 2014, pledged to work together to make sure people get the help they need when they are in mental health crisis. To achieve the aims of the Mental Health Crisis Care Concordat, public service providers around the country are taking a more creative approach to how they can provide support before people reach crisis point. Information sharing is integral to sustainable collaboration. The Centre of Excellence for Information Sharing is working with a number of local places to support them in uncovering and finding practical solutions to information sharing barriers in service transformation, focusing predominately on cultural barriers.
Leicestershire A conversation between Peter Jackson, former Chief Inspector of Leicestershire Police, and Matthew Wakely, Team Manager for Leicestershire Partnership NHS Trust (LPT), identified that mental health practitioners and police officers were sharing the same frustrations – too many people with poor mental health were repeatedly passing through the police custody suites and not getting appropriate help and support. Local discussions rallied support from colleagues from both organisations and wider partners from across Leicestershire. Collaboration supported by improved information sharing was identified as the key to improve outcomes.
“Collaboration supported by improved information sharing was identified as the key to improve outcomes.” A short local trial of joint working explored and developed a deeper understanding of the information sharing opportunities and limitations within each organisation. Having a shared understanding of the challenges enabled them to develop an approach that supports people at various stages in their journey through the system, but most effectively on the frontline, before the point of arrest. The solution provided has resulted in mental health practitioners being employed by the LPT to work in custody suites, probation offices and law courts. The police have access to mental health support through a ‘triage car’ and a back office mental health assessment helpline – where an officer and a mental health practitioner sit side-by-side and assess cases as they come in. Peter Jackson says the key to success was ‘culture change’. He said, “It’s about being prepared to share information that we didn’t previously and learning to respect each other’s viewpoints to work together as one team. It all started by putting two professionals side-byside to discuss cases.”
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Lord Bradley (third from right) and Jenny Talbot, Director of the Prison Reform Trust’s Care Not Custody programme (far right) at the Bradgate Mental Health Unit with (from L to R) triage car officer Darren Birch, LPT mental health nurse and triage crew member Furqan Mia, Dr Peter Miller, Chief Executive of LPT and Teresa Smith, Director of Adult Mental Health and Learning Disability Services at LPT.
Similar approach in Surrey Surrey’s journey has just begun. With different geographical and demographic challenges to Leicestershire – an aging population and wider dispersed communities – Surrey is applying a similar collaborative approach. By identifying the crucial role of information sharing, partners in Surrey have been piloting a system that suits the needs of its specific communities, placing a mental health professional in the police response centre. Through the development of community-based services, the region is also focusing on prevention as a way of supporting people from falling into crisis. This includes a ‘Time Out Café’, which is being looked at as a potential approach towards establishing ‘safe havens’, providing support for those experiencing or recovering from mental health crisis, as an alternative to attending A&E.
Vicki Noble, Senior Mental Health Practitioner with LPT, and PC Dave Wadsworth from the triage car.
At the heart of this has been the development of a partnership of stakeholders – Surrey Crisis Care Concordat Delivery Group, which includes statutory services, voluntary sector and the police with service users and carers. Using learning from other local places, such as Leicestershire, and with support from the Centre of Excellence for Information Sharing, Surrey has taken a pragmatic approach to identifying any challenges that may limit information sharing to achieve better outcomes for service users.
Real need for change Stuart Bolton, Engagement Manager for the Centre of Excellence for Information Sharing, facilitated a workshop for the group to help them identify the type of barriers they may come across when working collaboratively. He said, “There is a real recognition of the need for change and a willingness to work collaboratively to achieve this, despite some of the barriers they may be facing. Being open and honest and recognising the need for change are important cultural aspects to supporting local places on their information sharing journey and, through making changes in these areas, service development becomes easier and information sharing is the norm.” Regular updates will be published on the website shown below on Surrey’s journey in the coming months.
www.informationsharing.org.uk
April 2015
50 | ESTCOMPANY PROFILE
Delivering better value YPO has over 40 years’ expertise in public sector procurement. The company works hard to always give best value for all its customers – making them significant savings and freeing up their time and resources. Whether it is reviewing an everyday product or tendering for a multi-million pound service framework, YPO wants to help you achieve the best possible value. The organisation negotiates with the country’s leading suppliers to ensure customers are given the best selection without ever having to compromise on quality. YPO proactively manages suppliers and frameworks to ensure value for money. It makes sure that it provides customers with protection and peace of mind so that they don’t have to worry. Everything offered by YPO to customers complies with procurement regulations. This means the process is simple and straightforward and saves them time and money.
ICT related frameworks YPO can provide customers with a choice of the following ICT related frameworks: Electronic Office Supplies; Corporate Software Solutions; Technology Products; Local Authority Software Applications; Multifunctional Devices and Services, Managed Print Services and Print Audit Services. Visit the website at www.ypo.co.uk/contracts to find out more.
1. Advice and support: providing expert, reliable support as and when you need it 2. Options appraisal: assessing current public sector arrangements that may be available to you 3. Effective procurement: ensuring the products and services purchased are the most suitable for your requirements 4. Implementation: making sure that new arrangements are put into place correctly 5. Full compliance: all YPO products and services are fully compliant with the latest procurement legislation, providing customers with protection and peace of mind.
Current frameworks: • • • • • • • • •
Emergency Services Uniforms and Station Wear Structural Fire Fighters PPE Managed Service for PPE Smoke Alarms and related products Driving Licence Verification System Incident Command and control Software Incident Ground Feeding Industrial Gases Laundry.
