Volume 31 No. 2
April 2016
DEDICATED TO THE AMBULANCE SERVICE AND ITS SUPPLIERS
In this issue A concise history of ambulance services in Britain What would the ambulance service look like in 2020? 31 years in the ambulance service
www.ambulanceukonline.com
CONTENTS
CONTENTS 44
EDITOR’S COMMENT
47
FEATURES
47 A Concise History of Ambulance Services in Britain
56 What would the Ambulance Service look like in 2020 - ‘perfect vision?’
Ambulance UK This issue edited by: Barry Johns c/o Media Publishing Company 48 High Street SWANLEY BR8 8BQ ADVERTISING & CIRCULATION: Media Publishing Company Media House, 48 High Street SWANLEY, Kent, BR8 8BQ
58 31 years in the ambulance service – a personal perspective 60
NEWSLINE
84
IN PERSON
87
THE CLASSIFIED SITE
Tel: 01322 660434 Fax: 01322 666539 E: info@mediapublishingcompany.com www.ambulanceukonline.com PUBLISHED BI-MONTHLY: February, April, June, August, October, December COPYRIGHT: Media Publishing Company Media House 48 High Street SWANLEY, Kent, BR8 8BQ
COVER STORY Everything you need in an emergency SP Services (UK) Ltd have been awarded Approved Supplier Status on the NHS Ambulance Procurement Group Framework Agreement for Minor Medical Equipment, Consumables and Associated Products. The Framework Agreement provides UK Ambulance Trusts with a fully compliant route to market so that they can purchase with confidence from a reputable and approved supplier in the knowledge that they are receiving the best value for money.
PUBLISHERS STATEMENT: The views and opinions expressed in this issue are not necessarily those of the Publisher, the Editors or Media Publishing Company. Next Issue June 2016 Subscription Information – April 2016 Ambulance UK is available through a personal, company or institutional
Steve Bray, Managing Director stated “We have been supplying the NHS Ambulance Service for many years and being part of the Framework Agreement means that procurement is now even easier. It allows us to supply our entire portfolio of products to the 12 NHS Ambulance Trusts who can purchase safe in the knowledge that they are fully compliant with EU Procurement Regulations, local Standing Financial Instructions and eliminating the need for multiple quotations and the utilisation of systems such as MultiQuote. Being a part of the Framework Agreement reinforces our position as one of the leading UK suppliers of emergency medical equipment and consumables and allows us to deliver even better value for money to our NHS Ambulance customers.
subscription in both the UK and overseas.
Steve added “We are also able to offer additional volume discounts based on pallet order quantities to Trusts that are able to handle bulk deliveries, thereby passing on even greater savings.”
cards. Please ask for details.
UK: Individuals - £24.00 (inc postage) Companies - £60.00 (inc postage) Rest of the World: £50.00 (inc. surface postage) £75.00 (airmail) We are also able to process your subscriptions via most major credit
payable to MEDIA PUBLISHING.
Since the Framework Agreement went live at the end of 2015 we have seen a significant increase in enquiries from the Ambulance Trusts which has in turn has lead to increased orders and increased savings for the Trusts.
Designed in the UK by Hansell Design
AMBULANCE UK - APRIL
Cheques should be made
Steve and the team look forward to continuing to serve all of our customers, old and new, throughout this exciting year ahead.
43 Do you have anything you would like to add or include? Please contact us and let us know.
EDITOR’S COMMENT
EDITOR’S COMMENT Welcome to the April 2016 edition of Ambulance UK, and although we are coming into lighter evenings, spring like weather and a new financial year, it would appear that the pressures within the NHS will continue to dominate the ‘headlines’. The 2016 Budget, whilst warmly welcomed, in terms of the granting of £4.5 million towards the introduction of a new air ambulance service in Northern Ireland (making this the 38th dedicated Helicopter Emergency Medical Service (HEMS) in the UK), it did little else in easing the financial pressures and concerns that are, or will be, facing Ambulance Trusts in the year ahead. The announcement of redundancies within the West Midlands Ambulance Service (WMAS), as part of a £20 million savings package, is perhaps a stark illustration of the ‘difficult waters’ that lie ahead.
AMBULANCE UK - APRIL
“The tragic incident in Brussels on the 22nd March 2016, serves as a constant reminder of how the emergency medical services, and other blue light services, must be in a state of constant readiness, in order to respond effectively to the human impact of such atrocities.”
As we enter a new financial year, it provides the opportunity to look forward to 2020 and consider, despite the continuing presence of fiscal and operational pressures, what developments and opportunities, will present themselves to the Ambulance Sector, as the NHS strives to introduce a true 24/7 Health Service and continue the paradigm shift to providing more integrated, or converged care, within the community setting. Three feature articles ‘within this edition, look at firstly, the re-produced ‘Concise History of the Ambulance Service in Britain, secondly, a ‘personal reflection’ by the retiring CEO of the North West Ambulance Service, Bob Williams, on his 30 year service career, and thirdly, an interview with NHS Providers on the future role and direction of the service. Of course, all articles indicate what a significant transformation has taken place within the service over the past 40 years, and illustrates how it can now play a pivotal role in the future delivery of a clinically effective and cost efficient pre-hospital care services. The tragic incident in Brussels on the 22nd March 2016, serves as a constant reminder of how the emergency medical services, and other blue light services, must be in a state of constant readiness, in order to respond effectively to the human impact of such atrocities. We are fortunate to read within each edition of Ambulance UK the numerous day to day ‘heroics’ of the modern day ambulance service, and therefore, we must ensure that we continue to deliver a service that is fit for purpose’ both in the public safety, as well as the public health, environment. It’s really difficult to see how the next twelve months will feel any different, as sustainability remains key, and no doubt, the ambulance service landscape will continue to evolve and change, as politicians and key influencers continue to search for those policies that will facilitate the shift in the way that the providers of pre-hospital emergency and community care can effectively respond to the needs of all the patients. However, as commented at the beginning of the editorial, April marks the beginning of a new period, and therefore, let us focus on what represents best operational and clinical practice, and develop a service wide cultural attitude that embraces and values the role of the service, and one which is totally focussed on improved patient outcomes by delivering the right level of care in the right place at the right time.
Barry Johns, Co-Editor Ambulance UK
44 For further recruitment vacancies visit: www.ambulanceukonline.com
NEW
Advancing Acute Pain Management
At last, PENTHROX® is here...
Fast, effective pain management designed for fast, efficient patient management. PENTHROX is indicated for the emergency relief of moderate to severe pain in conscious adult patients with trauma and associated pain1
Now there’s a new PCA* in a lightweight, portable, handheld inhaler for emergency relief of moderate to severe pain in conscious adults with trauma. With minimal set-up and no need for cylinders, cannulas or mandatory opioid-related A&E attendances, PENTHROX offers you the potential to reduce dedicated treatment time and improve patient management. less than 3 months, may increase the potential for hepatic injury. Cautious clinical judgement should be exercised when PENTHROX is to be used more frequently than on one occasion every 3 months. Potential effects on blood pressure and heart rate are known class-effects of high-dose methoxyflurane used in anaesthesia and other anaesthetics. Caution required in elderly due to possible reduction in blood pressure. Potential CNS effects such as sedation, euphoria, amnesia, ability to concentrate, altered sensorimotor co-ordination and change in mood are known class-effects. The CNS effects can be a risk factor for potential abuse. To reduce occupational exposure to methoxyflurane, the PENTHROX Inhaler should always be used with the AC Chamber which adsorbs exhaled methoxyflurane. Multiple use of PENTHROX Inhaler without the AC Chamber creates additional risk. Elevation of liver enzymes, blood urea nitrogen and serum uric acid have been reported in exposed maternity ward staff when methoxyflurane was used in the past at the time of labour and delivery. PENTHROX is not appropriate for providing relief of break-through pain/ exacerbations in chronic pain conditions or for the relief of trauma related pain in closely repeated episodes for the same patient. Interactions: Methoxyflurane is metabolised by the CYP 450 enzymes, particularly CYP 2E1 and to some extent CYP 2A6. It is possible that enzyme inducers (such as alcohol or isoniazid for CYP 2E1 and phenobarbital or rifampicin for CYP 2A6) which increase the rate of methoxyflurane metabolism might increase its potential toxicity and they should be avoided concomitantly with methoxyflurane. Concomitant use of PENTHROX with CNS depressants, such as opioids, sedatives or hypnotics, general anaesthetics, phenothiazines, tranquillisers, skeletal muscle relaxants, sedating antihistamines and alcohol may produce additive depressant effects. If opioids are given concomitantly with PENTHROX, the patient should be observed closely. Concomitant use of methoxyflurane with medicines (eg contrast agents and some antibiotics) which are known to have a nephrotoxic effect should be avoided as there may be an additive effect on nephrotoxicity; tetracycline, gentamicin, colistin, polymyxin B and amphotericin B have known nephrotoxic potential. Sevoflurane anaesthesia should be avoided following methoxyflurane analgesia, as sevoflurane increases serum fluoride levels and methoxyflurane nephrotoxicity is associated with raised serum fluoride. When methoxyflurane was used for anaesthesia at the higher doses of 40–60mL, there were reports of drug interaction with hepatic enzyme inducers (eg barbiturates) increasing metabolism of methoxyflurane and resulting in a few reported cases of nephrotoxicity; reduction of renal blood flow and hence anticipated enhanced renal effect when used in combination with drugs (eg barbiturates) reducing cardiac output; and class effect on cardiac depression, which may be enhanced by other cardiac depressant drugs, eg intravenous practolol during cardiac surgery. Fertility, pregnancy and lactation: No clinical data on effects of methoxyflurane on fertility are available. As with all medicines care should be exercised when administered during pregnancy especially the first
trimester. There is insufficient information on the excretion of methoxyflurane in human milk. Caution should be exercised when methoxyflurane is administered to a nursing mother. Effects on ability to drive and use machines: Methoxyflurane may have a minor influence on the ability to drive and use machines. Patients should be advised not to drive or operate machinery if they are feeling drowsy or dizzy. Undesirable effects: The most common non-serious reactions are CNS type reactions such as dizziness and somnolence (≥1/100 to <1/10) and are generally easily reversible. Serious dose-related nephrotoxicity has only been associated with methoxyflurane when used in large doses over prolonged periods during general anaesthesia. Adverse drug reactions observed in PENTHROX clinical trials in analgesia: Common (≥1/100 to <1/10): Amnesia, anxiety, depression, dizziness, dysarthria, dysgeusia, euphoria, headache, sensory neuropathy, somnolence, hypotension, coughing, dry mouth, nausea, feeling drunk, sweating; uncommon (≥1/1,000 to <1/100): paraesthesia, diplopia, oral discomfort, fatigue, feeling abnormal, increased appetite and shivering. Post-marketing experience: rare (≥1/10,000 to <1/1,000) reports of hepatic failure/hepatitis have been observed with analgesic use of methoxyflurane. Other events linked to methoxyflurane use in analgesia include drowsiness, agitation, restlessness, dissociation, affect lability, disorientation, altered state of consciousness, choking, hypoxia, oxygen saturation decreased, blood pressure fluctuation, vomiting, hepatitis, increased liver enzymes, jaundice, liver injury, increased serum uric acid, urea nitrogen and creatinine, renal failure, blurred vision and nystagmus. Overdose: Refer to SPC. Legal Category: POM. NHS Price: £17.89. Marketing Authorisation Holder: Medical Developments UK Limited c/o Price Bailey LLP, Causeway House, 1 Dane Street, Bishop’s Stortford, Herts, CM23 3BT, United Kingdom. MA Number: PL 42467/0001. Full prescribing information available from: Galen Limited, Seagoe Industrial Estate, Craigavon, BT63 5UA, United Kingdom. Date of Preparation: November 2015.
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Galen Limited on 028 3833 4974 and select the customer services option, or e-mail customer.services@galen-pharma.com. Medical information enquiries should also be directed to Galen Limited.
AMBULANCE UK - APRIL
PENTHROX 3mL inhalation vapour, liquid: Please refer to the Summary of Product Characteristics (SPC) before prescribing. Abbreviated Prescribing Information. Presentation: Each vial of PENTHROX contains 3mL of methoxyflurane 99.9%, a clear, almost colourless, volatile liquid, with a characteristic fruity odour. Each PENTHROX combination pack consists of one 3mL bottle, one PENTHROX Inhaler and one Activated Carbon (AC) chamber. Indications: Emergency relief of moderate to severe pain in conscious adult patients with trauma and associated pain. Dosage and administration: PENTHROX should be selfadministered under supervision of a person trained in its administration, using the hand held PENTHROX Inhaler. Adults: One bottle of 3mL PENTHROX to be vaporised in a PENTHROX Inhaler. On finishing the 3mL dose, another 3mL may be used. The dose should not exceed 6mL in a single administration. Methoxyflurane may cause renal failure if the recommended dose is exceeded. The lowest effective dosage to provide analgesia should be used. Onset of pain relief is rapid and occurs after 6-10 inhalations. Patients are able to titrate the amount of PENTHROX inhaled and should be instructed to inhale intermittently to achieve adequate analgesia. Continuous inhalation provides analgesic relief for up to 25-30 minutes; intermittent inhalation may provide longer analgesic relief. Administration on consecutive days is not recommended and the total dose to a patient in a week should not exceed 15mL. Children: PENTHROX should not be used in children under 18 years. For detailed information on the method of administration refer to the SPC. Contraindications: Use as an anaesthetic agent. Hypersensitivity to PENTHROX or any fluorinated anaesthetic. Patients with known or genetically susceptible to malignant hyperthermia or a history of severe adverse reactions in either patient or relatives. Patients who have a history of showing signs of liver damage after previous methoxyflurane use or halogenated hydrocarbon anaesthesia. Clinically significant renal impairment. Altered level of consciousness due to any cause including head injury, drugs or alcohol. Clinically evident cardiovascular instability. Clinically evident respiratory depression. Warnings and Precautions: Methoxyflurane causes significant nephrotoxicity at high doses. Nephrotoxicity is also related to the rate of metabolism. Factors that increase the rate of metabolism such as drugs that induce hepatic enzymes can increase the risk of toxicity with methoxyflurane as well as sub-groups of people with genetic variations that may result in fast metaboliser status. The lowest effective dose should be administered, especially in the elderly or patients with other known risk factors of renal disease. Methoxyflurane should be cautiously used in patients with conditions that would pre-dispose to renal injury. Methoxyflurane is metabolised in the liver, therefore increased exposures in patients with hepatic impairment can cause toxicity. PENTHROX should be used with care in patients with underlying hepatic conditions or with risks for hepatic dysfunction. Previous exposure to halogenated hydrocarbon anaesthetics (including methoxyflurane when used as an anaesthetic agent), especially if the interval is
Reference: 1. Penthrox Summary of Product Characteristics. October 2015. Date of preparation: December 2015. PMR-JUL-2015-0239
Before administering PENTHROX, make sure you have read and fully understood the SmPC and educational materials, which provide important information about how to safely use the device to minimise risk of serious side effects. PENTHROX educational materials and training on its administration are available from Galen on request. *PENTHROX should be self-administered under supervision of a person trained in its administration, using the handheld PENTHROX Inhaler.1
For all your equipment needs visit: www.ambulanceservicesuppliers.com
45
FEATURE
ÂŁ
AMBULANCE UK - APRIL
46 For further recruitment vacancies visit: www.ambulanceukonline.com
FEATURE
A CONCISE HISTORY OF AMBULANCE SERVICES IN BRITAIN By M L Burr, MB, BS, DPH, DObstRCOG Medical Officer of Health, Stone Urban and Rural Districts, Assistant County Medical Officer, Staffordshire
Preface: This account of the history of ambulance services in Britain was originally published in April 1969 in ‘The Medical Officer’ (vol 121: 228-35). It is reproduced by kind permission of its author, Dr M L Burr, a former Medical Officer of Health in Staffordshire and through the good offices of Professor Douglas Chamberlain.
Early methods of conveying the sick and wounded Primitive Forms of Sick Transport The ambulance services in any country usually spring from two main sources – the conveyance of wounded soldiers in wartime, and the need for specific transport for infectious patients to avoid infecting the healthy. The first specific provision for the wounded in Britain was probably in the Roman army, which employed eight or ten strong men in each troop of 200-400 to ride behind the fighting line and pick up the injured. They were provided with bandages and water-bottles, and received a piece of gold for every life they saved (Bird 1913). The defeated Britons – according to Tacitus (Agricola 38.1) – dragged away their wounded at night after the battle of Mons Graupius. In Anglo-Saxon and medieval England invalids of rank used the horselitter when travelling, humbler patients being conveyed in a cart if one was available. Bede refers to both these methods of sick transport being used in the seventh century (Eccles. Hist, III 9, IV 6; Lives of Abbots 22), and many other examples occur throughout the Middle Ages. The Anglo-Saxons also used a hammock suspended in a wheeled frame,
This was unheeded, however, and in the 17th century Civil War there was still no proper ambulance service. The victorious soldiers would remove their wounded colleagues after a battle in such wagons as were available, and the local inhabitants were ordered to care for the enemy’s casualties. The Pest-coach During the outbreaks of plague in the 17th century “pesthouses” were erected outside the towns for the isolation of patients. One of the earliest references to a feverambulance is by Godskall (1603): “In the time of plague, there is appointed a Waggon or Coache to carrie the sicke to the Pest-house, and there to be healed.” Pepys in his Diary (3rd August, 1665) describes one of the pestcoaches, with curtains drawn, taking a maid suspected of having the plague back to the pest-house from which she had escaped. Many patients were still conveyed in unsuitable ways, however, so that Mead (1722), in outlining measures to be taken to control plague, advised that “all possible Care should be taken to provide such means of Conveyance for the Sick, that they may receive no Injury.” Conveyances for General Hospitals
but how widely it was available is not known.
Some of the provincial hospitals founded in the 18th century were
The 14th century chare and the 16th century coach were sometimes
ambulances. For example, the Staffordshire General Infirmary’s first
used by the more affluent invalids, but owing to the state of the roads
over a hundred years ahead of those in the larger towns in providing Annual Report in 1767 records:- “The Trustees have provided a Carriage
they must have had most uncomfortable rides.
hung upon Springs, to be drawn by one or more Horses, for the
At the surrender of Malaga in 1487 a field hospital, conveyed in 400
that the Patient may either sit up or lie at length. It is always in Readiness
“ambulancias”, was provided by Isabella of Castile. This “Queen’s
when applied for.”
conveyance of the sick or maimed from any distance, in such a manner,
system was advocated for England by Digges(1590) :-
Sick Transport during Epidemics In 1783 hospital wards were first set aside for fever patients by Haygarth
“It were convenient to appoint certaine carriages and men, of purpose to
in Chester. He issued a set of Rules of Safety for preventing the spread
give their attention in every skirmishe and incounter, to carry away the hurt
of typhus, then very prevalent. Patients were to be immediately carried to
men to such a place as Surgions may immediately repayre unto them.”
the hospital “in a sedan chair of a peculiar colour, to be employed solely for this purpose, with a moveable linen lining, which is always to be taken
This, he said, greatly encourages the soldiers, relieves them of the
out and shaken in the fresh air after it has been used, and to be frequently
distraction of attending to the wounded during the battle, and conceals
washed.” This chair was so constructed that it could be adjusted to
their losses from the enemy, “a matter of no small importance”.
provide a recumbent or semi-recumbent position (Haygarth 1818).