Dedicated support When you buy from YPO, you can be assured that you will receive the highest levels of advice and support. YPO’s Emergency Services team works with establishments across the UK to understand the specific procurement needs of the sector. The only dedicated team at any public sector buying organisation in the country, YPO is able to develop a unique proposition for customers’ needs by working closely with them.
www.ypo.co.uk
Five key ways YPO can help you Emergency services can benefit from accessing support from YPO whenever it is needed without having to pay fixed overhead costs. This procurement advice can be tailored but the key ways the organisation can help include:
Upcoming frameworks for 2015/2016: • • • •
Smoke Alarms Training for Emergency Services Portable Fire Safety products Temporary Resilience and Mass Incident Equipment and First Aid • Hand Held Radios and Communication Bandwidth • Alerters and Station End Equipment.
Policing for the events industry Definitive Event Policing (DEP), a high level specialist policing service for the events industry, has launched with a mission to help event organisers cut policing costs, keep the public safe and prevent crime. The newlook service, launched at the recent Event Production Show at London’s Olympia, is an addition to regular security services and not a replacement, aiming to help organisers use fewer regular police officers on site. Operating at almost equal capacity to the police, says the company, thanks to considerable investment in resources and training, DEP has the credible facility to supplement police resources at events – and in some cases to completely substitute them. Director David Boswell, an experienced security professional who entered the field following an exemplary record in the Armed Forces Household Cavalry Lifeguard Regiment, officially launched the service. He said, “This is an exciting time for Definitive Event Policing – and the response to our launch has been incredibly encouraging. It has taken many years of hard work and investment to get to this point, building relationships within the events industry and of course with police forces too.
Identified a real need “During that time we identified a real need in the industry for an alternative service to that provided by
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police at festivals, a service which they perform extremely professionally but which places a strain on police resources and which of course has cost implications for organisers. “There will always be some events which require a police input but with DEP this requirement can now be considerably reduced, providing cost-saving advantages for event organisers.
“Our training is the best in the business and far in advance of anything normally offered to security staff, especially as our officers undergo refresher courses every year.”
www.dep-policing.org.uk
Police partnerships What makes DEP different from companies that concentrate on stewarding and security is its intense training programme, which is regularly updated and, significantly, a partnership with former senior police officers Allan Binks and Martin Greaves. Allan, formerly an Inspector with Greater Manchester Police and a trainer at the College of Policing, provides strategic input and has vast experience of commanding major events. Martin, who spent 30 years in policing, including leading on self-defence, arrest and restraint for the Association of Chief Police Officers, was previously a Training Manager for the Metropolitan Police at Hendon and is now entrusted with the DEP training programme. “Having Allan and Martin on board as consultants is vital to the DEP offering,” said David Boswell.
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ESTCOMPANY PROFILE | 51
Keeping your staff ‘on the run’ The demand on your service is growing. If today is a challenge then tomorrow will be harder. You know this and you know you must meet the pressure of managing this demand while at the same time planning for the unexpected. You do this by managing your assets and having a resilient workforce. Or do you? Words: Gareth Knights & Pete Reeve, Emergency Athlete.
Our most valuable asset is our staff but how do we build their resilience? How do we enable them to continue throughout the long hours and ever increasing demands of shift work? To tackle the unexpected and then return to normal operations with capability intact?
believe that to improve your strength you should be using multiple muscle groups to move heavy resistance. Our favourites are deadlifts and squats — big exercises with big demands on the system, but done in a way that mirrors working activities. To improve overall fitness, we believe you should follow a general physical preparation (GPP) programme, mixing different energy systems in the same workout. Consider 15 minutes of chest compressions in a cardiac arrest scenario followed by a patient carry down two flights of stairs. No problems for a practitioner who's been doing 15 minutes of box jumps, deadlifts and burpees. What about dynamic entry into a house followed by restraining a subject? It'll seem easy after shuttle sprints, pull ups and shoulder presses, all repeated seven times.
anaerobic performance, but also a 14 percent increase in aerobic capacity. An endurance only group in the same experiment showed a 10 percent increase aerobically, and no anaerobic increase. HIT was more effective across the board.
Four pillars of health Injury prevention
Emergency Athlete promotes the four pillars of health: nutrition, sleep, stress mediation and exercise. It aims to hit a balance between these four pillars to promote optimum performance and increase resilience to the demands of emergency service work.
“Training should be enjoyable, challenging but most importantly relevant.” Exercise Within all of our working activities, complex demands are made on our fitness. For a police officer a foot pursuit may end with the need to restrain a subject. Heavy cardiovascular demands are followed immediately by a need to express maximum strength while already fatigued. A firefighter may need to make repeated stair climbs while carrying equipment, simultaneously taxing multiple physiological systems. So to operate functionally at work we must demand complex movements from our bodies yet rarely do we train or aim to improve in a similar way. Traditional approaches to physical improvement promote ideologies that cardiovascular fitness is increased by steady state or interval running and strength is increased by performing sets and repetitions (usually on machines) with measured rest intervals. These methodologies have been used for decades and can be effective, but research has shown us new ways to improve our functional capability and we should look to embrace them and introduce them to our staff.
More effective training We advocate high intensity training, otherwise known as HIT, which has been proven highly effective in many research studies. Even in studies where it was shown to be no more effective than ‘traditional’ methods, the HIT protocols required a much smaller time commitment. In a study of anaerobic and aerobic capacity, a HIT training group showed not only a 28 percent increase in
All of this fitness is useless unless you can apply it, and being injured stops you doing just that. Another core concept at Emergency Athlete is mobility. Injuries stem from poor positions, and poor positions stem from poor mobility. A few minutes each day working on your ability to adopt the correct position by improving mobility will save you months on the sidelines with an injury. This is a simple aspect of training that yields benefits to both staff and the employer. We cannot change the operational task on the ground but we can prevent the injury. Training should be enjoyable, challenging but most importantly relevant. Visit emergencyathlete.com for more information on functional training techniques, improving mobility and workout suggestions.
www.emergencyathlete.com
Improved resilience At Emergency Athlete, we advocate a variety of techniques to improve performance. We believe that to improve resilience, you should be strong. We also
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ESTCOLLABORATION | 53
JESIP continues to improve Principles of interoperability Over the past two years we have regularly reported on the progress of JESIP – Joint Emergency Services Interoperability Programme. Following a six-month transition phase from October 2014, some significant steps have been taken. Words: Joy Flanagan, JESIP Engagement Manager. Firstly, JESIP now becomes Joint Emergency Services Interoperability Principles – a joint working code everyone can understand and to which everyone can work. The next few months and years are about embedding those principles. Secondly, with continuing oversight from Ministers, the Interoperability Board has been established. Led by the national strategic leads from police, fire and ambulance, this national board will have membership from a range of stakeholders such as Government departments, Devolved Administrations, Local Resilience Forums and the MOD.
“To ensure the use of JESIP becomes second nature by all emergency response staff and control rooms, integrating and embedding JESIP is key.” The board will have responsibility and ownership of JESIP, the Joint Doctrine and, most importantly, the continuing improvement of emergency services interoperability. It will make sure the emergency services have a mechanism by which they can not only identify lessons that need to be learnt but have the structure in place to analyse those lessons, find solutions and apply change on the ground – the Joint Organisational Learning process and application.
What will successful interoperability look like? We have developed a JESIP Maturity Framework (shown below), which lays out what successful interoperability will look like. The categories on the left are the areas of work that can impact on interoperability – the focus for the JESIP team. The levels across the top show the range of behaviours, with Level One being an indicator of where we were before JESIP started. The target is to get to level four across the board by 2020. Services will soon be asked to ‘self assess’ their local progress against this framework.
National JESIP network continues All services have been asked to nominate a strategic level lead officer. These service strategic leads will have local ownership of JESIP and provide a connection from the services to the centre. They will oversee embedding activities in their services and have responsibility for ensuring any lessons identified through Joint Organisational Learning (JOL) are implemented in their service. A small national JESIP team will remain in place to support the Interoperability Board and the services as they embed JESIP; manage the JOL system through final development to launch (expected from April 2015); and, finally, to maintain the Joint Doctrine and other JESIP products to ensure they remain fit for purpose. So, JESIP has done what it set out to do. We developed the missing joint working guidance (JESIP Joint Doctrine) and we initiated the most ambitious training programme the emergency services have ever seen. Over 40,000 staff from the emergency
services have now received JESIP training, attended an awareness session or have completing e-learning, and we are still counting! This is alongside staff from the wider responder community also embracing JESIP with many national bodies aligning their practices to JESIP and partners being included in multi-agency training run by the emergency services. This is a fantastic result and one the emergency services themselves should be proud of. However, as many of our delivery leads and trainers agree, JESIP has started something really good, but there is much more to do. Both Skills for Justice, who facilitated the workforce surveys for JESIP, and the overall programme evaluation concluded that without continued effort and without JESIP being part of the continued professional development of staff; the knowledge gained through training will quickly fade away. People will naturally resort to historic practices they feel comfortable with and the principles will not be applied.
Embedding JESIP is key To ensure the use of JESIP becomes second nature by all emergency response staff and control rooms, embedding JESIP and integrating at all levels is key. Nationally, JESIP is working with each sector to ensure all national doctrine is aligned to the principles and models from the Joint Doctrine. Emergency services now need to focus on local embedding and integration. We need all relevant staff to really understand JESIP and be able to apply it without thinking. This alignment and embedding work will take time but it is why no-one can assume that JESIP is now done! With the Interoperability Board in place linked to services via the network of local strategic leads; the emergency services are well placed to take ownership of JESIP and really improve how they work with partners and peers when responding to incidents. As more and more staff learn about JESIP; how its principles make sense and that they can see a difference on the ground; JESIP is making a difference and the vision we set out to achieve is becoming a reality: Working Together – Saving Lives.