AMBULANCE UK - APRIL
hospital” appeared again at the siege of Granada in 1489, and a similar
47 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE These measures were so successful that when “Houses of
A British branch of the Red Cross, then known officially as the National
Recovery” opened in Manchester (1796), London (1802), and
Society for aid to the Sick and Wounded, was founded through the
elsewhere, a sedan chair was installed at each for the free transport
efforts of Furley and others of the Order in 1870. This did important
of patients (Ferriar 1810, London Fever Hospital 1803).
work during the Franco-Prussian War, although Furley was arrested and almost shot as a spy.
A fever hospital was provided in Glasgow from March 1818 to July 1819 owing to a severe epidemic of what was probably relapsing
The experiences of the wars aroused an awareness of the need for a
fever. “At first, Sedan Chairs were used for conveying the sick to the
regular ambulance service in civil life. The Order of St. John became
Hospital; these were replaced by a low hung Chaise, and latterly a
very concerned about this, and in 1872 it attempted to obtain the co-
covered Litter on springs was substituted.” (Cleland 1820).
operation of the London hospitals in establishing ambulance training for laymen (Fletcher 1949). It was suggested that a three months’ course
Similar method were used for transporting smallpox patients. Later
in surgery could be arranged by the hospitals as part of a training
the “smallpox cab” appeared, often kept with ordinary cabs and
scheme for ambulance staff, but the hospitals were not interested and
sometimes interchanged with them, so that it fell under suspicion of
the scheme came to nothing. It is strange to reflect that nearly a century
spreading the disease.
later there is still no national course for training ambulance workers.
Temporary hospitals were provided in many places during the
The large number of accidental injuries occurring in the mines and factories
cholera epidemic of 1832. In Bilston a horse and covered carriage
led to the establishing of ambulance stations in the industrial areas. The first
were obtained to convey patients to the hospital, but the driver
to be opened was at Burslem in 1873, and was soon followed by others.
succumbed to the disease.
Each was equipped with a two-wheeled litter and other ambulance material, being manned at first by staff trained in the Army.
“He had been repeatedly warned... on no account to ride with the sick but walk by the side of his horse; the advice was not followed,
In 1877 the St. John Ambulance Association was founded with two main
and he perished in the fortieth year of his age” (Leigh 1833).
objects – instruction in first aid, and spread of useful ambulance material.
Patients placed in the Manchester cholera van were so terrified
Classes were started all over the country for teaching of first aid, and
by its hearse-like appearance that their condition was said to
gradually Ambulance Corps sprang up. “Ambulance Crusades” were held
deteriorate noticeably (Gaulter 1833). These various forms of sick
in different areas to promote the spread of the Ambulance Movement.
transport were thus mostly of a temporary nature, discontinued as One of the principal medical pioneers in this field was Dr. James Cantlie,
soon as each particular epidemic was over.
who helped to write the first textbook on first aid in 1880. The following The start of regular ambulance services
year he organized the first public demonstration, which was witnessed
It is to the wars of the 19th century that we really owe our
by doctors from Germany, Spain, and Russia, and led to the introduction
ambulance services. Throughout the Napoleonic wars the British
of civilian ambulance work into those countries.
had no light ambulance* carriages like Baron Larrey’s voitures Early Ambulance Equipment
d’ambulance in the French army.
Furley designed a strong lightweight stretcher to replace the Disturbed by the primitive condition of sick transport, a veterinary
cumbersome devices then in use. When attached to a two-wheeled
surgeon named Cherry designed a collapsible dual-purpose cart; it
undercarriage and fitted with hood and apron it became the two-
was fitted with springs, which were used when it carried stretchers
wheeled litter or hand ambulance.
or sitting patients, but not when conveying heavy goods. A prototype was sent for trial to Chatham Hospital in 1820 and found
One variety could also be drawn by a donkey or pony, while another
to be quite satisfactory. Other conveyances were similarly invented
type could be fixed between two tandem bicycles. Various horse
and tried out in various British hospitals (Longmore 1869).
ambulances 1 existed, from small ones taking only one stretcher with attendant to the “four-in-hand” smallpox ambulances used at one time by the Metropolitan Asylums Board (MAB) in London.
The Red Cross and the Order of St John An international conference was called in 1863 by Henri Dunant,
AMBULANCE UK - APRIL
who had been greatly influenced by the work of Florence
In 1884 Furley recommended the formation in London of a permanent
Nightingale in the Crimean War, and by his own experiences at
“Ambulance Museum” containing displays of ambulance material, under
the battle of Solferino in 1859. This resulted in the founding of the
a committee to recommend selection and changes in design. This
International Red Cross movement, and the formation in many
was not carried out, and the ensuing absence of standardization has
countries of national societies affiliated to it.
persisted ever since.
The English branch of the order of the Hospital of St. John
The Liverpool Ambulance Service
of Jerusalem had been revived in 1831. Having had an
In 1881 Reginald Harrison, a surgeon, visited the United States to
ancient tradition of hospital work it was represented at this
investigate ambulance services there. He found that certain American
first conference by John (later Sir John) Furley, under whose
cities had developed a service of horse-drawn ambulances, well
leadership it developed its important role in the ambulance
equipped for first aid, which was quite unlike anything in this country.
services of Britain.
The New York service had started in 1869 and was based on the
48 For more news visit: www.ambulanceukonline.com
FEATURE hospitals, from which a surgeon always accompanied the ambulance
Ambulances for Infectious Patients
on its calls. It was kept ready for immediate use, and thus could be at
The 1866 Sanitary Act permitted the Nuisance Authorities to provide
the scene of an accident within a few minutes of being called.
carriages to take infectious patients to the hospitals set up under the same Act. The Local Government Board issued an official memorandum
On his return Harrison addressed the Liverpool Medical Institution
in 1876 containing advice on the type of ambulances needed. In 1893
and urged the necessity of establishing a similar service in Liverpool.
the County Councils were empowered to set up Isolation Hospitals and
The result was that in 1884 a horse ambulance designed by Furley
required to attach ambulances to them.
was installed at the Northern Hospital, Liverpool, constantly ready for emergencies. During its first year this service conveyed 580 patients to
A marked stigma was associated with these ambulances, however;
hospital, the average time between call and departure of the ambulance
the urchins ran behind them shouting “Fever!”, and patients refused
being two minutes (day) and four minutes (night). This appears to have
to travel in them. This “extreme sensitiveness of public feeling”
been the first municipal ambulance service in this country and was a
(Parsons 1914) was so widespread that vehicles were built resembling
great success, gradually increasing its scope. The vehicles belonged
broughams externally but opening at the back to admit a recumbent
to and were driven by the police, but were attached to the Liverpool
patient, whose feet went under the driver’s seat. These “broughams”,
hospitals for many years (Harrison 1904).
having no outward indication of their nature, became the usual fever ambulances, ultimately giving way to motor broughams constructed on
Other towns followed, so that by 1902 there were at least 16 English
similar lines.
towns providing a horse ambulance service, run either by the police, the fire brigade, or the hospitals, while many others had hand ambulances
The formation of the London Ambulance Service
installed at police stations (LCC 1902).
Perturbed by the inadequate ambulance services available in London, the London County Council (LCC) set up a sub-committee under Sir
The St. Andrew’s Ambulance Association
William Collins to investigate. It reported in 1902, the situation being
In 1882 the St. Andrew’s Ambulance Association was formed in
then as follows:-
Glasgow, and started work there with an ambulance wagon bought by public subscription.
A. Infectious diseases
The MAB had first used ambulances for smallpox patients,
The secretary at once publicized the service by having the ambulance
who were conveyed to wharves on the Thames and then taken
driven furiously so as to attract attention. “At all times of the day it could
downstream by special steamers to recuperate in an old warship.
be seen careering through our streets on imaginary journeys at a break-
In time the service had expanded, and by 1901 the Board had 100
neck speed, the secretary himself not infrequently accompanying it,
horse ambulances, which could take any infectious patients from home to a suitable hospital.
seated beside the driver or standing up on the footboard, gesticulating wildly, and blowing a shrill-sounding whistle... Its performance... became
B. Non-infectious invalids
a matter of notoriety and got on the public nerves... the result being that
Vehicles available for hire were owned by the St. John Ambulance Brigade, the Boards of Guardians, hospitals, railway companies,
a less demonstrative attitude was taken up” (Beatson 1910).
and private persons. Gradually the work spread to other Scottish towns, and in 1905 the
C. Accidents and sudden illness in the street
Association pioneered the use of motor ambulances in its Glasgow service.
(1) The St. John Ambulance Brigade provided wagons at public gatherings or on hire. They possessed 25 stations with litters and first-aid equipment but only three of these were staffed.
Rural Services In country districts the provision of ambulances depended largely on
(2) The Bischoffsheim or Hospitals Association Street Ambulance
local enthusiasm, sometimes being supplied by an individual of private
Service was founded in 1889 by the Secretary of St. Mary’s Hospital
means. One such service was organized by Sir Thomas (later Lord) and
and Mr. H. L. Bischoffsheim, being equipped and conducted solely
Lady Brassey, who provided an ambulance centre at Battle, Sussex,
at the latter’s expense. This service provided wheeled litters and
connected by telephone with 12 outlying parishes at each of which were
first-aid appliances in weatherproof sheds, situated at cab-ranks,
posted various appliances (Evatt 1884).
street corners, fire and police stations, and hospitals. At its peak there were 80 such stations, at which over 2,000 cases were treated
The St. John Ambulance Brigade
annually. No attendants were supplied, the object being to provide
The transport of patients to and from hospital has always been a
the means of first aid and transport for the use of the cabrank
the inauguration by the St. John Ambulance Association of “Invalid
(3) The Volunteer Medical Staff Corps, founded by Cantlie, was
Transport Corps” in 1882, which conveyed the poor free of charge and
a military reserve force formed mainly from medical students. It
others for a small fee. These existed in various parts of the country and
assisted the police at special occasions only.
were manned by paid staff or volunteers.
(4) “The London Ambulance Service” – an imposing title which at this time represented a dismal story of failure to start a regular
In 1887 the various Corps of certificated pupils of the St. John
ambulance service in London. In 1882 money was raised by public
Ambulance Association banded together to form the Brigade. This
subscription to provide three small horse ambulances, under a
provided a horse ambulance, equipment, and staff for Queen Victoria’s
committee whose President was the Duke of Cambridge; the
Diamond Jubilee, which took place the same week as its inauguration.
Secretary of the London Hospital acting as Secretary.
AMBULANCE UK - APRIL
attendants and the police.
major part of ambulance work. The need for such a service led to
49 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE
The intention was to form a service run by the hospitals as in
Bischoffsheim died in 1908, and the service he had provided
Liverpool; the hospitals, however, would not support the scheme.
immediately declined through lack of support and ended two years later.
The three ambulances were therefore given to the police and housed at police stations at Stoke Newington, Fulham, and
Formation of an Accident Ambulance Service
Lambeth, together with a hand ambulance of the pony type which
In 1909 the committee reported on the grave defects of the ambulance
was put in the charge of the Vicar of Stepney. Total failure of this
services in London: 70 per cent of casualties arriving at hospitals were
enterprise resulted, firstly because it was not advertised and its
in entirely unsuitable conveyances,and the number of street accidents
existence was unknown to most people; secondly because the
had risen by 60 per cent while it had been sitting. The majority of the
charge for use of an ambulance (five to ten shillings) was more
committee recommended the provision of a unified service by the MAB;
than that for a cab; and, thirdly, since neither horses nor drivers
this was opposed by Collins, who was a member of the committee and
were provided, being obtained when required from contractors.
the LCC and also an MP. He successfully piloted through Parliament a
Thus the ambulances were never ready for immediate use, and it
Bill conferring the requisite powers on the LCC. It was not able to obtain
is not surprising that they were infrequently employed (Evatt 1884,
the existing ambulances of the MAB and the Boards of Guardians,
Fletcher 1949).
as Collins intended, so ultimately it started an independent service for accidents and emergencies. This was opened in February, 1915,
Collins’ Recommendations
with the gift by the Grand Duke Michael of Russia of a new motor
Collins included in his Report a summary of the excellent services
ambulance, which was installed at Fulham under the control of the Chief
available elsewhere in the country and abroad. He drew attention
Officer of the Fire Brigade. Five other ambulance stations were opened
to the unsuitable ways in which casualties were arriving at London
later that year, and in December the service dealt with 566 calls (Collins
hospitals, and gave startling numbers of those who were brought in
1920, Daley 1949).
vans, carts, harrows, and bath-chairs, often with disastrous results. He recommended the provision of a complete ambulance service in London with special staff, where possible attached to hospitals and accompanied on calls by senior medical students.
Consolidation and progress The First World War At the outbreak of the First World War the British Red Cross Society and
In 1903 the enterprising MAS acquired a steam ambulance, which
the Order of St. John set up a Joint War Committee to integrate their
contained eight stretchers and was driven at 5 m.p.h. It was so
work. Large numbers of ambulances were acquired, mainly for military
uncomfortable to travel in that it was disposed of the following year, when
use abroad. Others were kept in Britain and used to form “ambulance
a petrol-driven ambulance was obtained, which travelled at 15 m.p.h.
columns” to transport wounded soldiers to various English hospitals.
Gradually motor vehicles replaced the horse ambulances, which were
Since 1912 there had been a “College of Ambulance” in Newcastle
discontinued in 1912. Otherwise the ambulance services in London
upon Tyne where first aid and related subjects were taught.
went from bad to worse. The “London Ambulance Service” wagons wore out and were not replaced, while the Collins Report was entirely
In September, 1914, Cantlie founded a similar College in Vere
ignored (MAB 1904, Powell 1930).
Street, London, independent of both the Red Cross and the St. John Ambulance Association and unconnected with the Newcastle College.
The Metropolitan Street Ambulance Association
He had begun simply by teaching emergency first aid to public classes,
In 1904 the medical profession for the first time became corporately
but saw in his College a national centre for the training and examination
concerned about the first-aid treatment and transport of injured
of ambulance students. During the war the College flourished, about
persons. As a result the Metropolitan Street Ambulance Association
14,000 students being trained in its first three years. It was moved to
was formed, with Harrison (founder of the Liverpool service) as
Queen Anne Street, where Cantlie collected into a Museum all kinds of
President; its members included Lord Lister, Sir Thomas Barlow, the
ambulance models and equipment.
Presidents of the Royal Colleges, and almost all other prominent
AMBULANCE UK - APRIL
doctors in London. It urged the formation of a unified horse ambulance
After the war ended, Cantlie, now knighted for his services to
service run by the LCC and summonable by telephone, its accident
ambulance work, did his utmost to perpetuate the existence of
work being organized in areas each in connection with a hospital. The
the College and endeavoured to raise funds for this purpose. The
Association obtained considerable publicity, and acquired the support
wartime enthusiasm for first aid had passed, however, and many
of almost all candidates in the LCC elections, and of the City Police
believed that ambulances would not be needed in peace-time
(Harrison 1904).
(Ferrier 1951). Furthermore he had to contend with some suspicion on the part of his colleagues in the Red Cross and the St. John
Clauses were included in a Bill in Parliament to effect this scheme,
Ambulance Association, who to some extent regarded this venture
but the Home Office opposed them on grounds of expense and
as a rival. In 1923 the College was sued by a disaffected donor, and
suggested a conference with the LCC. As a result a committee was set
although the case failed Cantlie felt it impossible to advertise further
up to consider the matter. Faced with the prospect of indefinite delay
for funds, so in 1925 the College closed (Cantlie and Seaver 1939).
the Corporation of the City of London started its own highly successful
In retrospect the failure of this College of Ambulance to become
service in 1907 with an electric ambulance, increasing to three when
permanently established seems especially regrettable in view of the
a second station was opened. These were kept in constant readiness
absence of standardization in training and equipment which has
day and night, summonable by telephone from 52 call-boxes.
persisted until the present day.
50 For further recruitment vacancies visit: www.ambulanceukonline.com
FEATURE
Purchase with confidence from SP Services in the knowledge that you are receiving the best value for money.
• • • • • • • • •
Fully compliant route to market OJEU avoidance Competitive prices Extensive product choice Dedicated sales & customer support Prompt delivery Settlement discounts Leading healthcare brands Bespoke products to your specification
For more information call 01952 288 999 or visit www.spservices.co.uk
Do you have anything you would like to add or include in Features? Please contact us and let us know.
AMBULANCE UK - APRIL
Don’t leave it to chance, buy from one of the largest and long established suppliers of emergency medical supplies in the UK. You can rely on us to supply everything you need in an emergency.
Benefits of SP Services
51
FEATURE Formation of a National Ambulance Service
Finance
During the war a large number of ambulances had been acquired
During the inter-war period the financial arrangements were as varied as
for use on the battlefields, and a substantial sum of money had been
the provision of the ambulances. The public services were supported by
collected for their support. With the end of the war these resources
the rates, charges for use being levied to a varying extent and waived
became available for civil purposes, so in 1918 “The Order of St. John
for the very poor.
and British Red Cross Society Act” was passed to allow this change of Some voluntary hospitals provided a service for their own purposes
use.
which was run by their contributory funds. The St. John Ambulance The result was that the two bodies set up a joint Home Service
Brigade charged for the use of their ambulances; one such scale just
Ambulance Committee, which promptly started a scheme for a national
before the Second World War was at 1 shilling (5p) per mile up to 50
ambulance service for England, Wales, and Ireland. The large fleet of
miles, with a minimum of 3 shillings (15p), and other rates for longer
ambulances at their disposal enabled them to plan ambulance stations
journeys.
15 miles apart throughout the land (Fletcher 1949), and in 1920 a Register of Ambulance Stations was printed and circulated nationally.