www.jesip.org.uk JESIP Maturity Framework
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April 2015
54 | ESTCOLLABORATION
The often under-estimated role of fire and rescue services in wider public service reform Recently, a public comment by a high ranking police officer got me thinking about how poor we in the UK fire and rescue service have been in demonstrating the value that we create within society. The police officer commented that the cuts were turning his force into a ‘fire brigade’ police service! I think I know what he meant, but for a proud member of a national service that has totally transformed what it provides to the British public I was disappointed by the inference. We in Greater Manchester Fire and Rescue Service (GMFRS) don’t have the traditional ‘Vision’ or ‘Mission’ statement expected by businesses, instead we have a clear purpose - it is to ‘protect and improve the quality of life of the people in Greater Manchester’. Every role in our organisation aligns to this purpose, a purpose that makes no mention of fire! Words: Peter O’Reilly, Designate Chief Fire Officer, Greater Manchester Fire and Rescue Service. Despite a 29 percent (£25m) reduction in the revenue support grant we receive from central government we’ve been successfully working to this purpose for the last four years, and it has really focused and aligned all of our business. Our firefighters, Community Risk Intervention Teams (CRITs), Community Safety Advisors (CSAs) and volunteers will be in 60,000 homes across the city region in the next 12 months; primarily to reduce the risk of fire but increasingly to reduce other foreseeable risks such as falls and crime. They will also offer health and well-being advice around drugs, alcohol, obesity, mental health and even provide information on energy switching.
Community Risk Intervention Teams focus on improving the health and well-being of the community.
This is not a volume-based activity; it is driven by a sophisticated model that identifies where the most vulnerable in our community live. It is no coincidence that the people who live in these homes are also receiving services from other public sector partners such as social care, youth services, housing and the police. The relationships we have built with our partners in the public sector have seen us move to a position where we are investing to bring an integrated approach to helping local people.
In Moss Side the community fire station boxing club has over 400 regular members of all ages and physical/mental ability, while a dedicated team also delivers a practical alternative curriculum programme, which has been developed for those young people that are disengaged from mainstream education and at risk of exclusion from a local high school. The Driver and Vehicle Standards Agency uses two other stations as driving test centres, and the intention is to role this model out across more of our stations. Our communities have used the community rooms in fire stations, free of charge, over 2000 times since April 2014. Recently our volunteering and youth engagement programmes have expanded to the point where over 400 local people regularly volunteer to carry out community development activities on our behalf, which include: responding to help residents clean up after a fire (Post Incident Team (PIT)) and working with young people each week on our cadet units. Since it began in 2008 our volunteers have contributed almost 200,000 hours of service to the public. Over the past year we have enabled 1000 young people to obtain in excess of 1700 practical and academic qualifications.
Supporting communities So has any of this had an impact for our community? Well, we think so. The numbers of fires continue on a downward trend; fewer people are being rescued from fires and more people who suffer a fire have had a previous experience with our staff that has helped them survive potentially life-ending events. We’ve expanded our youth engagement programmes, created apprenticeship frameworks, and employed young people directly into the service from our youth
Working together For example, we have converted a fire station in Tameside to accommodate the entire neighbourhood team from the local authority. This team now shares the same space as our community safety team and police. In Salford we have transformed the fire station at Irlam into a fully integrated police, ambulance and fire community station. At present we are installing a climbing wall onto the traditional drill tower to increase the types of health and well-being activities the local community can access.
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Since it began in 2008 our volunteers have contributed almost 200,000 hours of service to the public.
Peter O’Reilly, Designate Chief Fire Officer, Greater Manchester Fire and Rescue Service.
engagement programmes on newly developed apprenticeships. We are one of the Government’s Trailblazers, creating a new apprenticeship standard for Business Safety Adviser Apprentices, and we are leading the introduction of Traineeships within the UK fire and rescue service.
Supporting business As the fire safety regulator in Greater Manchester we make up one of over 60 regulatory departments that enforce legislation on our businesses. Businesses, particularly small and medium sized enterprises, complain that they are over-burdened by regulatory inspections and often they receive conflicting or contradictory direction. It is not actually difficult to understand this if all of the regulatory departments operate on separate risk assessments, separate action plans and are located in separate facilities. In Greater Manchester Fire and Rescue Service we have pushed our Fire Safety Enforcement officers into the regulatory teams of the local authorities. Why? We believe that integrating all regulatory teams will have short, medium and long-term benefits for the business communities and the taxpayer.
April 2015
ESTCOLLABORATION | 55 The last of the three teams became active on 5 January this year, and we will be recruiting an additional 70 team members to form seven more teams across Greater Manchester.
Reducing costs
The adoption of Ultra High Pressure Cold Cutting equipment as standard on all frontline fire appliances will provide firefighters with an additional tool to control and extinguish fires safely.
In the short term the teams will begin to understand the working practices of their peers. In the medium term joint risk assessments, action plans and training will enable staff to deliver education and awareness to businesses on behalf of each other. In the longer term we may see the development of a truly integrated management, and delivery, of the regulatory services across the whole of Greater Manchester. In Tameside, where we first integrated with the local authority regulators, businesses are already seeing an improved support service from local regulators. And in Manchester, co-locating with Manchester City Council has saved local businesses, in the Northern Quarter, hundreds of thousands of pounds. To support this approach we have authored a national competency framework, which has allowed us to recruit Business Fire Safety Advisors, particularly from under represented communities, to engage with their local business communities to help them understand and comply with their statutory responsibilities under fire safety legislation.
“The relationships we have built with our partners in the public sector have seen us move to a position where we are investing to bring an integrated approach to helping local people.”
These teams also respond, on behalf of the police and ambulance services, to non-emergency calls, which impact on the ability of these services to respond to serious incidents, such as minor falls or calls that are non-crime related, which tie up police resources for long periods. The three teams have been fully available for just over six weeks (at the time of writing) and have responded to almost 700 incidents including cardiac arrests, falls and concerns for welfare. This has lessened the impact of these types of calls on ambulance and police services, freeing up their professionals to deal with other emergencies. The Cost Benefit Analysis (CBA) that accompanied our bid to the FTF illustrated a potential payback period of less than two years to cover the initial investment. To coin a phrase, the fruit from the work of these teams falls in the gardens of others, such as health, social care and police. The impact that the teams have had has already surpassed the expectations of the CBA.
Community Risk Intervention Teams respond, on behalf of the police and ambulance services, to non-emergency calls.
Multi-agency prevention hub The Fire Transformation Fund has also supported the establishment of a multi-agency prevention hub in Salford. Fire and local authority youth services will co-locate and be jointly managed with police and
Over 400 local people regularly volunteer to carry out community development activities on behalf of the service.
community organisations to engage local young people and their families, with the aim of providing a positive pathway for development. This will rely heavily on our experience of providing alternative curriculum, traineeship and apprenticeship opportunities. The philosophy that will drive forward the work of this team is that they will strive to provide ‘what matters to people and communities’ rather than concentrate on ‘what is the matter with them’. Already other local authority partners are keen to see this model developed elsewhere and we are exploring how this can be achieved. GMFRS have not lost sight of our traditional responsibilities, and are making great strides, through innovation, to improve the safety of our firefighters and the public. The adoption of Ultra High Pressure Cold Cutting (UHPCC) equipment as standard on all frontline fire appliances will provide firefighters with an additional tool to control and extinguish fires safely. Combining UHPCC with thermal imaging, positive pressure ventilation and providing firefighters with new, layered personal protective equipment is a strategic, tactical and operational commitment to protecting and improving the quality of life of our staff and communities.
www.manchesterfire.gov.uk
Reducing risk We are now taking the same approach to integrating with community risk reduction services. Our Community Safety Advisors are being placed within Integrated Neighbourhood Teams, where these have been established, and we are working with partners including GP surgeries to ensure that we are in the homes of those most at risk. But, how do we help drive public sector reform by using our experience to prevent more than fires? We have come up with a couple of ideas, which, thankfully, the Fire Transformation Fund (FTF) has supported. We have employed 30 people, drawn from fire, police and ambulance service volunteers, as well as from those military personnel that have recently left the service, to form three new Community Risk Intervention Teams. These teams focus on improving the health and well-being of those who they meet as well as concentrating on many areas of prevention including: crime, fire, falls and carbon monoxide poisoning.
www.emergencyservicestimes.com
A national competency framework has allowed GMFRS to recruit Business Fire Safety Advisors, particularly from under represented communities, to engage with their local business communities to help them understand and comply with their statutory responsibilities under fire safety legislation.
April 2015
56 | ESTCOLLABORATION
CFOA call on government to make our nation safer With political parties already campaigning for the General Election in May, The Chief Fire Officers’ Association (CFOA), in conjunction with the Local Government Association (LGA), have called on the next government to implement a number of changes to help make communities safer and to assist the fire and rescue service as they take on the challenge of continuing austerity. ‘The Fire and Rescue Service: Making our nation safer’ is the fire and rescue part of the LGA’s wider ‘Investing in our nation’s future: The first 100 days of the next government’ campaign, which was launched at the end of 2014. The document lays out a number of challenges to a new government – including detailed policy proposals, which should be implemented within the first 100 days of the new parliament, along with the financial benefits. Some of the key policy requests have been on the wish list for fire and rescue services for many years, including a call for a change to the law to make smoke alarms compulsory in all private rented accommodation. Smoke alarm ownership is lowest among private renters and this change would ensure that the risk of injury or death from fire was lowered in over four million homes across the UK. [Housing Minister Brandon Lewis announced on 11 March that the Government will make it obligatory for private landlords to install smoke alarms in rented properties. The measure is expected to take effect from October 2015.]
“These are evidenced, thought-through proposals which will save lives, protect businesses and save the economy millions of pounds.” The current system of council tax referendum limits are particularly restrictive for fire and rescue authorities, which charge much less each year than local councils and often cover several council areas. It has been estimated that if every fire authority in the country were to hold a referendum to raise council tax by five percent under the rules as they currently stand, it would cost £41m – some £3m more than it would generate in extra
another to help improve services; the introduction of a Graduated Licensing Scheme for young drivers, who remain the most at risk on our roads; and the establishment of an independent body to distribute funding to fire and rescue services. CFOA President Peter Dartford has urged any new government to take the proposals seriously. He said, “These are evidenced, thought-through proposals which will save lives, protect businesses and save the economy millions of pounds. We would like to see the next government take seriously, recognise and take action within the first 100 days.”
One policy request is a call for a change to the law to make smoke alarms compulsory in all private rented accommodation.
income. The LGA and CFOA would like to see this problem rectified and fire and rescue services given greater flexibility over council tax precepts, similar to Parish Councils, who often collect higher levels of precept than fire authorities already.
Innovative changes There is also a call for innovative changes to the Stamp Duty Land Tax regime to encourage the fitting of sprinklers by construction firms. The proposal would mean that commercial premises that have sprinklers fitted were eligible for a lower rate of stamp duty land tax, which in turn means the construction firm could increase the sale price to offset the cost of including the schemes. Those purchasing the premises would benefit from a building fitted with sprinklers but at no additional overall cost. Analysis of warehousing – which is particularly susceptible to large and damaging fires – estimates that some £32m a year could be saved in losses and damage to the economy and environment if all large warehouses were fitted with sprinkler systems.