In some areas an ambulance was paid for by subscribers, each paying
The vehicles were regarded as loaned from the central headquarters
a contribution according to his means which entitled him to use it when
to the local branches, and thus could be recalled or re-distributed in an
necessary.
emergency (Ferrier 1963). In 1926 the St. John Ambulance Brigade began a Road Service Scheme in conjunction with the motoring organizations. This linked up existing ambulance stations by first-aid posts, each consisting of personnel, equipment, and patrols.
Ambulance services during the Second World War Preparatory Measures The Air Raid Precautions Act of 1937 made it a duty of counties and county boroughs to prepare air raid precaution schemes in accordance
Further Developments The LCC gradually expanded its ambulance service, dealing with accidents, urgent non-infectious illnesses, and maternity cases. The staff received lectures by the Medical Officer of Health and were required to have obtained within six months a certificate in first aid given by the LCC, the St. John Ambulance Association, or the Red Cross. Casualties were usually taken to the nearest hospital, whether a Poor Law Infirmary or a voluntary hospital. Some of the hospitals were not adequately equipped to deal with casualties, so in 1924 the King Edward’s Hospital Fund recommended that a list of suitable hospitals should be drawn up, which was done (LCC 1925). In 1930 the MAB was abolished and its work taken over by the LCC, as a result of the Local Government Act, 1929. At this time the Board was the largest user of civil ambulances in the world (Powell 1930), possessing 150 petrol-driven vehicles and six large ambulance stations, open day and night. The LCC had 20 ambulances at this time and 14 ambulance stations. The five river steamers had been
with certain requirements. They were to earmark trade vehicles, and supply them with stretcher-carrying fittings so that they could be taken over and used immediately as part-time ambulances if need arose, continuing their normal work meanwhile. Cars were likewise earmarked for transporting sitting cases. In order to keep hospital beds available in the centres of urban areas, ambulance services were planned both to bring casualties to hospital initially and to take them after treatment to hospitals in the surrounding country. The Situation at the Outbreak of War On 3rd September, 1939, war was declared. At this point the provision of ambulance and related services may be summarized as follows:
(1) The ordinary ambulances and their staff continued their peacetime duties, being generally organized with the National Fire Service.
(2) Inter-hospital ambulances were improvised out of over 1,000
kept to convey smallpox patients from three special wharves to
coaches and 34 railway trains, of which 220 and 21 respectively
the smallpox hospitals at Dartford (which had replaced the old
were for use in London. During the first three weeks of September
ships); they survived for another two years, being popularly known
large numbers of patients were evacuated from hospitals in the
as “Micawber’s Navy”. At the same time the Boards of Guardians
large centres of population to the smaller towns by these means,
were abolished, and the London Poor Law Infirmaries with their
leaving the beds available for the expected airraid casualties. Other
ambulances were acquired by the LCC. A single ambulance service was formed, separate from the Fire Brigade, for all patients
vehicles were supplied by local authorities for the same purpose.
(3) The Civil Defence ambulance services were the responsibility of
AMBULANCE UK - APRIL
in London. Other local authorities similarly acquired the infirmary
local authorities under the general direction of the Ministry of Health.
ambulances, and the larger towns, already possessing a general
Many of the ear-marked vehicles proved to be unsuitable for the
service, unified their ambulance work at this time.
purpose, some had changed ownership and could not be traced, while others had also been earmarked by a Government department.
Since 1907 local authorities had been empowered to provide ambulance services for accidents and emergencies, and in 1925 the
Thus the numbers available were found to be inadequate.
(4) The Joint War Organization of the British Red Cross Society
Public Health Act provided for the conveyance of non-urgent cases.
and the Order of St. John was set up by those bodies on 2nd
These powers were only permissive, so that the resulting provision
September. The ambulances they then possessed were already
of ambulance services varied considerably throughout the country,
in full use, so an appeal for funds was launched to provide further
gradually extending until the outbreak of World War II.
vehicles, equipment, and training.
52 For more news visit: www.ambulanceukonline.com
FEATURE Four other Civil Defence services existed which were not strictly for
Heavy Raids on London
ambulance work and yet were intimately connected with it:-
The fall of France was followed by intensive air raids on London, which subjected the emergency services, until now untested, to the severest
(5) Fixed first-aid posts had been established in various
strain. The ambulance services generally ran remarkably smoothly
premises and amply equipped for first aid and gas
despite the previous inexperience of their staff and the extreme danger
decontamination. They were staffed by volunteers, mostly part-
In which they often worked. The stretcher parties displayed great
time women, the larger posts having a doctor and a trained
bravery in their work, during which many were themselves injured or
nurse also. In rural areas first-aid points, each consisting of
killed. Owing to the great difficulty of quickly removing the aged and
a box of equipment, were established without paid staff at
chronic sick from the old Institutions after bomb damage, the decision
selected centres.
was taken to evacuate all such buildings in the London area. This was
(6) Mobile first-aid units were large motor vehicles containing
done in November, 1940, by 34 special trains, and caused a spate of
first-aid equipment and medical staff, driven from hospitals to
complaints from the evacuees, who preferred the risks of bombing to
“incidents”, as bomb sites were euphemistically called.
being uprooted from their environment. At the beginning of 1941 the
(7) First-aid or stretcher parties were volunteers possessing
raids decreased in severity, but they then increased again until April,
first-aid certificates. Four men with a car, driver, and first-aid
when in one night 1,720 people were killed and 2,030 seriously injured
equipment would proceed to an “incident”; after giving first aid
in London. During this period the Civil Defence and the inter-hospital
they passed casualties on to first-aid posts or ambulances for
ambulance services are said to have been given universal praise
conveyance to hospital, according to the needs of the case.
(Dunn 1952*).
(8) Rescue parties were slightly larger groups of men frequently drawn from the building trade, whose work was to extricate
Heavy Provincial Raids
casualties from damaged buildings and debris.
All the large population centres were bombed about this time, the ambulance and related services performing their vital work throughout
The Early Part of the War
the raids. Several hospitals were damaged, requiring the evacuation of
The absence of bombing at first allowed resources to be fully
their patients by bus ambulances, as in Coventry in November 1940.
organized and training revised in the light of wartime needs. The
The Mill Road Hospital, Liverpool, was completely demolished in May
Joint War Organization gradually acquired a fleet of vehicles, while
1941, and many patients and staff, including 14 ambulance drivers,
the local authorities started buying secondhand cars to supplement
were killed. At such times, when the local resources were strained to
their resources. Unfortunately they were restricted to paying £30
the limit, help was given by the voluntary organizations, which lent
for each purchase, which, combined with rising prices due to the
ambulances and staff. The St. Andrew’s Ambulance Association, who
demand, resulted in their acquiring many unsound old vehicles
had all their usual work to do as well, placed their entire service at
requiring considerable expenditure in maintenance.
the Government’s disposal during the air raids on Scotland until the situation had eased. The Joint War Organization sent 12 ambulances
Trailers were fitted to some ambulances but were found to be
to assist in the Coventry crisis and continued to provide help where it
quite unsuitable for use in debris-strewn streets when the bombing
was needed throughout the war, as did American Ambulance (Great
began.
Britain).
The first spate of military patients was due not to hostilities but to
Lessons from the Raids
epidemics of influenza and rubella, which in early 1940 required
The pre-war training was soon found to have been too meticulous for
many to be brought home to hospitals in England.
wartime conditions, so that too much rather than too little treatment of casualties was attempted on the site. The lack of reciprocal training
A sudden heavy flow of casualties then occurred on the evacuation
of first-aid and rescue parties caused delays in their work, so joint
of the British Expeditionary Force from France in May and June
training was arranged and ultimately the two services were merged
1940. They were carried to hospitals all over the country in
to form the Civil Defence Rescue Service. An improved syllabus of
ambulance trains and coaches, many being taken to the London
instruction, devised to meet the needs of air raids, was taught in
area. At this time the Joint War Organization offered 100 manned
Regional Training Schools, and the senior officials of the services were
ambulances to the Home Forces, which were accepted and
given courses at the Civil Defence Staff College in Surrey.
gradually added to throughout the war (Cambray and Briggs 1949). In November, 1941, the local authority ambulance services were separated from the overall control of the National Fire Service and
In July, 1940, the American Ambulance Organization was
placed under the Civil Defence Ambulance Service. All the casualty
inaugurated by the American Ambassador being financed entirely
work was thus unified under the Medical Officers of Health, and
by private donations from America. This provided 50 ambulances,
the efficiency and morale of the ambulance services improved.
50 cars, and 50 mobile first-aid posts, the last each comprising
Nevertheless many local authorities accommodated their staff “under
two vehicles, one carrying equipment and the other personnel. The
conditions of extreme discomfort and even squalor”, without sleeping
number of ambulances more than doubled in time, and they were
or sanitary provision. Some drivers were obliged to sleep in their
staffed by the organization and by members of the Mechanized
ambulances, and since these were kept in the open without antifreeze
Transport Corps. They took part in all duties of ambulances during
in winter, the engines had to be started at intervals during the night to
the war, especially the inter-hospital transport of patients.
prevent their radiators freezing.
AMBULANCE UK - APRIL
American Ambulance (Great Britain)
53 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE When this became known, the Minister of Health sent a circular to local
cars” (Ministry of Health 1954). Annual costing returns comparing
authorities in June, 1942, expressing concern at these conditions;
the expenses of all ambulance services were published to stimulate
some improvement followed, though still inadequate in many cases
an interest in economy and draw attention to high costs needing
considering the selflessness expected of the staff. In other areas better
investigation. In 1954 the Ministry started surveys of many ambulance
conditions existed, however, both personnel and vehicles being properly
services to see how far their running costs could be reduced.
provided for.
Recommendations were then made to the individual LAs and hospitals concerned.
The Later Period of the War In 1944 and 1945 a renewal of heavy bombing was supplemented
These efforts were rewarded by a fall in the mileage per patient carried
by the arrival of flying bombs and rockets, which caused a time of
and a levelling off in the total numbers carried after 1955.
intense activity. The proportion of injured to dead was much higher than before, requiring many more ambulances at each “incident”, with a
Since 1959 these numbers have risen again, however. The Harrow
corresponding increase in work for the staff. Although the numbers of
and Wealdstone railway disaster occurred in October, 1952, when 274
staff and vehicles had fallen considerably by this time, the experience
casualties were removed by ambulance including 103 who were dead or
gained in the. earlier raids led to a far more efficient use of the resources
dying. Major accidents of this kind have been fortunately rare, however.
available. Following the Normandy invasion a succession of military casualties were brought home to hospitals in England. Eight casualty
The London Ambulance Service
evacuation trains were secretly equipped along the South Coast and
The worst episode for the London service since the war was the
supplemented by ambulances, the Joint War Organization equipping
Lewisham railway accident in December, 1958, when 223 persons were
four of the trains and providing many of the ambulances. Owing to
removed by ambulance, including 85 dead. In 1964 the re-organization
further air raids the London hospitals were evacuated in August, 1944,
of London government resulted in the formation of a single large
13,152 patients being moved by train, many of them to Scotland.
ambulance service covering the entire Greater London area.
After the war ended they had to be brought back, and since the Civil Defence services had been disbanded, their staff were not available as
Rail Transport
previously to provide stretcher bearers at the railway stations. Many who
For long journeys it is often most economical, comfortable, and speedy
had been Civil Defence workers assisted as volunteers, however, and
to transport patients by rail. Recumbent patients are conveyed using
about a hundred Italians supplied the remainder.
special equipment; some difficulties have arisen here owing to the change in design of carriages, those with central corridors being less suitable for this purpose.
The National Health Service Section 27 of the National Health Service Act, 1946, made it a duty for all local health authorities to ensure that ambulances “are available,
Voluntary Services
where necessary, for the conveyance of persons suffering from illness or
As their agency ambulance work has declined, the voluntary bodies
mental defectiveness, or expectant or nursing mothers, from places in
have turned their attention to providing a Hospital Car Service.
their area to places in or out of their area”. Many health authorities then formed their own services with ambulances they already possessed,
This is a service of private cars run by the Red Cross, the St. John
plus others acquired from district authorities, Civil Defence, American
Ambulance Brigade, and the Women’s Voluntary Service, singly or in
Ambulance (Great Britain), and voluntary hospitals. Others relied, wholly
combination. It is used mostly for out-patients and persons going to
or partly, on the St. John Ambulance Brigade and the British Red Cross
training centres, and its members are paid expenses only. In dense
Society to provide services as their agents.
urban areas where traffic and parking are difficult it is unattractive and less supported, but overall it has been gradually increasing its work. The
Local Authority Services
voluntary organizations offer various other services not available under
When this statutory duty came into operation in 1948 there was a rapid
the National Health Service, such as taking the disabled and elderly on
increase in the work. This was largely due to out-patient transport,
outings and to meetings. The St. John Ambulance Brigade continues
which frequently led to a doubling of the use of ambulance services.
to provide ambulances at public gatherings, while the Association has
Many new vehicles were required, and the help of voluntary workers
expanded its teaching work, especially in first aid.
was invaluable at this time. The Ministry of Health repeatedly urged the
AMBULANCE UK - APRIL
hospitals and general practitioners to restrict their use of the service
Other Ambulance Services
to what was strictly necessary. The appointment of hospital transport
Some Government organizations, such as the General Post Office, and
officers was recommended to co-ordinate out-patient transport, routine
the larger private firms have provided ambulances for their staff, usually
admissions, and discharges, since ambulances were travelling back
operated by persons trained by the St. John Ambulance Association. This
and forth with one or two patients at a time.
has proved amply justified in the management of industrial accidents and sudden illnesses coming on at work. Certain industries are bound by law
The gradual introduction of radio-telephone into ambulances has
to provide ambulances the National Health Service Amendment Act of
allowed them to be redirected while in use as well as to inform the
1957 permits LAs to supply these on an agency basis.
hospital of emergency cases being brought in. Local authorities were asked to consider ways of reducing demand, and some requested the
A few private ambulance services still exist, mainly for taking private
doctors to take “a stern attitude towards unjustified and sometimes
patients to and from nursing homes or private wings of hospitals. They
intimidating demands by patients for free transport in sitting-case
also take convalescent patients from one private address to another.
54 For further recruitment vacancies visit: www.ambulanceukonline.com
FEATURE The Scottish Ambulance Service In January, 1946, the St. Andrew’s Ambulance Association and the Red Cross, who owned most of the ambulances in Scotland, formed the combined Scottish Ambulance Service. This then became the sole agent for providing ambulances on behalf of the Regional Hospital Boards under the National Health Service, acquiring vehicles from the police, Civil Defence, local authorities, and American Ambulance (Great Britain). In 1948 radiotelephone was introduced in the Edinburgh
References Beatson, GT (1910). Glasgow Med. J., 73, 27. Bird. MM. (1913). “The Errand of Mercy,” p. 36, London. Cambray, PO , and Briggs, GGB. (1949). “Red Cross and St. John Joint War Organization 1939-1947” London. Cantlie N.& Seaver G.. (1939). “Sir James Cantlie” London.
ambulances, and gradually extended to other areas.
Cleland, J. (1820). “The Rise and Progress of the City of Glasgow,” p. 106, Glasgow.
A Hospital Car Service was organized by the Women’s Voluntary
Collins WJ. (1920). “Harmsworth’s Universal Encyclopedia,” s.v. Ambulance, London.
Service, which considerably economized on the out-patient work. At first the service was administered by local committees, but with its expansion a more regional system became necessary, with overall control by a Joint Central Committee. In 1954 an Ambulance Committee was established in each Hospital Region, bringing together the providers and users of the service to coordinate the demand and limit
Daley, A. (1949). Report of the Medical Officer of Health and School Medical Officer of the LCC for the year 1949. Department of Health for Scotland (1946-1965). Annual Reports on Health and Welfare Services by the Department of Health (Scottish Home and Health Dept.), Edinburgh, H.M.S.O.
it to what was strictly necessary. For several successive years after this
Digges T. (1590). “Stratioticos,” p. 323.
there was a reduction in the cost and mileage of the service.
Dunn CL. (1952). “The Emergency Medical Services,” Vols. I and 11, History of the Second World War (UK Medical Series), H.M.S.O. London.
In 1967 the Joint Central Committee was reconstituted to contain
Evatt GJH. (1884). Health Exhibition Literature, Vol. VII p. 257, London.
representatives of the St. Andrew’s Ambulance Association and the
Ferriar J. (1810). “Medical Histories and Reflections,” Vol. Ill p. 99, London.
Regional Hospital Boards, a representative general practitioner and MOH, a representative of the Red Cross, and two independent members appointed by the Secretary of State for Scotland. Since the service now
Ferrier HT. (1951). The New Universal Encyclopedia, s.v. Ambulance, London.
international principles to withdraw as an organization from running it.
– (1963). “Concise History of the Ambulance Department 1919-1963,” London. Fletcher NC. (1949). Annals of the Ambulance Department of the Venerable Order of St. John, 2nd. Ed., London.
Since January, 1934, an air ambulance service has existed which now
Furley J. (1884). Health Exhibition Literature, Vol. VIII, p. 315, London.
came under Government direction, the Red Cross was obliged by its
extends to most of the Highlands and Islands. British European Airways maintain a 24-hour service for emergency transfer of patients to hospital, and to a lesser extent for their return when medically indicated. The helicopters of the police, the Navy, and the RAF may be called on if required, but this occurs only rarely (Department of Health for Scotland
Gaulter H. (1833). “The Origin and Progress of the Malignant Cholera In Manchester,” London. Godskall J. (1603). “The Arke of Noah,” sig. H3v, London. Harrison R. (1904). “The Ambulance in Civil Life and the Proceedings of the Metropolitan Street Ambulance Association,” 6th Ed., London.
1946-1967).
Haygarth J. (1818). Gentleman’s Magazine, 88, ii, 25.
Current Trends
Leigh, W. (1833). “An Authentic Narrative of the Melancholy Occurrences at Bilston... during the awful visitation... by Cholera” (etc.), p. 28, Wolverhampton.
So many developments are occurring within our ambulance services at present that it is impossible to deal with them here in detail. The entire administration of the English and Welsh services may be transferred from local authorities to the Regional Hospital Boards if the Ministry of Health’s recommendation (1967) is followed. Both the vehicles an their equipment are constantly evolving in respons to changing conditions of usage and medical practice. Perhaps the most important current development is the systematic training of personnel, as advocated by the Ministry of Health Working Party on equipment (1966). In view of the attempt to start proper training in 1872, and the Colleges of Ambulance
(1925). The London Ambulance Service, London. London Fever Hospital (1803). State of the Institution for the Cure and Prevention of Contagious Fever in the Metropolis, London. Longmore T. (1869). “Treatise on the Transport of Sick and Wounded Troops”, p366, London. Mead R. (1722). “A short Discourse concerning the Pestilential Contagion”, 8th Ed., London. Metropolitan Asylums Board (1904). Annual Report of the MAB for the year 1903. London.
this to be established.