“CFOA and the LGA have joined the police and road safety charities such as Brake to call for a lowering of the drink drive limit.” CFOA and the LGA are highlighting the proposals within the document in the run up to the election. Both associations will look to work with whichever parties form the next government in order to progress these ideas as soon as possible.
www.cfoa.org.uk/19312
Lower drink drive limit
It is estimated that some £32m a year could be saved in losses and damage to the economy and environment if all large warehouses were fitted with sprinkler systems.
www.emergencyservicestimes.com
CFOA and the LGA have joined the police and road safety charities such as Brake to call for a lowering of the drink drive limit from 80mg of alcohol per 100ml of blood to 50, a change the Scottish government made in 2014. England and Wales now has the dubious honour of having the highest drink drive limit in the EU, tied only with the tiny island state of Malta. Academic studies have estimated as many as 160 deaths and 4950 crashes a year could be avoided if the drink drive limit is lowered, saving the economy over £280m per annum. Other proposals include a data sharing bill to encourage public bodies to share information with one
A copy of The Fire and Rescue Service: Making our nation safer document can be found on the CFOA website.
April 2015
ESTCOLLABORATION | 57
Intra-operability in the East of England moves a step closer Norfolk and Suffolk Police have established a landmark agreement with the counties’ fire and rescue ervices to provide technical assistance in police search and rescue operations and an additional MTFA/firearms response capability. Meanwhile, Kent Fire and Rescue Service (KFRS) is set to go live on a new joint mobilising system that will maximise the benefits of having the two fire and police 999 emergency services co-located in the same control room at Kent Police headquarters. Words: James Belcher, Lead Officer for the Emergency Services Collaboration Working Group. In addition to the long standing agreement to use Norfolk Fire and Rescue Service’s dive team, the new agreement between Norfolk and Suffolk Police and the counties’ fire and rescue services will see the police use the expertise of the fire and rescue service in missing person and evidence searches involving confined space, height, water or hazardous materials. The agreement also sees the fire and rescue service taking on a key role in coordinating the use of volunteers in high-risk environments. Norfolk and Suffolk Police, along with Norfolk and Suffolk fire and rescue services, have come together to jointly fund and develop a new MTFA response within the East of England, extending the close relationship into new areas. Roy Harold, Deputy Chief Fire Officer, Norfolk Fire and Rescue Service, says, “Police and fire and rescue services in Norfolk are focused on public safety outcomes. In the context of sustained reductions in funding, working together to pool resources and share whatever we can, whenever we can, is the sensible and pragmatic way to maintain that focus.”
Joint 999 system for Kent Kent Fire and Rescue Service’s new mobilising system is believed to be the first fire and police control room working on a common system – SteriaSTORM. In terms of public safety, the fact that fire and police will be
sharing the same mobilising system will: ensure the right resources are rapidly mobilised to incidents; police and fire will be able to instantly share essential information – particularly during a major incident or if an incident requires both police and fire and rescue services to attend; both services will have a common view of the situation, so, for example, there shouldn’t be any risk of duplication, or errors relating to two different incident addresses; deliver savings; and provide improved resilience and interoperability. KFRS control staff were co-located with Kent Police headquarters in March 2012 following the cancellation of the Government’s FiReControl project. Benefits have already included giving KFRS’s 999 staff access to a countywide CCTV network, greater access to the Airwave communications network and closer working
especially during major emergencies such as the flooding last Christmas. Ann Millington, Chief Executive of KFRS, said, “We have been working successfully with Kent Police over the last 10 years, this is the next step on that journey. The two services want to find ways we can sensibly work together to keep local people safe. Co-locating the two control teams and using a shared system makes the most of our resources and ensures we can keep local services like our essential 999 control team within the county, which is something local people have made clear they want.” Deputy Chief Constable Paul Brandon said, “Kent Police and Kent Fire and Rescue Service have always worked very closely and by co-locating the two control rooms we are able to better share information and more work effectively and efficiently together. We will continue to explore any collaborative opportunities that can improve the service we provide to the communities of Kent.” Sean-Bone-Knell, KFRS Director Operations, said, “This new system will enable us to share information with Kent Police, whilst still preserving the integrity each service may need during security incidents. Our aim is to ensure Kent and Medway is a safer place for our residents and businesses.”
http://ow.ly/HODGG
Driven to partnership success Hampshire Fire and Rescue Service (HFRS) and Royal Berkshire Fire and Rescue Service (RBFRS) have recently celebrated the first anniversary of a unique partnership. January 2014 saw the beginning of a mutually beneficial arrangement whereby RBFRS vehicles make use of capacity at HFRS’s Fleet Maintenance Centre.
www.emergencyservicestimes.com
One year on and the project has been deemed a success, achieving over £200,000 worth of public savings and in the region of 3500 hours of vehicle maintenance carried out on RBFRS vehicles.
Vehicle maintenance RBFRS has, for many years, outsourced its vehicle maintenance to a number of private sector providers and wanted to bring service provision back in house. Meanwhile, HFRS has dedicated specialist workshop facilities with capacity to undertake additional workshop based maintenance. From January last year, RBFRS appliances began arriving at HFRS’s Fleet Maintenance Centre (FMC). HFRS operates the main workshop with RBFRS contributing a member of staff to the team. ‘On the road’ repairs and maintenance are undertaken by mobile workshops, staffed in the south by HFRS technicians and by RBFRS technicians in the north of the combined region.