Ministry of Health (1954). Annual Report for the year 1953, Parti, H.M.S.O.
Acknowledgements
— (1966). Report of the Working Party on Ambulance Training and Equipment, Part 1, H.M.S.O. London.
I thank the following, for supplying me with information on this subject: Council; H T Ferrier, Esq., MVO, MBE lately Director of the Ambulance
— (1967). Written evidence submitted to the Royal Commission on Local Government in England. H.M.S.O. London.
Department, St. John and Red Cross Joint Committee; J W Limb, Esq.,
Parsons HF. (1914). “Isolation Hospitals”. Cambridge.
County Ambulance Officer. East Sussex County Council; and R.Marshall,
Powell GA. (1930). “The Metropolitan Asylums Board and its Work, 1867-1930”. London.
J D Burton, Esq., lately Assistant Director of Supplies, Greater London
Esq., Secretary and Treasurer, the Scottish Ambulance Service.
AMBULANCE UK - APRIL
founded in 1911 and 1914, it is surprising that it has taken so long for
London County Council (1902). Report of the Sub-committee on the London Ambulance Service, London.
55 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE
WHAT WOULD THE AMBULANCE SERVICE LOOK LIKE IN 2020 ‘PERFECT VISION?’ Introduction It often appears that the NHS in general, and the Ambulance Service in
the Home Office from the Department of Communities and Local
particular, are constantly operating in ‘firefighting mode’ in dealing with
Government (CLG), with a duty to collaborate, will no doubt raise
the seemingly never ending series of short term crises. My interest has
the historical debate on where does Ambulance Services sit in
always been in what will tomorrow look like, and will it actually feel any
terms of Public Safety and Public Health. The reality is that it sits
different, or would the organisational behaviours of today persist, but
in both, and therefore, will continue to develop its collaborative
more importantly, will the patient receive an improved level of care and
arrangements with both Police and the FRS in terms of Public
service?
Safety, but its core focus will be on its role within Health and the paradigm shift to care models with the community setting.
To help me consider the future role of Ambulance Services in an evolving and changing healthcare environment, I took the opportunity of discussing with Ben Clacy, Director of Development and Operations, and Siva Anandaciva, Head of Analysis, at NHS Providers (the representative body of all NHS Trusts), their thoughts and views on a range of subjects that may or may not influence the shape of things to come. Of course 20/20 vision is not actually ‘perfect vision’, but in optometry terms, it does indicate clarity and sharpness, which in considering the future, is an essential ingredient. Perhaps the most important observation to arise from the discussions with Ben and Siva is to reflect that, other than the profession’s own vision for ‘2020 and beyond’ as published by the Association of Ambulance Chief Executives (AACE) in September 2015, there is no actual coordinated overall NHS strategic thinking currently taking place
Organisational Infrastructure There appears little appetite for any further organisational structure changes, and therefore the 10 services, as currently configured within England, following the re-organisation in 2006, will continue. Despite the challenges associated with the services conducting business through a multiplicity of clinical commissioning groups and clinical networks, the funding process will remain largely unchanged, although the efficiencies required by the NHS, as part of the overall economic recovery, will no doubt impact on future discussions.
Critical Care
in respect of the future role of ambulance services - so no National Master Plan being developed, and therefore, change will probably
Although only representing less than 10% of the activity, critical
come about from a ‘bottom up’ and ‘piecemeal’ process. However, the
care is a key aspect of the ambulance service, with the service
‘drivers for change’ will still focus on improved outcomes for the patient
being delivered through both land and air based resources, with
by ensuring that the appropriate clinical pathway is followed. Mobile
the emphasis on the speed of response, the provision of enhanced
healthcare treatment and assessment, as well as health promotion, will
clinical interventions and the rapid transportation of the patient
underpin the fundamental ethos of the service.
to the most appropriate treatment centre for ongoing specialist care. The Helicopter Emergency Medical Service (HEMS) is now
AMBULANCE UK - APRIL
Given that development will be geographically based, then it is perhaps
an integral transport platform of providing critical care, although
the current 50 NHS Vanguard sites (set up in 2015 to lead on the
different organisational and delivery models, based on charity
development of new care models that will act as a blueprint for the
funding, have emerged, with increasingly the clinical dimension
NHS moving forward), and particularly the 8 Urgent and Emergency
being delivered by specialist doctors supported by critical care
Care (UEC) Vanguards, that will influence the progressive role of the
paramedics.
Ambulance Service, although as evidenced in the past, Ambulance Services will need to be represented at the table, if its full potential is to be realised.
The challenge is to get the right patient with the right assessment, with the right level of pre-hospital care, by the right transport platform, to the right hospital, in the right time for prompt acute
Politics
investigations and treatment. Does this raise the question as to whether critical care provision should be positioned alongside the
Inevitably ‘politics’ will determine future policy, and the recent
emergency room within the major trauma centre, or remain within
announcement of the Fire and Rescue Service (FRS) returning to
the provision of the ambulance service, or charity?
56 For more news visit: www.ambulanceukonline.com
FEATURE
Emergency and Urgent Care This provision of service has pleasingly over recent years been moving from input response standards to clinical outcome measures, and the 999 ‘dispatch by disposition model’ trialled by the London and the South West Ambulance Services, and now operating in 5 of the 10 English Ambulance Services, as well as being part of the pilot study in Wales, appears to be the way forward as the standard approach to the initial triage and assessment in determining the most appropriate care pathway for the patient. Red calls will continue to receive the rapid response standards and clinical interventions required for life
different health and social care packages that enables the patient, wherever possible, to remain within their own community setting. Information technology will need to underpin this transition to integrated or converged care, by providing a single point of access (SPA) whereby a coordinated approach can be undertaken by each care provider in the full knowledge of the patent’s needs.
Conclusion
threatening conditions, with Green emergency calls being determined by the outcome of the disposition assessment.
Whilst there is no definitive blueprint available for the future of role of ambulance services, there is a growing recognition of the vital role
Non-emergency transport
services can provide in the migration to improved community care.
Over the last decade, this element of service provision has witnessed,
In summary, the role of the service in 2020 will be:-
as a result of competitive tendering, a seismic shift from the public to the private sector, a position which is unlikely to change in the future. This entry by the private ambulance sector has also opened the door for service support into the emergency and urgent sector, as pressures on the demand element of the emergency service has required assistance from both the private and voluntary sectors. This leads to the question as to whether, in relation to green calls, there will be increased
• the collaborative role in public safety, • the provision of the front line response to out of hospital critical and urgent care, • front end receiver and dispatcher of all emergency calls, • mixed participation in delivery of the ‘green’ emergency calls, • increased involvement in the delivery of community based care,
involvement from the private sector.
• minimal involvement in the provision of non-emergency patient
Clinical competence
• further enhancement in the assessment and diagnostic skills of the
The registration of Paramedics, the development of graduate degree programmes, the introduction of Consultant Paramedics, the formation of the College of Paramedics and the significant enhancement in additional clinical skills has raised the profession to new heights. It’s this development that has led to the scope of practice being applied into community settings, where the role of the community paramedic provides an effective option in the provision of care to patients. So other than critical and acute, will be provided within the community enhanced assessment and diagnosis skills and possibly prescribing will assist in enabling the profession to undertake a pivotal role in determining the most appropriate treatment and care pathway for the patient.
ambulance paramedic. One thing is for sure, and that is that the ambulance service is held in high esteem by the general public, and its greater involvement in the delivery of healthcare will be widely supported. It has been a decade since the last major re-organisation for ambulance services, and therefore, it is probably safe to say, that the next 4 years leading up to 2020 will not witness any major shift in emphasis in the service’s role, but hopefully, all developments of good practice will be adopted on a universal basis, in order that all patients can benefit. I would like to thank Ben and Siva for their time, thoughts and views on the future of the ambulance service, and we can only wait and watch the developments unfold. I would also like to thank Tim Friedman for the
Integrated Care
photography.
AMBULANCE UK - APRIL
what next for the ambulance paramedic, given that increasingly care,
transport,
Barry Johns The future will depend upon a multi-vendor provision of a range of
Co-editor, Ambulance UK
57 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE
31 YEARS IN THE AMBULANCE SERVICE – A PERSONAL PERSPECTIVE Bob Williams, Chief Executive, North West Ambulance Service. So how do you adequately reflect on the last 30 years of change
competition, NHS Direct, NHS111, KA34, AQI’s, CHI, CQC, SHA’s,
in the ambulance service in a single short article? All I can express
CCG’s, TDA, Monitor, NHSI, ambulance service mergers, virtualised
is what I have seen and the bits I have been involved in, which
regional control rooms, AMPDS, NHS Pathways, and a few other
probably won’t be the same as everyone else because as we all
bits…not a lot has changed in that time. As an operational paramedic
know individual perspective is just that.
fundamentally the job is still the same – you work shifts on an ambulance or car attending patients to assess, treat and possibly
If a potted career history helps – I joined the ambulance service on
transport. But, at an incredibly higher level of activity, with much more
PTS in Northamptonshire in January 1985, what seems like a lifetime
clinical decision making capability and many more end determinant
ago now, wearing a shirt, tie and cap (at all times) for 6 months, did my
options available. Add to that the fundamental change in the control
Ambulance Technician course in the July and then was incredibly lucky
room environment with dynamic deployment models, clinical decision
to be in the very first cohort at Markfield for
hubs and condition pathway support
the new national Paramedic (or Extended
centres, from a leadership point of view the
Ambulance Aid as it was then known) course
service has changed enormously.
in July and August 1986. I qualified with the registration number 005 (there was only
So has how we need to lead the service
six of us) under the supervision of the late
at all levels. There is still too much of the
great Roly Furber. In 1990 I was one of six
remnants of a command & control feel to
experienced paramedics from all over the
management and too much of a macho
country who joined South Yorkshire to help
culture within parts of the service. There are
set up the new Rapid Response Vehicle
clearly times when direct supervision and
programme designed for paramedics to
management is required, but we are dealing
support the majority double Technician crews.
with sophisticated, educated, professional
I would have to say that this was probably
staff who literally have the lives of others in
the most exciting, enjoyable and varied
their hands – whatever their actual role in the
work experience I ever had. I went on to be
organisation – and we should treat them with
a Paramedic Training Officer before moving
that respect in more of a coaching style as
into an acute hospital setting in 1993, initially
the norm. Leadership through engagement,
as the Resuscitation Training Officer and
transparency and integrity is both incredibly
then as Business Support manager where I
hard and thoroughly rewarding, but also
did an MBA. I then rejoined the ambulance
improves culture and behaviours and the
service as a senior operational manager in
resultant patient experience. I think this is
Derbyshire before becoming the Director of
something that has developed faster and
Operations for Greater Manchester in 1999.
better in some services than others, and
Following three years at GMAS I then moved
in different parts of services, but is an area
AMBULANCE UK - APRIL
to West Yorkshire for three years as Director of Operations and NHSD
that will require significant improvement and commitment with the
before taking a year out in private industry as a senior consultant for
agenda ahead. Not least with the current paramedic shortage alongside
British Telecom and running my own Personal Fitness business. Following
ongoing concerns over meal breaks, shift overruns, hospital handovers
the mergers in 2006 I joined the new North West Ambulance Service
and pay bandings.
as Deputy Chief and Director of Operations before taking over as Chief Executive in 2012.
Most of the change up until recently has all effectively been about the way we run our services and deliver the operational model in order to
So, apart from the introduction of paramedics, RRV’s, Air ambulances,
achieve performance, balance the finances and improve quality along the
HART & USAR, Advanced paramedics, specialist paramedics,
way – or at least try to. The predominance and all-encompassing focus
community paramedics, consultant paramedics, JESIP, PTS
on 8 minute performance though has over the years been at great cost to
58 For further recruitment vacancies visit: www.ambulanceukonline.com
FEATURE service, staff, patients and the public at large. Whilst there is no question
ambulance stretcher because an ED unit has no capacity, or capability,
that many lives have been saved because of that focus, others have
to take over the clinical care – this is just simply wrong on so many levels.
been compromised because of it. Running operational models to get ‘a’
It makes a complete mockery of the initial response model, it infuriates
response to an emergency in 8 minutes to the exclusion of other patients
staff who now spend hours being nurses and porters (and incurring end
who have been waiting in pain for help for hours does not seem the most
of shift overruns) instead of what they should be doing, it wastes millions
moral methodology. Having the time start before the control room even
of invested pounds in ineffective ambulance/staff resources that the
knows where the incident is or what is required is just plain ridiculous.
commissioner’s expect a performance return on, and most importantly
More importantly, it fundamentally prevents any adequate opportunity to
directly effects patients well-being. Not just those ones on the stretchers,
assess a callers needs to determine whether any, or what best, response
but more importantly the ones still waiting lying on their own in roads or
is required so that ambulances are available for those who really need
houses because the responding ambulances are not available.
them. This situation has been compounded over the last couple of years with the significant growth in the Red proportion of calls. The Association
But that’s just the daily frustrations of working in the ambulance service.
of Ambulance Chief Executives has been working hard over some
Actually, we have come a very long way in 30 years. The clinical expertise
considerable time now with the Department of Health and others to revise
of the staff, the changing managerial culture, the effective operational
the current arrangements – the sooner they get changed the better it will
process, good governance and the only remaining regional oversight of the
be for both patients and the retention of operational staff.
emergency health and urgent care system are all outstanding. The shift of thinking into clinical care and a focus on the quality of the service we deliver
More recently, leadership in and of the ambulance services has also
rather than just the performance targets has meant a change in mind sets
been about effectively engaging in the shifting environment around
and collaborative approach which is still not universally accepted within the
us, highlighted in the North West with the emergence of the historic
service. The absolute reliance on the specialist ‘back office’ functions is still
Manchester Devolution agreement which raised the twin issues of local
largely misunderstood and undervalued by many outside of the service and
commissioning and blue light service alignment.
is actually where some of the greatest improvements and culture changes
The commissioning of regional ambulance services has resulted in significant cost savings through reductions in emergency control centres and Trust Board numbers, with both efficiencies and substantial resilience gains through virtual linked single control and operating system for all ambulance provision across multiple county areas. To separate the Manchester element out would entail re-provision of a separate control functionality and restricted use of a third of the overall operational resource. There is no valid argument for aligning today’s Ambulance Service with Police and Fire Services locally – as the outcome of the national Emergency Services Collaboration consultation discussions demonstrated. Less than 5% of the Ambulance Service workload is undertaken with the other blue light services, albeit it the high profile 5%. The ambulance service has changed dramatically over the last 15 years in particular and is now an integral part of the urgent demand seen throughout the health and social care environment which accounts for
have been seen. Above all else, the care and compassion shown by all staff, despite the frustrations remains exceptional. It’s been an interesting career, an incredible journey and it saddens me that my part in it has to come to an end at this particular point in time with so much change going on and finally our real chance to show what the ambulance service is capable of as an integral part of the system solution to the future models of urgent and emergency care. As I leave the ambulance service I am left with one overriding thought. The ambulance service does a fantastic job every day and our staff are some of the most caring, professional and pragmatic you will ever come across in any field of life. I am really proud to have worked alongside you and wish you best wishes for grasping and leading the way on the agenda ahead. If there is one final plea from me, it is to make sure that compassion remains at the heart of the way we do everything.
over 90% of our workload with only 10% of 999 being truly life threatening. Importantly the rest of the NHS system is now becoming far more attuned to the things that the ambulance service can do and the importance of our role in the strategic redesign of services. As the design for more localised plans about health and social care come to reality over the next eighteen months it is imperative that we are part of the strategic discussions and seen as key players in their implementation. The transition into the system wide solutions for urgent health and social care is where the majority of future patient interface is likely to be through telephone engagement via can be best dealt with – whether that is in the home, community setting, urgent care centre, ED department or one of the specialist pathway centres. That however has not helped resolve one of the most frustrating circumstances – delayed hospital handovers. These have always been poor during the difficult winter weeks, but the last two years they have become far longer and are in danger of becoming an unacceptable norm. Despite significant collaborative work and prompting to the regulators,
AMBULANCE UK - APRIL
111 and 999 as well as face to face decision making about where patients
it seems that poorly patients, that we have had to organise a service to respond to in 8 minutes, can then spend hours (literally) lying on a
59 Do you have anything you would like to add or include in Features? Please contact us and let us know.
NEWSLINE SCAS
SCAS is proud to be the provider of patient transport services across the Thames Valley region
SCAS has over 40 years of
A primary aim of the initiative is to
improved co-ordination of care,
experience of patient transport,
test the effectiveness of telehealth
closer to home, improved care
and in 2014/15 undertook over
monitoring and health coaching,
outcomes and experience and
500,000 patient journeys. A
for patients with long term
improved self-care/management
comprehensive mobilisation plan
conditions, to support improved
of long term conditions.
for the contract is underway,
management of their condition
managed by a dedicated project
in their own home, or within a
A spokesperson for North West
team, to ensure a smooth transfer
residential care setting. It will
Ambulance Service NHS Trust
to the new contract.
also aim to improve co-ordination
said: “North West Ambulance
of care for patients recently
Service recognise the benefits
South Central Ambulance Service NHS Foundation Trust
Director of Strategy, Business
discharged from hospital, in order
of using telehealth, in close
(SCAS) is proud to announce
Development, Communications
to reduce risk of re-admission
collaboration with other health
that it has won the contract to
and Engagement for SCAS,
whilst improving patient outcomes
services, to proactively support
provide the Non-Emergency
James Underhay, said: “We are
and experiences.
and care for patients who are
Patient Transport Service
really pleased to be providing the
(NEPTS) across the Thames
Patient Transport Service across
Working in partnership with
emergency and urgent care.
Valley region.
the Thames Valley and we are
Closercare, part of MSD
“This project will help patients
determined to deliver the best
Healthcare Services, this
to stay well for longer, promote
possible service to patients. I would
telehealth project is a first for an
greater self-care and enable
like to thank all the people who are
ambulance services in England
patients to receive more
working so hard to ensure a smooth
and Wales and will run for a
personalised care closer to
transition to the new contract.”
six month period until June
home.”
This is a new contract which brings together three existing contracts covering Berkshire, Oxfordshire and Buckinghamshire from 1 April 2016. SCAS is the existing supplier for these three contracts. SCAS already operates the NEPTS service across many parts of the South Central region, providing transport for people who are unable to use public or other transport due to their medical condition, and are: • Attending hospital outpatient clinics • Being admitted to or
at greater risk of requiring
2016. Up to 120 patients will be The service is available to all
recruited and will be split into a
Patients who are being monitored
patients who meet the eligibility
mixture of short term (1-2 weeks)
will have their addresses flagged
criteria, which are in place
and long term (up to 90 days)
so that ambulance clinicians
to ensure that resources are
telehealth monitoring. The Trust’s
can be made aware if they are
available to those patients who
network of Community Specialist
requested to attend.
need them most.
Paramedics (CSP) will manage and co-ordinate delivery of the project, working collaboratively
NWAS
NWAS delivers remote telehealth monitoring to patients
discharged from hospital wards
with local GP practices and other primary, community and acute care providers. The CSP will be supported by the Trust’s Urgent
SECAmb Fleet shortlisted in the Fleet News Awards 2016
Care Desk, which will provide 24/7
South East Coast Ambulance
remote monitoring and support for
Service NHS Foundation
patients, as and when required.
Trust (SECAmb) has been
North West Ambulance Service • Needing life-saving treatments
SECAMB
shortlisted in The Fleet News
NHS Trust is implementing an
Patients will take their
Awards 2016 in no less than
such as radiotherapy,
exciting new project to provide
observations in the morning each
six categories – Fleet of the
chemotherapy or renal dialysis
remote tele-healthcare for
day and answer some simple
Year (251 to 1000 vehicles),
or DVT treatment
patients across the North West.
questions about how they are
Most Improved Fleet of the
feeling. These will be uploaded to
Year, Safe Fleet of the Year,
a monitoring system where alerts
Green Fleet of the Year, Cost
will be generated if the patient’s
Saving Initiative of the Year
observations or answers fall
and Fleet Manager of the Year.
outside the agreed parameters AMBULANCE UK - APRIL
set by their GP or consultant.
It is the third awards event SECAmb has been shortlisted
The Trust’s Urgent Care Desk will
for in the last 6 months. It was
contact patients who generate an
only last year that SECAmb won
alert to complete a more in depth
at the Commercial Fleet Awards
assessment and then follow an
the Blue Light & Public Sector
agreed care plan set by the GP or
Fleet of the Year and was also
consultant. The project will deliver
Highly Commended at the Green
a range of benefits for patients
Fleet Awards in a competition
including early intervention and
with 600 other applicants.
60 For more news visit: www.ambulanceukonline.com
NEWSLINE The SECAmb fleet team, which
questionnaires; with 97.7%
has been on a modernisation
describing the overall service
programme in recent years,
as either satisfactory or very
is directly competing, not with
satisfactory they received from
other blue light services, but with
the East of England Ambulance
commercial organisations on an
Service NHS Trust (EEAST) in
even par.
November.
Fleet operators have the
In addition, 100% of respondents
opportunity to demonstrate
were very satisfied, satisfied, or
commitment to the highest
fairly satisfied with the care they
standards in terms of operational
received from staff. A patient
excellence, technology, cost
from East Suffolk said: “I feel
savings and improvements in
safest with EEAST staff; I would
efficiency and safety.
not be here without their capable
Evidence based airway management in emergency medicine and resuscitation
hands or speed, they are the Justin Wand, Head of Fleet
best.”
and Logistics for SECAmb, who has been shortlisted for Fleet Manager of the Year, said: “This is once again a great accolade for the Trust and a huge validation of what the team has been able to achieve over recent years. It illustrates how crucial the fleet team are to responding reliably and sustainably to the needs of the patient.
Another patient added: “They have all been wonderful, professional, kind, reassuring and experts at what they do. I cannot stress enough how grateful I am for their help.” Sandy Brown, Director of Nursing and Clinical Quality at EEAST said: “It’s enormously beneficial
“Their focus on improving quality, innovation and support for the frontline is unrivalled and in these cost-conscious times this proves great things can be achieved. I am immensely proud of all the team whose hard work is delivered day in day out and which contributes directly to patient care.”
www.i-gel.com
to see respondents informing us on these high levels of quality of care. It’s something which is at the forefront of our priorities and which we will continue to work on moving forward.” More than 96% of respondents found the service either met their expectations or exceeded them but 5.1% did say that their
The winner will be announced at an awards ceremony on 10 March at the Grosvenor House Hotel, London.
journey in the ambulance was uncomfortable. Robert Morton, Chief Executive of EEAST, said: “It is extremely alike to hear such positive comments about the service people have received. “These results speak volumes about the constant high levels of
Staff at the region’s ambulance
professionalism and care all of
service has been commended
our staff in the East of England
as ‘completely professional’,
put in on a daily basis. I’d like
‘the safest in the country’, and
to thank all who provided us
‘amazing’ in its latest survey.
with this invaluable feedback; it
Quality, innovation and choice lnteract with us
www.intersurgical.co.uk
AMBULANCE UK - APRIL
‘You are stars’: Ambulance service praised in latest survey
rewarding for myself and staff
helps us improve the service we More than 90 patients completed
deliver.”
61 AMBULANCE_UK_03.16_i-gel_resus.indd 1 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
30/03/2016 15:42
NEWSLINE
Perfect Partners
Designed based on years of partnership with EMS, the LIFEPAK® 15 monitor/defibrillator and the LUCAS® 2 chest compression system work together to support your team in managing cardiac arrests.
AMBULANCE UK - APRIL
LUCAS® 2 Chest Compression System
LIFEPAK® 15 Monitor/Defibrillator
LUCAS 2 is designed to provide continuous, uninterrupted compressions while helping to reduce scene complexity.
The 15 provides the power of 360J, plus the most advanced monitoring parameters available.
For more information visit www.physio-control.com.
62
©2015 Physio-Control, Inc. Redmond, WA, U.S.A. GDR3322999_A
For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE HIOWAA
HEMS Operations Hampshire and Isle of Wight Air Ambulance (HIOWAA) and Thames Valley Air Ambulance (TVAA) have officially started night-time Helicopter Emergency Medical Service (HEMS) operations across the South Central Ambulance Service (SCAS) region. HIOWAA’s Airbus H135 helicopter is flown by highly-trained and experienced Bond pilots operating with the latest-generation of nightvision goggles. The aircraft is fully equipped and optimised for night operations, meaning the Charity’s specialist doctor and paramedic HEMS crews can bring their lifesaving care to the most seriously ill or injured people by night as well as by day, saving more lives. Bond operates an identical helicopter on behalf of TVAA. The two air ambulances, in partnership with SCAS, will work together to provide an additional seven hours of coverage every night until 2am across the counties of Hampshire, the Isle of
teams can be at the scene of an
to develop their knowledge and
stand down an ambulance or rapid
incident within minutes, ready
training to ensure we continue to
response vehicle from the incident.
to deliver an advanced level of
advance on-scene patient care.
critical care to the patient and give
The project is currently funded until
them the very best chances of
“We would not have been able to
survival and recovery”
take this important step forward
the end of March.
without the on going support
Dr Helen Alefounder, clinical lead
HIOWAA, alongside TVAA and
that we receive from the people,
for the service, said: “If a crew
SCAS, is committed to developing
companies and organisations that
arrives on scene and feels that
and enhancing its helicopter
support us, to whom we are and
there are other options available
emergency medical service in the
will always be very grateful”.
to the patient, then the doctors
region to provide the highest level of emergency care outside of a hospital environment. A full range of life-saving equipment is carried on board, including two state of the art ultrasound devices, a blood transfusion kit and an immediate blood analyser, helping to save valuable seconds in the
can offer advice. If it is not a time EEAST
Unique project between EEAST and GPs helps avoid thousands of A&E admissions
vital golden hour.
critical condition then we can discuss the case and if needed we can admit a patient directly or can provide them with self care advice so they can stay at home. “The aim is to treat the patient in the most appropriate place at the most appropriate time by the most
Thousands of A&E admissions
appropriate person. This scheme
The ‘Paramedic Physician
are being avoided in a unique
will also help reduce the number
partnership’ of doctors and
project between the region’s
of ambulances going into A&E, the
paramedics found on board is
ambulance service and GPs.
crews can stay in the area where
essential for a truly gold standard
they are needed and respond to the
delivery of pre-hospital emergency
New figures reveal that the East of
medicine, all of which is made
England Ambulance Service NHS
possible through the Charity’s
Trust (EEAST) 999 doctor clinical
The service was used more than
close working partnership with
support service was used 1,527
900 times in November, with
South Central Ambulance Service
times in December, with 85% of
81% of those not requiring A&E
NHS Foundation Trust.
cases resulting in alternatives to
admission.
patients they need to respond to.”
A&E being found. HIOWAA and TVAA’s aviation
Feedback from ambulance
partner Bond Air Services Ltd and
These include services such as
crews has also been positive
Buckinghamshire.
their highly skilled Helimed pilots
self care advice to remain at home,
with one paramedic saying: “My
are central to the service, ensuring
out of hours GPs, direct admission
experience was very good with
Both helicopters will remain
the most effective coverage for
to assessment units, palliative care
the GP, as I felt the patient was not
the entire region with the newest
services, and district nurses.
necessarily appropriate for A&E,
version of the Airbus helicopter, as
Following a successful trial in the
and this was confirmed by the GP
well as the safety and precision
Norwich emergency operations
I was talking to. The GP undertook
and speed of the operation.
centre for crews in Norfolk, doctors
the follow up of calling a district
have been working in a 999 control
nurse for the patient.”
Wight, Berkshire, Oxfordshire and
operational in their respective counties for 12 hours every day and then take it in turn for a period of 16 consecutive nights to cover the seven hour night-service for the whole of the South Central
Alex Lochrane concludes: “Since
room since July as part of the
region and the Isle of Wight.
the start of flying operations in
scheme to give ambulance crews
Another said: “It was very easy to
2007, HIOWAA has been steadily
additional advice over the phone.
get through to the GP and to get
Alex Lochrane, HIOWAA CEO,
expanding its service to the
commented: “Thanks to our
community. Introducing night
It is available for crews to call
unique partnership with TVAA,
HEMS operations adds another
seven days a week, and covers the
there is now a dedicated HEMS
dimension to our service, helping us
whole of the East of England.
crew operational until 2am, an
to save lives and provide emergency
additional seven hours every
medical support and transfer where
The doctors also have the option
was subsequently unable to help
night, covering the whole of the
and when it is most needed.
to speak to callers for certain
him, and he did not really want
Green 2 (serious, but not life-
to go to the hospital either, and
“I am immensely proud of our
threatening) calls and assess if
so speaking to the GP gave us
“Working in close partnership with
teams, who work tirelessly each
they are suitable for a different
confidence in our finding as they
SCAS to crew and deploy the
day and night; not only to deliver
care pathway. If they deem it
seemed happy for the patient to
service, our Doctor Paramedic
a unique life-saving service, but
appropriate and safe, they will
attend the walk in clinic.”
findings past them. “The patient had called because his own GP was not open and
AMBULANCE UK - APRIL
South Central region.
the patient triaged, and run our
63 For all your equipment needs visit: www.ambulanceservicesuppliers.com
NEWSLINE LAS
London Ambulance Service and London Fire Brigade team up for life saving trial A new initiative, which sees London’s firefighters responding to around 28 life-threatening emergencies a week alongside paramedics from London Ambulance Service in four of the capital’s boroughs, launched on Tuesday 16 February. The four month trial will allow fire crews - who already carry defibrillators - to respond alongside the ambulance service to a small number of people with an immediately life threatening condition across Merton, Wandsworth, Newham and Lambeth until a paramedic arrives on scene. Chris Hartley-Sharpe, Head of First Responders at the Service said “Our ambulance crews are facing unprecedented demand, treating over 1,500 critically ill patients every day and a further 2,000 patients with less serious illnesses and injuries. This initiative is a fantastic opportunity for the emergency services to work together and share resources and help save even more lives across London.
life threatening as a result of
campaign which saw over 1,000
Conference will again be taking
cardiac or respiratory arrest.
accredited defibrillators added
place in separate rooms, with a
to shops, gyms and businesses
range of topical presentations
Gareth Bacon, Chairman of
across London. More recently,
already confirmed, including
London Fire and Emergency
the Service embarked on an
‘Human Factor in End of Life
Planning Authority, which runs
exciting new partnership with
Care – Implications for Education
London Fire Brigade said:
the internationally acclaimed
and Training’, ‘How Safe is your
GoodSAM app, in which
Home?’, ‘Medical Command...
“As the number of fires and
clinically trained ambulance
The Future’, ‘Paediatric Retrieval/
fire deaths continue to decline
staff and members of the public
Resuscitation’, ‘Sepsis Guidelines
across London I’m delighted that
trained to an approved standard
– Early Recognition is the Key’,
firefighters can find new ways to
are able to sign up as volunteers
etc. To date speakers include
use their excellent training and
to respond to life-threatening
Ken Spearpoint, Barry Murphy,
remarkable skill to help save
emergency calls, including
Georgette Eaton, Keith Bromwich,
even more lives.
cardiac arrests.
Amy Chan-Dominy, etc. Once again an early bird rate of just £36
Life Connections 2016 Dates Announced
including VAT is on offer until July
respond to improve the survival
Life Connections 2016 will be
available at £96 and Meditech
chances of those in need of
taking place on October 18 &
Global are running a ‘Motorsport
rapid help.”
19 at the Kettering Conference
Medicine’ workshop with delegate
Centre, Kettering, Northants,
rates set at just £60 including VAT.
“When it comes to treating someone in cardiac arrest, if firefighters are closest, it makes perfect sense that they should
29. Jamie Todd is also running a ‘NAEMT Trauma First Responder’ course on this day with 16 places
Chris Hartley-Sharpe added:
NN15 6PB and, once again,
“We’re committed to providing
there is plenty to attract
Life Connections is a unique
the best possible care for all
delegate interest.
Multi-Conference/Workshop event that offers delegates a
of our patients and are always looking for new ways to improve
On Tuesday October 18 a
great deal of choice at affordable
patient outcomes.
Paramedic and an Emergency
prices which include tea/coffee,
First Responder Conference
lunch, etc. plus the opportunity
“We know that around 32 per
will be taking place in separate
to visit over 40 Trade Stands. In
cent of people survive a cardiac
conference rooms, speakers this
2015 over 650 delegates were in
arrest in a public place but,
year already include Professor
attendance and, from feedback
where there is a defibrillator and
Sir Keith Porter, David Halliwell,
received, they enjoyed the whole
someone trained to use it, the
Stuart Blatston, Steve Pratten.
Life Connections experience and
chance of survival can increase
Conference programmes cover
the presentations that were given.
to 80 per cent. The more people
a wide range of topics such as
available to respond to these
‘How Resuscitation Works’, ‘The
types of incidents, the better.”
Changing Face of Major Trauma’, ‘Hypothermia vs. Hyperpyrexia in
The trial is the latest in a number
the Poisoned Patient’, Enhancing
“London’s fire crews will respond
of initiatives supported by the
the Scope of Practice for
to a small number of calls a
London Ambulance Service to
Emergency First Responders’,
week alongside our ambulance
increase cardiac arrest survival
‘Easing the Pressure on
crews, which means that if they
rates in the capital.
Emergency Services – Who Pays?’ etc. With early bird delegate
are in a closer proximity, they
To view this year’s Conference Programmes and, to register, please visit our dedicated website: www.lifeconnections.uk.com where there are a number of special offers available for combining the various Conferences/Workshops to suit your CPD requirements,
AMBULANCE UK - APRIL
start basic life support until a
The Metropolitan Police Service
rates starting from just £36
skilled clinician arrives.”
is already working together with
including VAT, the day represents
the London Ambulance Service,
tremendous value for money!!
Under the trial, if a 999 call
which has seen 110 defibrillators
Jamie Todd of Pre Hospital Care
received into London Ambulance
added to police vehicles,
Consultancy is also running an
Service’s control room meets a
allowing officers to respond
‘Essentials of Advanced Airway
set criteria, both the Brigade and
alongside the ambulance service
Management’ workshop which is
the LAS will be dispatched to the
to people in cardiac arrest.
available at £96.
Racing Legend Signs Up For Bike4Life Ride Out 2016
criteria covers calls to patients
Last year, the London
On Wednesday October 19
With three cycle racing
whose condition is immediately
Ambulance Service launched a
a Resuscitation and a First Aid
Championship titles and five
alternatively, you can call the Organisers on: 01322 660434.
incident at the same time. The
64 For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE truck racing championships
before finishing at RAF Cosford,
funds such a vital emergency
Jason Levy, fundraising and
under his belt, Midlands Air
home to the Bike4Life Festival.
service.
marketing director for Midlands
to announce Steve Parrish
In 2015 10,000 bikers, families,
“I hear the atmosphere on the
has signed up to the charity’s
couples and general motorcycle
Ride Out is electric with people
3,500-strong Bike4Life Ride
enthusiasts from all across
lining the bridges over the
Out 2016 on Sunday 8th May.
the UK took part in what has
motorway to watch the bikes
become one of the biggest
pass by. I can’t wait, and as it is
Parrish had a successful race
and best biker days in the
pre-registration only, if you’re a
career in the 1970s and 80s,
country. And whilst a great day
biker sign up now so you don’t
and is now best known for
out, Midlands Air Ambulance
miss out.”
his entertaining commentary
Charity’s Bike4Life event is
on sports such as the world
partnered with the Safer Roads
On arrival at the Bike4Life
event, there are only 3,500
class MotoGP, Eurosport World
Partnership to raise awareness
Festival, visitors will be treated to
places available in the Ride Out,
Superbikes and the Isle of Man
of biker safety.
a host of activities and displays
and pre-registration is a must.
to watch, plus there will be live
Tickets cost £10 for one biker
Ambulance Charity is proud
Air Ambulance Charity and chair
TT, making him a well known and
of the Bike4Life committee, adds: “Having Steve Parrish and Nick Sanders on board this year is fantastic, their support will undoubtedly help raise further awareness of Bike4Life.” Due to the popularity of the
much loved character in modern
On his support of Bike4Life,
music and a range of refreshment
motorsport.
Steve comments: “Bike4Life
and pillion for the Ride Out and
stands, exhibitions, tutorials
Ride Out and Festival has grown
and stalls, making it a great day
entry to the Festival, while entry
Steve, who will join racing
year on year, so I’m honoured
out for all. Those interested in
legends in the Bike4Life Ride
to be invited to join the Ride
further motorcycle training will
Out including famed adventure
Out on behalf of Midlands Air
also have chance to speak with a
motorcyclist and author Nick
Ambulance Charity. Thankfully
variety of organisations. As part
Sanders, is appealing to bikers
I have never had to rely on an
of his support on the day, Steve
to pre-register for the Ride
air ambulance, but in my line of
will be hosting the main stage,
To register to get involved in the
Out on 8th May, which starts
work, I’ve seen several bikers
interviewing further motorcycle
Ride Out led by Steve Parrish
at Meole Brace in Shrewsbury,
who have. We really can’t afford
racing legends who sign up to
and Nick Sanders, simply visit
taking in 23 miles of the M54
not to support the charity that
the event.
www.bike4lifefest.com.
to the Festival only is £5 per person. All proceeds to towards the life saving work of Midlands Air Ambulance Charity.