In terms of the volume of vehicles that can pass through the FMC in Eastleigh, HFRS has around 330 vehicles and approximately 970 pieces of associated equipment, while RBFRS has around 150 vehicles and 230 pieces of associated equipment. Hampshire Fire and Rescue Service Chief Officer Dave Curry said, “This arrangement is producing benefits for both fire services – there is a combined public sector benefit of around £200,000 per annum. And it’s definitely helping us both meet our ongoing financial challenges. As far as I’m aware there’s nothing else like this in the UK Fire Service where two authorities are sharing the running costs at one single facility.” Chief Fire Officer Andy Fry from RBFRS said, “This partnership has been so successful in terms of saving jobs and money, that we have just had Fire Transformation funding awarded to help create a light vehicle workshop to extend and enhance the partnership.”
www.hantsfire.gov.uk
April 2015
58 | ESTPRODUCTS
First Responder Stations – Bull Products
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www.bullproducts.co.uk A new range of First Responder Stations has been launched by Bull Products to improve health and safety provision at construction sites, factories and warehouses. There are three First Responder Stations available: a Fire Point Centre, a Spill Control Centre and a First Aid Centre, all of which are trolley based mobile units. Moulded from tough rota-moulded plastic with brightly coloured doors, these cabinets house the fire extinguishers in the Fire Point Centre, the spill absorbents in the Spill Control Centre and the first aid kit in the First Aid Centre. All cabinets protect the contents from the weather, have clear windows for visual inspection of contents and also have anti-tamper pins for the cabinet latches to prevent misuse.
XEO19R headlamp – LED Lenser
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www.ledlenser-store.co.uk The XEO19R hands-free lamp from LED Lenser produces 2000 lumens of light, giving a potential beam range of up to 300m. The light comes from two powerful CREE® LEDs, which for the first time can be independently controlled to provide the wearer with the optimum combination of flood or spot beam. The lamp features its own unique thermal Speed Cooling system, which makes the LEDs shine brighter the faster you go, thereby making the XEO19R the ideal light for those where critical performance is called upon. For extended life (up to 40 hours run time) the lamp is rechargeable thus making it more energy-efficient and better for the environment. It is also multi-functional: by detaching the lamp head and battery pack from the headband the XEO19R converts easily from a headlamp into a hand-held super torch or, with separately available accessories, into a body lamp for off-head hands free lighting or the perfect helmet light.
Heatcase – Espar
www.espar.co.uk Heatcase from Espar is a stand-alone diesel fired portable heat source, which utilises the Eberspächer Airtronic D4 heater. When fully charged and full of fuel, Heatcase can give up to five hours of hot air heating almost anywhere. Convenient for providing heat in remote off-grid locations, Heatcase can be a lifesaver when used to provide personal warmth where there is a danger of hypothermia, such as at the scene of road traffic accidents, during extreme outdoor events and as an aid to paramedics, fire and rescue, mountain rescue, lifeboats, coastguard and disaster relief organisations. To use Heatcase remotely, it must first be connected to a 240V AC power supply to charge up the onboard power pack. The unit will provide 4kW of warm air heating, which can be ducted to the area where the heat is needed. Should Heatcase’s internal power pack become low, or fully discharged, it is possible to operate the heater by connecting it to a 12V battery with the external power loom and crocodile clips supplied with the unit.
TIKKA®PRO headlamp – Petzl
Carbon fibre hovercraft – Hov Pod
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www.hovercraft.org The new Carbon Infinity 120HP Turbo seven-seater hovercraft from Hov Pod has out-performed the company’s expectations in recent test field results. The seven-seater Hov Pod Carbon Infinity, the world’s first production carbon fibre hovercraft, can pick up 500kg in weight from an on-water start, subject to operating conditions. From land it will lift 675kg in weight. The performance is made possible by the selection of lightweight materials including carbon fibre / Kevlar and HDPE, materials that provide strength while reducing weight.
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www.petzl.com A newcomer to Petzl’s line of professional headlamps, the TIKKA®PRO is compact and lightweight yet doesn’t miss out on all the essential qualities that are expected of a headlamp: power, burn time and durability. With a weight of only 85g and an ultra-compact shape, the TIKKA®PRO headlamp is ideal for temporary proximity lighting that allows working in a dark environment. Thanks to its two lighting modes, the headlamp offers efficient lighting, whether for proximity lighting needs or for moving across short distances. Its maximum light output is 100 lumens, and its burn time attains 180 hours. The headlamp’s push-button allows easy and rapid selection of the lighting mode, its elastic headband is easy to adjust and its battery case opens easily for battery replacement. Thanks to the KIT ADAPT accessory (not included), TIKKA®PRO may be worn on any type of helmet, keeping all of its options for adjusting the tilt of the headlamp.