AMBULANCE UK - APRIL
65 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE organising their own fundraising
“The move also coincides with
system and targets areas for
and awareness campaigns during
a review and the identification of
improvement.
this time. The move, from the last
further improvements which will
week of September is strategic
be announced later in 2016 and
The Ambulance Quality Indicators
New Date for National Air Ambulance Week 2016 Monday 19th – Sunday 25th September
and forms part of a broader plan
2017. This is being driven by the
(AQIs) will track performance
which culminates moving the
Communications Subcommittee of
within the new five step model –
date forward a further week in
the AAA before being approved by
launched in October 2015 - which
2017 to its new permanent home.
the Board.”
ensures that patients receive
The Association of Air
ambulances which are mainly
AAA
Ambulances (AAA) is delighted to announce that the new date of National Air Ambulance Week
the right care at the right time
Clive Dickin, National Director of the Association said: “NAAW is the annual event when all 20 charities across the UK celebrate and encourage support for air funded by donations. With many investing funds to expand their operations to provide night HEMS
Newly published Ambulance Quality Indicators provide comprehensive analysis of patients’ care and experience
and may not always involve dispatching an ambulance. The data covers the period 01 October 2015 to 31 December 2015 and will be published independently by EASC on a quarterly basis, and includes data on:
2016 is Monday 19th to Sunday
missions, upgrading their aircraft
25th September.
or placing investment into the
The Emergency Ambulances
advanced education and training
Services Committee (EASC)
• The percentage of patients who
NAAW is an initiative created by
of their paramedics and doctors,
has published the first full set
received the appropriate ‘care
the AAA and celebrates the work
there is no better to show them
of data that measures clinical
bundle’ after having a heart
of local air ambulances, giving
your support. “The change is
care, operational efficiency and
attack caused by a blood clot in
them a national voice and an
a strategic decision allowing
patient experiences of those
opportunity to promote the work
for a number of factors to be
using the Welsh Ambulance
they do at a local level. This annual
accommodated in our member’s
Service.
event is a regular feature on event
plans; be it better weather,
calendars across the UK, with
longer days and a less cluttered
The data links the ambulance
many air ambulance charities
program of other national events.
service with the wider healthcare
the heart. • The performance of ambulance staff in providing pain relief to patients with a suspected hip
AMBULANCE UK - APRIL
66 For more news visit: www.ambulanceukonline.com
fracture. • Handover times at hospitals
NEWSLINE • How often the ambulance service manages patient needs over the telephone • The percentage of patients with
development but this first set of
David was so pleased with Evie’s
“I was so impressed by her
comprehensive data highlights
“maturity, calmness and willingness
attitude, it must have been a really
some good performance as well
to help” that he nominated her
scary situation for her but she was
as areas for improvement.”
for a ‘Laverick Award’ which was
so brave. By helping her mum she
presented at her school.
made my job a lot easier. I wanted
suspected stroke who receive the appropriate assessments
The full Ambulance Quality
and treatment before getting to
Indicators as well as definitions
Siobhan, a Youth Support Worker
and am very proud to present her
hospital
that explain what each of the
from Humberstone Leicester
with the award. I hope one day
• Number of responses by Community First Responders • Number of incidents that resulted in patients being treated at scene by the
indicators mean are available to view on the Emergency Ambulance Services Committee (EASC) website.
generated by frequent callers Dr Brendan Lloyd, Medical Director at the Welsh Ambulance Service said: “We welcome this first set of Ambulance Quality Indicators published by the Emergency Ambulance Services Committee that helps us understand more about how the clinical care we are providing to
said: “I have never been in so much pain, it felt like child birth and I was really worried about what was going to happen. I tried to encourage Evie to go to bed because I didn’t want her to see
ambulance crew • The number of incidents
her to receive some recognition
EMAS
Special award for aspiring paramedic Aspiring Paramedic Evie was presented with a special award to recognise her bravery. Nine year old Evie Demeyer was extremely brave back in November when her mum,
me in pain but she kept saying to me ‘mummy I am going to be a paramedic, I know how to help you.’ It was like our roles reversed. “When David arrived he was fantastic with her, he involved her and made the experience so
to see her out in our ambulances responding to patients.” Evie has wanted to be a paramedic since the age of six and will have the opportunity to look round an ambulance, learn first aid and CPR on Friday with her class mates before receiving her award. Siobhan added: “When David arrived he was brilliant with Evie
interactive which she loved.”
and involved her in every step of
David said: “I was taken aback
me calm and reassured Evie. She
my care which helped to keep
by how mature Evie was. Siobhan
can’t wait to see him again and
was in a lot of pain and very
say thank you.
our patients is helping them as
Siobhan Hirrell, had to call 999
opposed to just measuring the
after being unable to move due
needle phobic, as I was preparing
time we took to drive there, which
to excruciating pains. Despite
pain relief for her Evie was giving
“Whenever anyone asks her why
is the measurement that was
the distressing situation Evie
her instructions on how to breath
she wants to be a paramedic she
previously used.
remained calm and helped her
(in through her nose out through
always says ‘I want to save lives’
mum and EMAS paramedic David
her mouth) telling her it was all ok
and now she has a role model in
Joyce when he arrived on scene.
and holding her hand.
David, I’m very proud of her.”
“Some AQIs are still under
AMBULANCE UK - APRIL
67 Life Connections - The Affordable CPD Provider: www.lifeconnections.uk.com
NEWSLINE NWAS
NWAS signs up to support mental health in the workplace North West Ambulance Service NHS Trust (NWAS) is
signed the pledge and joined
By signing up to an action plan
will see 30 life saving devices
other healthcare and emergency
under the pledge, the Trust will
installed at locations across the
services employers demonstrating
create a working environment in
West Midlands.
the organisation’s support of
which staff and volunteers are
the programme to tackle mental
encouraged to talk freely about
The University of Wolverhampton
health discrimination.
any mental health issues they
has signed a memorandum of
may have, promote a better
understanding with the Trust
Bob Williams said: “Ambulance
understanding of mental health,
pledging its commitment to install
crews, call handlers and support
and provide support and wellbeing
defibrillators at its University
staff do a very demanding job and
advice within the service.
campuses in Wolverhampton,
committed to promoting better
can be regularly exposed to many
understanding of mental health
stressful and traumatic situations,
Part of the programme includes
issues and to end stigma in
as at partner Academy schools in
which can take its toll physically
the Blue Light information line
the workplace after signing
the region.
as well as emotionally.
which is exclusive to emergency
up to the national “Blue Light
Walsall, Telford and Burton as well
services staff, volunteers and
Programme” led by the mental
An automated external defibrillator
“Staff welfare has been high on
their families. It offers confidential,
health charity MIND.
is a device which helps to restart
the agenda for the Trust for some
independent and practical
the heart of someone in cardiac
time now, and giving our support
support, advice and signposting
MIND state that one in four people
arrest. There are over 3,000
to this programme not only aims
around mental health and
in the UK will experience a mental
defibrillators in communities
to keep colleagues and staff
wellbeing.
health problem in any given year
across the West Midlands and
supported whilst they are at work,
and their independent research
but demonstrates the positive
showed that the estimated quarter
steps being taken towards
of a million people who work
challenging the stigma of mental
and volunteer in the emergency
health.”
services are even more at risk
even though they come in many
Wolverhampton University and ambulance service work together to save lives
different makes, colours and sizes, they all do the same thing and are extremely easy to use. Professor Geoff Layer, Vice
of experiencing mental health
The Trust already has a number
problems than the general
of staff who are Blue Light
population, but less likely to get
Champions and have promoted
support.
MIND’s Blue Light Programme
A pioneering partnership
Chief Executive Officer Anthony
with NWAS staff and they were
between West Midlands
Marsh met on Monday 15th
Chief Executive Bob Williams
instrumental in getting the pledge
Ambulance Service and the
February to officially sign the
and Chair Wyn Dignan publically
signed.
University of Wolverhampton
memorandum of understanding
Chancellor at the University of Wolverhampton, and West Midlands Ambulance Services
which defines the responsibilities of the two parties in the provision of an Automated External Defibrillator (AED) and basic life support (BLS) to a person in a cardiac arrest until the arrival of the statutory ambulance response. Anthony Marsh said: “As a Trust, we’ve helped to install thousands of defibrillators and trained 60,000 people in lifesaving CPR skills across the Region. Over the last 12 months alone, we’ve worked AMBULANCE UK - APRIL
incredibly hard to place hundreds of defibrillators across the Black Country in locations such as sports facilities, supermarkets, tourist attractions and schools to help someone in cardiac arrest.
Photo caption from left to right: Wyn Dignan (Chair), Amanda Ferguson (EMT), Kate Walsh (EMD), Dan Farnworth (EMT), Esmail Rifai (Clinical Safety Officer), Bob Williams (CEO)
68 For further recruitment vacancies visit: www.ambulanceukonline.com
“It’s a privilege to welcome the University of Wolverhampton and its Academy Schools on board
NEWSLINE our project to help save even
can provide emergency care to
Two new specially equipped
only operated from 07:00 until
more lives in the Black Country.
someone in cardiac arrest quickly
air ambulances have been
19:00.
With thousands of students and
and effectively prior to the arrival
launched to attend night-time
members of staff on campus
of an ambulance bearing in mind
emergencies in the south.
each day it seems a logical place
that eighty-five percent of those
to have defibrillators and whilst
people who suffer a cardiac arrest
The Airbus H135 aircraft, which
the partnership between the two
we hope they are never used, its
have the ability for their heart to
are fitted with spotlights and carry
charities was “unique”.
peace of mind for the university
be shocked back to a normal
night-vision goggles, can be
that the devices are there to help
rhythm by defibrillation.”
deployed for 19 hours a day and
He said: “Our teams work
until 02:00 GMT.
tirelessly each day and night; not
in an emergency.”
Sir Tim Jenner, Thames Valley Air Ambulance chairman, said
only to deliver a unique life-saving
The University has already Professor Geoff Layer said: “As
installed six defibrillators in its
The £5m service will cover
service but to develop their
an institution with thousands of
Wolverhampton City Centre
Oxfordshire, Buckinghamshire,
knowledge and training.
staff and students on site, as
Campus locations, three at
Berkshire, Hampshire and the Isle
well as our campuses being
its Walsall Campus, two at its
of Wight.
located right in the heart of our
Telford Innovation Centre, two at
towns and communities, it’s really important that we officially show support and commitment to the West Midlands Ambulance Service – helping them to provide a rapid response in the event that someone suffers a cardiac arrest whilst on our premises. “These machines are extremely easy to use, meaning anyone
the Wolverhampton University Science Park and one at its Burton Hospital Campus as well as 16 at partner Academy Schools.
Thames Valley and Hampshire air ambulances launch night service
“Our ambition of delivering a gold standard service is dependent
It is run by a partnership between the
on the generosity of the people,
Thames Valley and Hampshire and
companies and organisations
Isle of Wight air ambulance charities.
who support us, to whom we are very grateful.”
A spokesperson said the decision to end the service at 02:00 was due
The service is run in partnership
to the lack of calls relating to major
with Bond Air Services Ltd, which
trauma beyond that time, but this
provides the helicopters under
could be reviewed in the future.
a long-term contract, and South Central Ambulance Service NHS
Previously the air ambulances
Foundation Trust.
Welcome to the next generation in simulation technology. The iSimulate ALSi Simulation platform provides an economical, highly advanced and realistic patient condition simulation package that enables advanced patient simulations that can be run quickly and easily without the need for expensive and complex manikins or monitors.
• Smart and easy to use scenario builder • Over 50 ECG waveforms • Over 20 additional parameter settings
It is so easy to use you can be up and running in less than 2 minutes allowing you to train anywhere and at anytime with a fully featured, multi-parameter monitor, AED and defibrillator without the cost and complexity of traditional simulators.
• Ability to use 12-lead ECG, import video and x-ray images • Realistic trending of vitals over time
Run off only two iPad’s, students view a realistic patient monitor while the instructor uses a handheld control ipad to control everything from parameters to time.
Monitor Mode
• Instant CPR and PEA simulation • Safe to use on a simulated live casualty
Defibrillator Mode
Facilitator Screen
AMBULANCE UK - APRIL
AED Mode
• Sophisticated and realistic vital signs monitor
Advanced simulation, without the cost The iSimulate ALSi Simulation Platform provides an economical, highly advanced and realistic patient condition simulation package that enables advanced patient simulations that can be run quickly and easily without the need for expensive and complex manikins or monitors.
education
equipment
enterprise
69 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE reducing the weight and load required to carry the bag by the ambulance crews. This made both the bag and Jigsaw staff more responsive in emergency situations. Additionally, with Jigsaw
SP Services - Bespoke Medical Bags
LAS
London Ambulance Service trialling app to help guide first responders to emergencies
experiencing a sustained period
Upon receiving an alert from the app, first responders in the area can either accept or reject the request. If they accept, the responder will be directed to the scene of the emergency using GPS and will also be shown where the nearest defibrillator is located. The caller is able to communicate
of unrivalled growth in the
Callers can use GoodSAM to
with the responder through the
industry, the bags have also been
send live video from the scene
app so they can speak to them en
designed to custom fit their brand
of an emergency to responders
route if necessary and send them
Having established a long
new ambulances that been have
term relationship with Jigsaw
recently added to the Jigsaw
The London Ambulance Service
Medical since their inception, SP
medical fleet. SP, Jigsaw and
is trialling a new smartphone app
Being able to administer such
Services were keen to discuss
the vehicle builder have worked
that alerts trained first responders
emergency care in the minutes
the idea of designing some new
together to ensure that all the
to nearby emergencies. The
following an incident is critical in
medical bags with them.
bags fit the new cupboard spaces
GoodSAM app uses GPS to
determining the outcome for the
this making everything more
guide qualified staff to incidents
patient: for example, somebody
efficient and safer.
where they can deliver emergency
suffering cardiac arrest is 10%
first aid before ambulance teams
less likely to survive with every
can get to the scene.
minute that passes without
Extensive discussions between senior Jigsaw Medical clinicians
live video from the scene.
and the SP Parabag development
Jigsaw Medical Director of Clinical
team regarding the content and
Services, Richard McManus
design of the bags resulted in a
stated: “We are pleased to have
In an emergency, users who
range of brand new, fully bespoke
worked so closely with a company
have downloaded the app can
bags, made specifically for Jigsaw
as reputable as SP Services
open it and press a button
Medical for use on their NHS
and we are really happy with the
to send out a notification to
contracted ambulances and RRVs.
results. We have received nothing
doctors, nurses, firefighters
but positive feedback from the
and other trained personnel
By streamlining the equipment to
ambulance teams out around
in the immediate vicinity who
only the essential items needed to
the country, and look forward
have registered themselves on
provide the very best in medical
to growing and developing our
GoodSAM as a first responder.
care, two existing SP bags were
relationship with SP and Parabag
At the same time, a 999 alert is
amalgamated into one, thereby
in the future.
sent to emergency services.
receiving CPR. Mark Wilson, GoodSAM co-founder and London Air Ambulance doctor, said: “If someone is in cardiac arrest the earlier quality CPR can be performed, the better the chance of patient survival. GoodSAM alerts nearby first responders that can go and help before the ambulance service arrives. If a defibrillator is readily available, the location of which is shown on the GoodSAM app, patients are up to six times as likely to survive.” The London Ambulance Service has used the app 20 to 30 times a day for the last five months, the Telegraph reports, with around 7,500 users said to have registered for the service in the UK. The creators of the app, which is available on both Android and iOS, are now
AMBULANCE UK - APRIL
appealing for more medically trained personnel to sign up as “responders” and to members of the public to become “alerters”. Wilson said: “Everyone who has a smartphone has a life-saving device in their pocket. They just need to Richard McManus - Jigsaw Medical Director of Clinical Services
70 For more news visit: www.ambulanceukonline.com
download the GoodSAM app in case they ever need to use it.”
LIFE CONNECTIONS IS BACK!!! NEWSLINE
Diary Date: Tuesday 18 & Wednesday 19 October 2016 Kettering Conference Centre, Kettering, Northants, NN15 6PB GREAT CHOICE-GREAT VALUE-GREAT CPD OPPORTUNITIES! Life Connections is a unique two day multiconference/workshop event that brings together delegates from many professions who are responsible for saving lives. The event is supported by a trade exhibition positioned at the hub of all conference areas which allows those in attendance to see the latest equipment and technology currently available. Over 650 delegates attended last year's event and their important feedback included the following: "I would like to thank you for another informative and interesting conference", "Many thanks for a most enjoyable/thought provoking day" and "Thank you for a very affordable experience".
TUESDAY 18 OCTOBER Paramedic Practice Conference - Professor Sir
Keith Porter, David Halliwell, Dan Cody and Amy Chan-Dominy are among this year's speakers who will be giving thought provoking presentations on a wide range of topics including: The Changing Face of Major Trauma, How Resuscitation Works, The Role of Critical Care Paramedics and Airway Management. Early Bird Offer - Book by July 29 to secure a delegate rate of £36.00 (saving £12) or pay £60.00 to also attend the Resuscitation Conference taking place the following day (saving £36.00).
EFR Conference - 100 SUBSIDISED PLACES AVAILABLE - Due to the generosity of WEL
Medical we are able to offer 100 discounted delegate places on a 'first come first served' basis, the discount being £18 per person to include lunch, tea/coffee, etc. The following topics form part of this year's programme: Enhancing the Scope of Practice for EFR's, Indirect Resources - Easing the Pressure on the NHS - Who Pays?, The Rise of the Machines. Speakers again include Professor Sir Keith Porter, David Haliwell, Steve Pratten, etc.
Pre-Hospital Care Consultancy Ltd Essentials of Advanced Airway Management
Resuscitation Today Conference
We are delighted once again to be hosting a resuscitation conference which this year will contain a number of topical presentations including: Human Factors in End of Life Care - Implications for Education & Training, Medical Command...The Future and Paediatric Retrieval/Resuscitation, presented by Ken Spearpoint, Stuart Blatston and Amy Chan-Dominy. Early Bird Offer - Book by July 29 to secure a delegate rate of £36.00 or pay £60.00 to also attend the Paramedic Practice Conference taking place the previous day.