New website – Excelerate Group
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www.excelerate-group.com Excelerate Group, a leading provider of real time data, video and voice via satellite and wireless solutions, has launched a new global website. The site provides an accessible platform for visitors around the world to browse benefits-led information about the company’s products and services. Visitors to the site can gain greater insight into the applications of Excelerate’s solutions in the emergency services and local and central government. They can also learn about the application of the company’s solutions in commercial sectors such as transport, oil and gas, and security. The site includes live social media feeds and an upcoming events schedule and is optimised for viewing on all devices, including smartphones and tablets.
www.emergencyservicestimes.com
April 2015
ESTCLASSIFIED | 59
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www.emergencyservicestimes.com
April 2015
60 | ESTLAST WORDS
Do first responders need to wear body armour? In today’s world, firefighters and paramedics no longer face only the risks inherent in their work, but also the threat of attack. Across England and the United States, shocking reports of crews being assaulted with bottles, fireworks, and even – in rare cases – guns continue to make the news: for most people, the idea of standing in the way of any emergency service worker as they try to do their job is unthinkable, yet a minority of thugs find it amusing. Furthermore, with terrorism continuing to pose a threat across the globe, emergency services need to ensure their workers are protected against larger dangers outside of their everyday expectations. Words: Chris Taylor, an expert in body armour and bullet proof vests for SafeGuard Clothing. Following the devastating Charlie Hebdo massacre that shocked Paris, and the rest of the world, on 7 January 2015, Europe remains on high alert for further atrocities. Police, paramedics, and – if needed – firefighters are first responders to emergency situations, and they may know few details before they arrive on the scene. While police officers might be armed and clad in body armour, paramedics and firefighters may simply be wearing their standard gear – leaving them exposed to extreme dangers they may not expect. To help all first responders stay as safe as possible in the face of unpredictable and dangerous risks, body armour should be available at all times, to all who need it. In January 2015, special units were formed within British fire and ambulance crews, with certain workers trained in the proper use of body armour, treating ballistic trauma, and more, in preparation for potential future terrorist attacks. This is to ensure crews remain safe as they tend to injuries and extinguish blazes in ‘warm zones’ (areas in which attacks have taken place and may see further activity), though they are not expected to enter ‘hot zones’, where danger is absolute. Beyond this, many first responders have been issued with body armour, in the event of an attack.
Identifying the key types of armour Three types of body armour are produced today: ballistic, edged blade and spike. Each is designed to protect the wearer against a specific threat, with multiple levels available within each type to accommodate the varying levels of expected danger. These levels are assigned to each vest following stringent testing by both the UK’s Home Office Scientific Development Branch and the USA’s National Institute of Justice (NIJ), based on the amount of protection they provide against specific weapons and ammunition.
Covert bullet proof vests carrier with velcro.
www.emergencyservicestimes.com
Ballistic armour (otherwise known as bulletproof vests) is made with Kevlar, and is designed to stop certain bullets by absorbing their energy on impact, before dispersing it throughout the materials, flattening the tip in the process. These are available in six levels: the first four levels are classed as soft armours, as they’re made with multiple layers of Kevlar, and feature no rigid plates whereas hard armours are designed for more extreme threats.
“Body armour should be available at all times, to all who need it.” This range covers most types of ammunition, from more common 9mm bullets to armour-piercing rifle rounds – the more protection a vest offers, the heavier and bulkier it is. However, in most situations involving suspected or actual terrorist activity, firefighters and paramedics may not know exactly how much danger they could face, and how advanced the suspects’ weapons are: are they carrying handguns or assault rifles? Sub-machine guns? Or grenades? Wearing the toughest armour available is typically the best approach.
Lightweight and comfortable Some first responders may expect wearing thick bulletproof vests as well as firefighters’ gear – oxygen masks and tanks, helmets etc – to add extra weight; while paramedics may expect treating patients to be made more difficult, but they would be surprised by how lightweight and comfortable even the thickest ballistic armour is today. Regardless, such considerations are outweighed by necessity: if extreme gunfire appears a viable risk, wearing a level III or IV vest (both of which carry ballistic plates, alongside multiple layers of Kevlar, to stop high-velocity rifle-fire) is vital. Edged blade armour is designed to protect you against knives and other sharp objects, featuring multiple layers of tightly-woven Kevlar to cause friction against the blade, preventing it from tearing through. These are available in three levels, based on the varying amounts of force attackers may use. Many stab vests also feature spike protection, to stop attacks made with pointed items, such as hypodermic needles or shivs; these vests have an extra-tight weave, to trap the tips before they can pass between the fibres, as they would in standard clothing.
Photo: iStockphoto.com
Stab and spike protection is typically worn by paramedics working in areas with high crime-rates or when expecting a hostile response. As most terrorist threats today involve gunfire or explosives, emergency crews are best wearing more resilient armour, though stab and spike protection could be added to ballistic vests for more comprehensive protection.
Is fit Important? In a word, yes. When you wear body armour, it absolutely has to be the right fit for your shape, otherwise you may leave yourself exposed to danger in ways you might not expect. For example, if you choose a vest which is too big for your size, you’ll find it pushes up into your throat or drops away from your chest at times – a terrible distraction when you need it least; likewise, a vest which is too small may prove highly uncomfortable, digging into your skin or leaving you feeling restricted.
Preventing loss of life To get the most out of your armour, you need to feel as if you can move exactly as you have to – whether to run, give chase, defend yourself against physical assault, or, in the case of police officers, forcibly restrain a suspect. To be sure you get the best size, measure your height and chest before you order, and check these against your supplier's size chart – never be afraid to seek expert advice before you buy. As emergency services are essential to preventing loss of life in violent situations, first responders should be given access to the very best body armour and protective accessories available, to ensure they remain as safe as possible while aiding those in desperate need.
www.safeguardarmour.co.uk
April 2015