First Aid Conference supported by AoFA
This year's programme is again made up of presentations that will be of great interest to first aiders and first aid trainers, including: Sepsis Guidelines - Early Recognition is the Key, Minor Injury Management, How Safe is Your Home?, and Practical Management of Paediatric Emergencies. Early Bird Offer - Book by July 29 to secure a delegate rate of £60.00
Pre-Hospital Care Consultancy Ltd NAEMT Trauma First Responder Course
This continuing education course that teaches the principles of PHTLS is ideal for first responders, EMS practitioners, etc. Topics being covered include: Airway/Oxygenation & Ventilation, Circulation and Shock, Traumatic Brain Injury & Spinal Trauma. Only 16 places are available at a delegate rate of £96.00.
Meditech Global are running a Motorsport Medicine CPD Workshop, aimed at medics and rescue personnel involved or interested in motor sport events. The day will include: Concussion in Motorsport, Casualty Extrication - A New Way Forward, A Paramedics Life in Motorsport, The Use of Haemostatatic Dressings, etc. Speakers will include; FIA Doctors and active motor sport paramedics. Only 20 places are available at a rate £60 per person.
All prices quoted are inclusive of VAT. To secure your delegate place or to register for any of the above conferences/workshops visit www.lifeconnections.uk.com or call the organisers office on 01322 660434 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
AMBULANCE UK - APRIL
Learn the full range of Airway Management techniques, including: The Use of Extraglotic Devices, Video Assisted Intubation and Surgical Cricothyrotomy. Only 16 places are available at a rate of £96.00 (50% below normal course costs)
WEDNESDAY 19 OCTOBER
71
NEWSLINE Miracle Man’ to meet medics who shocked his heart 17 times When Yvonne Ainsworth found her partner collapsed at home last September she feared the worst. After calling 999 she realised he had gone into cardiac arrest and followed the call handler’s instructions to perform compressions to try and keep him alive. Having been taught CPR a few years ago Yvonne was able to put in to practice what she had learnt to give Patrick Ewing the best chance of survival. Ambulance crews raced to the
until we were able to stabilise him
meet the team who saved my life.
she does as well as acting as
and he was then flown straight to
What they did for me might of just
a true role model within the
Glenfield.
been part of their day job but they
organisation. Sandy Brown,
worked so hard to keep me going,
Director of Nursing and Clinical
I will forever be grateful.”
Quality said: “Tracy is full of
“By performing CPR as soon as she saw him collapse Yvonne
commitment, energy and passion
gave Patrick the best chance. Her
“It’s all very surreal” added
to all in the ambulance service.
bravery should be commended
Yvonne, “I am honoured to be
She is constantly striving to learn
for remaining calm in such a scary
able to meet the people who
and develop her own knowledge
situation.”
shared this experience with us
which she in turn shares with
and kept my partner alive. I just
colleagues. In addition, she has
want to say thank you.”
been instrumental in developing
Yvonne, from Ashwell, Oakham, had learnt CPR when a defibrillator was installed in their village. She said: “Whilst I knew I needed to pump his chest I was terrified by what was happening. The 999 call handler (Joshua Selwood) was so calm and gave me clear instructions helping me stay in rhythm whilst reassuring me that I was doing the right thing. I couldn’t have done it
patient care.” EEAST
ALF 2016 Awards: EEAST celebrate two winners Two staff members from the East of England Ambulance Service NHS Trust (EEAST)
without him.
including a senior manager
Patrick for over 50 minutes, using
“It is down to the call handler
awards at this year’s
a defibrillator to shock his heart
and paramedics that my Patrick
Ambulance Leadership Forum
17 times.
is alive. Some of them had just
(ALF) Awards. Head of Clinical
finished a 12 hour shift but were
Quality Tracy Nicholls won the
Paramedic Daniel Sneath was
still willing to stay with us, working
outstanding senior manager
first on scene, he said: “Patrick
on Patrick for over an hour during
award and Student Technician
was clearly a fighter. This was a
our moment of need.”
Steve Wainwright won the
emergency and took over CPR from Yvonne. They worked on
real team effort and everyone on
outstanding non-paramedic
scene worked hard to keep him
Yvonne and Patrick will met their
alive. As we were working on him
“heroes” on Wednesday 17
he continued to show signs that
February.
his heart had started but then it would stop again. We kept going
have won nationally recognised
clinician award. Tracy was nominated following her passion for patient care
Patrick said: “I am really excited to
which is at the heart of everything
Speaking on her win, Tracy said: “A nomination in itself is amazing; I was thrilled to stand with Steve as part of EEAST. Taking two awards out of the ten is a real achievement but I have to give credit to my brilliant team who enable us to take strides forward in patient safety, effectiveness and quality.” She added: “The Trust has staff that does an amazing job every day so I look forward to seeing them continue to raise the bar for our patients and services in every aspect.” This year was no exception in standards for nominations, Association of Ambulance Chief Executives (AACE) Managing Director Martin Flaherty OBE said: “It was a particularly high standard for nominations, but these awards are a fantastic way to recognise and commend ambulance service employees across England who have truly gone above and beyond the call of duty.” Steve was nominated because of his dedication to educating school
AMBULANCE UK - APRIL
children across Peterborough about the ambulance service. So far, Steve has visited schools on 47 separate occasions while working for EEAST and speaking on his win, he said: “I was so proud and very honoured to be nominated, let alone win. I have thoroughly enjoyed the last three years getting to this point.”
72 For further recruitment vacancies visit: www.ambulanceukonline.com
w.emergencyuk.com | Hall 5 | NEC | Birmingham | 21-22 September 2016 | www.emergencyuk.com | Hall 5 | NEC | Birmingham | 21-22 September 2016 | www.emergencyuk.com | Hall 5
NEWSLINE xxx
xxx xxx xxx
xxx
xxx xxx xxx
xxx
xxx xxx xxx
Bringing the Emergency Services together to improve public safety A unique event for everyone who works in the emergency services • Network with like-minded emergency staff • Source new kit and save money • Meet the market leaders in emergency services products • Get updated on collaboration and multi-agency plans • See the newest products on the market • Gain CPD points from our free College of Paramedic workshops • Learn from past emergency situations at the free seminars • Get up to speed on UAV technology in the Drone Zone • Watch live water rescue demo's For more information visit www.emergencyuk.com.
www.emergencyuk.com
Show supporters and sponsors include COLLEGE OF
paramedics
Do you have anything you would like to add or include in Newsline? Please contact us and let us know. leading the development of the paramedic profession
AMBULANCE UK - APRIL
ESS - the only show for the entire spectrum of the Emergency Services
73
NEWSLINE Ireland - Major Investment in Ambulance Service Fifty new ambulances are to
“The introduction of over
As part of the investment, a
Its Chief Executive, Robert
150 vehicles in 2015 and
further 10 intermediate care
Bertram said:
2016 is a real boost for the
vehicles, which are used for non-
ambulance service. It allows us
emergency patient transport, will
“Central Manchester has world
to replace older vehicles and
be purchased. This will increase
class hospitals and air ambulance
expand services, especially
that fleet from 50 to 60.
service, now they urgently
in non-emergency transport.
need a helipad to complete the
Moving patients from high to
Intermediate care vehicles play
emergency care triangle. Having
lower acuity facilities means
a crucial role in patient transport
a helipad on the hospital site will
of a major investment in the
that patient flow in our major
because they perform hospital
significantly reduce the amount
National Ambulance Service.
hospitals will improve, which
transfers and can carry more than
of time it takes for a seriously ill
should help to ease pressure on
one patient, freeing up emergency
patient to get to the expert care
Some €18 million in capital
our Emergency Departments,”
ambulances to respond to
they urgently need. The quicker
funding is being made available
commented the Minister for
emergency calls.
they can see a consultant, the
to the service in 2016, which
Health, Leo Varadkar.
be purchased this year as part
will allow for the purchase of the new vehicles, as well as the refurbishment of a further 35 ambulances.
better chance of survival and Meanwhile, a new rapid response vehicle will also be purchased,
vehicles ‘will also help to reduce
bringing that fleet up to 120
“Knowing that the HELP Appeal’s
costs and improve reliability’.
vehicles. These vehicles are
£1million donation will bring the
responsible for ensuring that “Our ambulances and crews
advanced life support arrives
cover enormous distances every
quickly to the scene of an
year. It is vital that we continue
accident, ‘so that sophisticated
to invest in and upgrade our
treatment can begin while the
fleet, so that our highly trained
ambulance is en route’, the
this year, ‘depending on the
paramedics can give the best
department explained.
decommissioning requirements
service they can when our
of older vehicles’.
patients need it,” he said.
According to the Department of Health, this means that the ambulance fleet should expand to 268 vehicles by the end of
making a full recovery.
He noted that replacing older
This year’s new vehicles will come on top of the 65 that were bought last year. They will be ‘spread throughout the fleet nationally, to replace vehicles which have reached the end of their life cycle and to support additional services’, the department added.
HELP Appeal donates £1million to CMFT Charity’s Helipad Appeal
CMFT Charity’s Helipad Appeal significantly closer to its goal is fantastic.” Using the strapline, ‘Time Saves Lives’, CMFT Charity’s Helipad Appeal will enable the creation of a brand-new 24-hour access primary helicopter landing site, the first of its kind in central Manchester. This will allow the Trust to save many more lives and will increase the chances of a full or improved level of recovery in a great many seriously ill or injured patients. Located on the roof of the new multistorey car park on Grafton Street, the helipad will be connected to the hospitals by a high-level link bridge and roof top corridor. Currently the hospitals on the
AMBULANCE UK - APRIL
The HELP Appeal - the
central site, including Royal
only charity in the country
Manchester Children’s Hospital,
dedicated to delivering
Manchester Royal Infirmary and
helicopter landing pads at all
Saint Mary’s Hospital, rely upon
Major Trauma Centres and
a secondary landing site in a
key A&E hospitals across
nearby park. This arrangement
England and Scotland - has
means that patients initially
pledged £1 million to Central
transported by air ambulance
Manchester University
must then be transferred the
Hospitals NHS Foundation
final mile of their journey by land
Trust (CMFT) Charity’s new
ambulance. This second transfer,
helipad appeal. A huge
often undertaken on muddy or
kick start to its fundraising
uneven ground, significantly
campaign, as the donation
adds to the risk of complication,
amounts to over a quarter of
particularly in children, due to
the total funds needed.
additional handling of the patient.
74 For more news visit: www.ambulanceukonline.com
NEWSLINE A secondary transfer also adds
likely have been much increased if
that the Charity now has £2.4
precious minutes to the overall
there was a landing pad onsite at
million to raise over the next year.
transfer time with every moment’s
the Trust.
delay greatly increasing the risk to life.
Donations small or large will all 17-year old Danielle Rigby was
make a substantial difference to our
When an adult or child suffers
a patient of Royal Manchester
aim of building a 24 hour access
a major trauma, the speed with
Children’s Hospital last year
helipad. Currently, the hospitals
which they can get specialist
after being involved in a road
medical help can be the
traffic accident in her hometown
cannot receive patients by air
difference between life and
of Bolton. Suffering a near-fatal
death or between recovering
arterial bleed on the brain, Danielle
and recovering well. The first 60
was airlifted to the children’s
minutes following a major trauma
hospital via parkland one mile
or severe injury is known as the
away from the hospital. An onsite
‘Golden Hour’. Fast access to
helipad would have meant Danielle
specialist treatment is vital to give
would have arrived at the hospital
patients the best chance possible.
much sooner and would not have experienced a risky and
ambulance at night. This helipad will make a real difference to major trauma patients, and those in
To watch the appeal film visit our charity home page or watch here: https://www.youtube.com/ watch?v=xVNhcDnUsxE To donate now text HELI15 (£AMOUNT) to 70070
need of specialist treatments, from across the whole of the North West and at all times of the day.“ Mark Evans, Clinical Service Manager at the North West Air Ambulance Charity, said:
Coinciding with the HELP Appeal’s
uncomfortable secondary transfer.
donation is the launch of the
Also included in the Appeal film
Charity’s official appeal video. The
is CGI footage which visualises
seven and a half minute long film
the landing pad on top of the car
features interviews with two families
park, as well as the link bridge and
who know first-hand the benefits
corridor to the hospitals.
sites, which we often resort to
Newborn Jeremiah Oderinde was
Maurice Watkins CBE, Chairman
the hospital. Saving vital minutes
airlifted from Saint Mary’s Hospital
of Central Manchester Foundation
in transfer time may save lives,
for life-saving ventilation treatment
Trust’s Charitable Fundraising
reducing instances of death,
last Christmas. Thankfully Jeremiah
Board, says:
disability and suffering.”
however, the new-born’s transfer
“We are incredibly grateful for the
“We are fully in support of a helipad
would have been much quicker,
very generous donation from the
for CMFT as it will enhance the life-
and his chance of survival would
HELP Appeal. Its support means
saving service our charity provides.”
an on-site landing pad would have.
To learn more about the Helipad Appeal and to get involved visit www.rmchcharity.org.uk or www.cmftcharity.org.uk
“Helipads are of upmost
#TimeSavesLives @RMCHCharity The support of the Central Manchester Foundation Trust Charity means that the hospital can provide additional resources that make life easier for patients and their families who use the hospital.
importance in urban areas such as Manchester where secondary using, are not in close proximity to
is a happy and healthy baby boy
The Charity has three main areas of work: • to support research projects to improve understanding of patient’s illnesses • to help to create an environment that’s more patient-friendly • to provide state-of-the-art equipment for diagnosis and treatment.
AMBULANCE UK - APRIL
75 For all your equipment needs visit: www.ambulanceservicesuppliers.com
NEWSLINE Emergency First Responder Conference - 100 subsidised places available!!! We are pleased to announce that the date of this yearâ&#x20AC;&#x2122;s EFR Conference has now been agreed and that, thanks to the generosity of WEL Medical we are able to offer 100 subsidised places on a first come first served basis. The Conference is taking place at The Kettering Conference Centre, Kettering, Northants, on Tuesday 18 October and once again a number of interesting and thought provoking presentations are being given by Professor Sir Keith Porter, David Halliwell, Steve Pratten, Amy Chan-Dominy, to name but a few. The full programme can be viewed on: www.lifeconnections.uk.com. The first 100 delegates to register will be offered a subsidised rate of just ÂŁ18.00 per person, including VAT, which represents tremendous value for money as it also includes lunch, tea/coffee, etc. Registrations and payment can be made by calling the Organisers on: 01322 660434
There have been several
call-takers mentored to improve.
interactions. What is more, it
instances where I have had
Failure to comply with the required
is possible to use this system
cause to dial the NHS non-
audit volumes could result in
as the foundation for a Quality
emergency 111 service. Each
the service losing its license to
Assurance programme.
time I spoke with someone who
operate. It works by automatically
was well-trained, empathetic and was able to give me the
The challenge for ambulance
annotating each call with crucial
reassurance and advice I
services is the sheer number of
data, such as the call-taker ID,
needed. In recent weeks,
calls being taken. How do you
CAD number and the DX code.
reports in the media have
listen to enough of the right types
Armed with this information
profiled incidents where the
of call for any form of ongoing
the system is able to schedule
great experience I received has
audit to be meaningful? Of course
the appropriate volume of the
not been replicated, and with
they could increase the number of
right type of calls to be audited
some tragic consequences.
auditors, but that is costly and not
by highly skilled medical
scalable for the long term.
professionals.
free 24 hours a day, 365 days
Forward thinking ambulance
This approach means auditors are
a year non-emergency medical
services have tackled the problem
not selecting calls at random to
helpline is a fantastic idea, but for
by taking a close look at how
audit and are spending far less time
me the question is how such a
commercial contact centres have
looking for the needle in haystack.
large operation can be monitored
addressed similar problems.
They can replay and review calls
to maintain quality standards
These contact centres have
and implement mentoring for those
and instil public confidence? The
seen the financial, operational
who need it most, and closely
answer may already exist in the
and customer service rewards of
monitor the improvement. What is
work being done by ambulance
managing calls more efficiently
more, the technology also makes
services that have adopted the
and effectively. They have become
it possible for them to not only
NHS Pathways Performance
highly adept at monitoring the
listen to each call, but also view
Framework for quality assurance.
quality of their agents (call-
the corresponding images from
Undoubtedly, the concept of a
takers), in environments where
the call-takers screen, to ensure
This framework obliges
extremely high call volumes are
what was said correlates with
ambulance services to complete
commonplace.
the process steps required to appropriately handle that type
huge numbers of audits
of call.
each month, to evaluate the
You might be surprised to learn
performance of call-takers in how
that ambulance services and
they handle the diverse array of
contact centres (in fact most
In 2015 the NHS 111 service
calls received. The idea is that
emergency services) use very
handled more than 30,000 calls
aspect of under-performance
similar call recording systems
every day, so finding consistently
can be quickly identified and
to capture and store their
under-performing call-takers, or broken processes is more
or register online at:
akin to looking for a needle in a
www.lifeconnections.uk.com.
field of haystacks. By adopting
Those registering online, will
this innovative new approach to
receive an invoice which must be paid by Friday July 29, should
Quality Assurance it would make
no payment be received by this
it possible for those running the
date your place will be offered to
111 service to implement an
someone else.
audit process whereby every call-taker, from the newest to the
AMBULANCE UK - APRIL
We look forward to welcoming
most experienced, is subject
you to Life Connections 2016
to the same level of scrutiny.
where we feel sure you will have a
Call-takers that need attention
rewarding time.
are provided with mentoring and the organisation can constantly ensure that it is providing the right
Giving NHS 111 an Assurance of Quality
training, resources and process to help them help those who really need it.
Author: Jamie Wilson, NICE www.nice.com
Systems
76 For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE WAA
Outline plans for Wiltshire Air Ambulance’s new home are granted
a Reserved Matters Planning
our helicopter our paramedics,
Application to Wiltshire Council.
who have advanced medical skills, can also respond to
Kevin Reed, Head of Operations
emergencies such as road traffic
at WAA, said: “We are delighted
collisions, heart attacks and
to have received Outline
strokes in a Rapid Response
Planning Permission from
Vehicle (car).
Wiltshire Council. We searched
AN Outline Planning
“The Outmarsh Farm site will enable us to have full control over the land and be future proof. It is centrally located in Wiltshire which would enable our helicopter to reach all parts of the county within 11 minutes.”
for over a year to find the
“Now we will work on the
most suitable site to build our
detailed design of our new home
new home and we carried out
and information on the public
extensive public consultation
consultation we will undertake
before we submitted our Outline
will be announced in due
Planning Application.
course.”
“The Outmarsh Farm site will
Currently the helicopter and
enable us to have full control
aircrew are based at a hangar at
over the land and be future
Wiltshire Police Headquarters in
to raise £1 million through a
one site for the first time.
proof. It is centrally located in
Devizes, while the charity team
Capital Appeal. The remainder
Wiltshire which would enable
is based at offices on Porte
will be funded by a private
The Outline Planning Application
our helicopter to reach all
Marsh Industrial Estate, Calne.
benefactor, who wishes to
received no objections. The next
parts of the county within 11
The lease on the hangar runs
remain anonymous.
stage for WAA is to undertake
minutes. As Melksham does
out on 31 December 2017 and
further public consultation
not have an ambulance station,
the lease on the offices runs out
WAA’s Outline Planning
to obtain the views of local
we believe that Wiltshire Air
at the end of January 2018.
Application can be viewed online
people and stakeholders on
Ambulance would provide
the proposed design of the
enhanced medical cover for the
The new home will cost up to
reference number is:
new home, before submitting
area. As well as responding in
£4 million, of which WAA hopes
15/10766/OUT
Application to build a new home for Wiltshire Air Ambulance (WAA) has been granted by Wiltshire Council. The new home, on land at Outmarsh Farm, Semington, near Melksham, will bring together WAA’s helicopter, aircrew and charity team onto
at www.wiltshire.gov.uk and the
on et re el.n mo erj ad at Re w.w ww AMBULANCE UK - APRIL
Professional burn care, anywhere - anytime!
77 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE Secondary Schools Invited to Sign Up for Free Life-saving Lesson on Restart a Heart Day 2016 and the Chance to Win a Defibrillator! Big-hearted Yorkshire Ambulance Service NHS Trust is inviting secondary schools across the county to sign up for a free life-saving lesson. Following on from the success of Restart a Heart Day 2014 and 2015, when more than 31,000 youngsters at 137 secondary schools received cardiopulmonary resuscitation (CPR) training, the event will be repeated again this year on Tuesday 18 October 2016. Hundreds of ambulance staff and volunteers will be available on Restart a Heart Day to teach youngsters what to do if they come across someone who has suffered a cardiac arrest - your actions can mean the difference
Resuscitation Manager for
“That’s why we’re determined to
TASC Chairman Cliff Randall,
Yorkshire Ambulance Service,
create a Nation of Lifesavers and
Trustees Roy Norris and Mik
said: “Restart a Heart Day is
our partnership with Yorkshire
Webb and Director of Support
becoming a well-established date
Ambulance Service has brought
Services Jean Hayes attended the
on Yorkshire’s calendar as a time
us one step closer to this goal.
annual conference at the Hinckley
when thousands of youngsters
This will be the third year we
Island Hotel for senior ambulance
learn how to save the life of a
have worked together to train
staff and their colleagues from the
loved one or a stranger who is
thousands of children in CPR on
NHS and academic institutions to
suffering a cardiac arrest.
Restart a Heart Day and we have
network and hear presentations
no doubt that this year’s event will
about topics affecting the UK’s
“Many people don’t realise that
mean thousands more potential
ambulance service leaders.
if someone suffers a cardiac
lifesavers are walking the streets.” Over 200 delegates attended the
arrest in front of a bystander, who immediately starts CPR before the
If your school would like to take
two-day event which included a
arrival of the ambulance service,
part in the event on Tuesday 18
gala dinner and charity auction
their chances of survival double.
October 2016, you can register
with £1,385 raised for TASC from
at http://www.restartaheart.
the generous guests.
“Currently in the UK, bystanders only get involved in doing CPR in
yas.nhs.uk. The deadline for applications is 29 April 2016.
2016 Ambulance Leadership Forum (ALF)
tickets for a future Wasps match
appeal to as many secondary
An auction at the UK’s
iPad Mini featuring the brand
schools as possible to take part
leading conference for senior
new ‘iCPG’ 2016 Ambulance
in Restart a Heart Day 2016 and
ambulance personnel raised
Clinical Practice Guidelines app
enable our staff and volunteers to
nearly £1,500 for a Coventry-
generously donated by Class
pass on their skills to pupils who
based charity.
Professional Publishing, a limited
to 73% in Norway where the survival rate is considerably higher. The evidence in favour of members of the public learning CPR is obvious. So we would
for life.”
limited edition Maglite torches from SP Services.
(ALF) for the first time since they
Yorkshire Ambulance Service
Council (UK), the British Heart
were formed last March.
pupils will be invited to take part
Rover Community Relations, an
Charity, attended the 2016 conjunction with the Resuscitation
incentive to enroll, all participating
two guests from Jaguar Land
Fine Art Publications and two
Ambulance Leadership Forum
your school now! As an added
Tour and Experience Day for
TASC, The Ambulance Services
The event has been organised in
hugely popular event so register
at the Ricoh Arena, a Land Rover
edition aviation print from SWA
will then have this valuable skill
between life and death.
anticipates it will again be a
The charity obtained a number of prizes including two hospitality
43% of cardiac arrests, compared
The TASC team also signed-up a number of new supporters for
Foundation, which provides the equipment free of charge as
The UK-wide charity helps to
TASC to continue raising the
part of its Nation of Lifesavers
provide vital advice and support
profile of the UK’s only charity
campaign, and St John
services to both serving and retired
solely focused on those working
Ambulance, to give thousands of
ambulance staff and their families.
in the ambulance industry.
in a poster competition and
schoolchildren the skills they need
the winner will receive a Zoll
to help save a life.
defibrillator for their school! Simon Gillespie, Chief Executive Currently in the UK, less than one
at the British Heart Foundation,
(8.6%) in ten people survive a
said:
cardiac arrest. The British Heart AMBULANCE UK - APRIL
Foundation (BHF) predicts that if
“The UK is a dangerous place to
the UK achieved the same survival
be if you are one of the 30,000
rates of countries like Norway
people who has a cardiac arrest
(25%), where CPR is taught in
outside of hospital this year. Less
schools, an additional 100 lives
than one in ten people survive
could be saved each week - the
- partly because too few people
equivalent of approximately 5,000
have the skills and confidence
every year.
to perform CPR and not enough defibrillators are available in
Organiser Jason Carlyon,
public places.
From the left, Jean Hayes, Roy Norris, Mik Webb and Cliff Randall from TASC at the 2016 Ambulance Leadership Forum
78 For more news visit: www.ambulanceukonline.com
NEWSLINE Cliff said: “There is no doubt
Ken Wenman, the chief executive
hotzone of incidents. The types
forward were first and foremost,
this is a challenging time for
of the South Western Ambulance
of incidents they could be called
excellent paramedics. However,
ambulance personnel because
Service NHS Foundation Trust and
upon to work in include:
to get through this initial round of
of the demand on the service
Hilary Pillin, who is a consultant in
and the presentations at the
healthcare response.
ropes
conference certainly provided some lively debates.
our other supporters, is vital in ensuring we provide the support
Leadership Forum was an
colleagues need in times of crisis,
ideal opportunity to spread the
bereavement, severe difficulty or
message further about our work
urgent need.”
among senior personnel in the
continue making a difference.
Putting their ‘HART’ into it
“The proceeds from the auction
For over 30 members of staff
will help TASC to provide grants
were given a small insight into
for rehabilitation services to
what could be a new career in
help those recovering from
the ambulance service.
a significant amount of money to
work-related injuries, long-term
fit, determined, up for working in a team, supportive and not afraid to show leadership when required.
“Their backing, along with all
“Attending the Ambulance
ambulance sector as well as raise
selection they also needed to be • Safe working at height using
• Within confined spaces such as collapsed buildings
“We were very pleased with just how well prepared the
• CBRN-E (chemical, biological,
candidates were – it was a very
radiological, nuclear and
positive day. Thank you to
explosives) incidents
Dudley Metropolitan Borough Council for allowing us to use
• Wide area flooding
the facilities at Himley Hall.
• Within the warm zone of
“We will be whittling the numbers
firearms incidents
down with a view to interviewing the successful candidates, if they
• Infectious diseases
get through that then they can begin a three month intensive
The staff who were trying to get
training package before they can
illnesses or surgery, provide
The paramedics were all vying
selected had to go through a
really start to learn as part of the
support to help people suffering
for places on the latest training
number of tests at Himley Hall
active HART teams.
with stress and Post Traumatic
course to be come a member of
in Dudley. These included a 2
Stress Disorder following
the Hazardous Area Response
mile run, swimming 20m in a
“Overall, we were delighted
traumatic incidents at work, and
Team (HART).
dry suit, helmet gloves and with
by the quality of staff and it
a floatation device, a detailed
will not be easy to pick the
HART teams provide paramedic
clinical assessment and an
successful candidates Whilst
“We signed-up a number of
care to patients within a
exercise that involved working as
we will be picking only a few to
new supporters during the
hazardous environment that
a team.
go forward, everyone who took
conference including Dr Anthony
would otherwise be beyond the
Marsh, chief executive of West
reach of NHS care. This includes
HART Manager, James Price said:
efforts; they are a credit to the
Midlands Ambulance Service,
working within the inner cordon or
“The staff that put themselves
paramedic profession.”
bereavement support.
part should be proud of their
AMBULANCE UK - APRIL
79 Life Connections - The Affordable CPD Provider: www.lifeconnections.uk.com
NEWSLINE to the PEPPOL e-procurement
Northern General Hospital’s helipad appeal receives over £1million from the ‘HELP Appeal’
community, is currently involved
The HELP Appeal – the only
* ‘Operational productivity and
charity in the UK dedicated
performance in English NHS
to funding the construction
acute hospitals: Unwarranted
of hospital helipads– has
variations - An independent
made another huge donation
report for the Department of
of £50,000 towards Northern
Health’, Lord Carter of Coles.
in a project to roll out PEPPOL to an NHS Trust and its suppliers that will act as a demonstration of PEPPOL’s benefits – which includes eliminating unwarranted variations in procurement.”
General Hospital’s helipad, bringing it ever closer to its final
EEAST
target of £2million. Over the past two years, the HELP Appeal has raised over £1 million
closer to achieving our fundraising
across all of the main resource
– over half of the total amount
target for our helipad appeal.
areas of English NHS acute
needed - for the ‘Saving Time,
Ambulance service welcomes national staff survey results
hospitals. As an example in
The region’s ambulance service
Saving Lives’ appeal launched
Sheffield Hospitals Charity are still
procurement, his report* found
has welcomed improved results
by the Sheffield Hospitals Charity,
raising funds towards the helipad
that “the average price paid for
in the annual NHS staff survey.
which has been dedicated
and we hope to conclude the
hip prosthesis varies from £788 to
to building the much needed
appeal during 2016. We are at a
£1590, and trusts buying the most
More than 1,400 staff in the East
helipad.
critical stage in the project and I’d
are not paying the lowest price”.
completed questionnaires and
like to urge anybody who can, to
Robert Bertram, Chief Executive of
get behind our appeal and help
One of the report’s
today, reveal that overall staff
the HELP Appeal said:
us to fund this vital development.”
recommendations to tackle
engagement (3.44) was better
variation is that all trusts commit
than the national average for
‘We feel very passionate about
to the Department of Health’s
ambulance trusts (3.39) and had
NHS Procurement Transformation
improved on the East of England
Programme (PTP). This includes
Ambulance Service NHS Trust’s
prioritising the role of procurement
(EEAST) 2014 score of 3.17.
this project and are very excited that construction is nearing completion. Our grant will go towards supporting the costs for this helipad, which will serve patients across South Yorkshire,
Data Interchange endorses Carter Report on NHS procurement efficiency
Derbyshire and East Midlands.
the 2015 findings, published
and enhancing current purchase to pay systems. Adopting Pan
It also scored higher than average
European Public Procurement
for staff motivation and more
Online (PEPPOL) standards is an
respondents recommended the
important part of this.
service as a place to work or
AMBULANCE UK - APRIL
David Eyes, Head of Business
‘The HELP Appeal has been
Development at B2B integration
involved from the very beginning
solutions provider, Data
David Eyes said: “PEPPOL
– committing £1million at the very
Interchange, enthusiastically
technology is not ground
Some of the improvements in the
start of this life saving project,
welcomes and supports the
breaking; it has been tried,
2015 staff survey:
through to seeing the first building
findings of the Carter Review,
tested and proven in retail and
work taking place in June 2015.
published on 5 February 2016,
automotive sectors. Moreover,
Having this new helipad will make
which says hospitals can save
NHS Trusts benefit from lessons
their job increased from 56% to
a huge difference to critically ill
money and improve care by
learned in these sectors. PEPPOL
71%
patients in the region.’
standardising procedures,
enables the NHS to take down
being more transparent and
the barriers and introduce an
• The percentage of staff looking
David Reynolds, Director of
working more closely with
interoperable network to allow
forward to going to work rose
Sheffield Hospital’s Charity said:
neighbouring NHS trusts.
the NHS to become a global
from 42% to 56%
receive treatment.
• Staff feeling enthusiastic about
purchasing service. Data
“We’d like to say a huge thank
Asked to carry out the review by
Interchange, which received one
you to the HELP Appeal for their
Health Secretary Jeremy Hunt,
of the first UK-based PEPPOL
related stress (48% compared
very generous donations. Thanks
Lord Coles found a significant
Access Point certifications,
with 51% in 2014 and national
to their support we are now even
amount of unwarranted variation
providing customers with access
average of 49%)
80 For further recruitment vacancies visit: www.ambulanceukonline.com
• Decrease in staff suffering work
NEWSLINE • 89% agreed their role makes a difference to patients
http://www.nhsstaffsurveys. com/Caches/Files/NHS_staff_ survey_2015_RYC_full.pdf
errors or near misses (35% compared with 42% in 2014) • More staff recommending the Trust as a place to work or receive treatment (3.39 compared to 3.04 in 2014 and 3.26 national average) • Staff motivation at work has increased from 3.39 to 3.71 with the national average for
NWAS
immediate managers (3.36 compared with 3.11 last year) • Increase in staff reporting good communication between senior
The donated defibrillators are
North West Ambulance Service (NWAS) has welcomed a £40,000 donation by a Preston based family charitable trust, who offered to meet the funding costs for a Rapid Response Vehicle (RRV).
Manager for Lancashire, said: “A big
Following a meeting with NWAS Community Fundraiser Kevin Hookham, the anonymous donor agreed to fund four community defibrillators and pay for the leasing costs of an RRV for a period of four years.
management and staff (22% compared with 15% in 2014 and 16% national average) However, more staff said they were working extra hours and there was an increase in the percentage of staff who said they
their best option was to sponsor
Newly donated vehicle ready to save lives in Preston
ambulance trusts at 3.69 • Improvement in support from
Cardiac Smart Team they decided an RRV and defibrillators.
• Decrease in percentage of staff witnessing potentially harmful
working closely with the Trust’s
The RRV goes will be operated by a fully trained paramedic responding to patients with life-threatening conditions in the Preston area. The unnamed family charitable trust was keen to sponsor an NWAS vehicle and
set to be placed on community buildings around Preston. Graham Curry, NWAS Sector thank you from NWAS to the family
“A big thank you from NWAS to the family trust for their incredible donation.”
trust for their incredible donation. This is the first vehicle we have had donated to the Service here in
This is a great example of two
Lancashire and I’ve no doubt it will
organisations working together to
make a huge contribution to saving
increase the number of resources
lives in Preston.
on our roads in Preston and the Trust is very grateful for the
Kevin Hookham said: “I’m absolutely
family’s kindness.”
delighted with this extremely generous donation from our
Donations can make a huge
anonymous donor. It’s great to work
difference to the Service and
in partnership with a family charitable
provide the Trust with additional
trust that wants to put something
resources to save lives. If you
back into their community in order to
or your business would like to
help local people.
make a donation please contact our Chain of Survival Community
“There was a range of options
Fundraiser Kevin Hookham on
on the table, but the donors were
Kevin.Hookham@nwas.nhs.uk or
very keen to sponsor a vehicle
visit the team’s website at http://
at £8,500 per year, along with
www.cardiacsmart.nwas.nhs.uk/
the defibrillators at £1,500 each.
fundraising/
had experienced physical violence from patients. Ruth McAll, Interim Director of HR, said: “More staff took part in the 2015 NHS Staff survey than the previous year, and we can take away many positives from the result. However, we have lots more to do and therefore we will be asking managers and staff to develop an action plan to address some of the issues the survey raised. We want this action plan to be owned by each department AMBULANCE UK - APRIL
to ensure the right things are addressed and completed. The Board have recently accepted our new people and culture strategy, which puts staff at the centre of our visions and values and the vital contributions they make to our success.” To read the full report, visit:
From the left, Kevin Hookham, NWAS Community Fundraiser, Graham Curry, NWAS Sector Manager for Lancashire and Cheryl Pickstock, NWAS Chain of Survival lead for Lancashire.
81 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE their career as paramedics in
First students on unique degree enter final year The first cohort of students studying a unique Paramedic degree, developed to meet the diverse needs of the changing NHS workforce, have entered the final year of their programme. Teesside University’s BSc (Hons)
organisations across the NHS. The degree is unique as, unlike similar courses, it is an entry-level qualification for students who do not necessarily have any prior experience of paramedic work. It has been developed to provide for the future needs of the profession and graduates will be eligible for registration with the Health and Care Professions Council, the professional regulator for paramedics.
Paramedic Practice degree
The degree, which welcomed
Programme Leader Mark Nevins
Teesside University’s School
was developed by stakeholders
its first cohort of students in
said: “We’ve worked closely with
of Health & Social Care has
such as NHS employers,
January 2014, was developed
the regulatory body and wider
equipped classrooms with state-
current practitioners and their
to reflect a growing desire
professional partners to develop
of-the-art equipment, including
professional body, the College
within the profession for a more
a degree which will prepare
a fully equipped ambulance,
paramedics who are fit for the
of Paramedics, to provide a
academic approach and wider
to ensure that the 50 students
future needs of the profession.
professional qualification for
skills base in non-traditional
per year who study the degree
areas such as GP surgeries
undergraduates who will be able
have all the skills and knowledge
and emergency departments,
“Skills training is, naturally, very
to meet the changing needs of
they need to begin a career as a
as well ambulances, to provide
important and trauma training
the NHS workforce and pursue
paramedic.
a wider base for paramedic
still plays a key role but with
education and an expanding
more care being required to
career pathway.
be delivered at home and the increased demands on
The three year degree takes a
Emergency Departments our
holistic approach to paramedic
students are getting the broadest
education rather than simply
based experience to meet those
focusing on trauma and critical
challenges ahead.”
emergencies which was the focus of traditional in-house
“However, with this degree we
ambulance training.
also wanted to look at the theory of being a paramedic and explore
It looks at the many different
professional issues such as care
skills paramedics are expected
and compassion and putting the
to master in the 21st century
service users first.”
in order to cater for the needs of the patient and become true
For more information about the
community paramedics.
BSc (Hons) Paramedic Practice
Students spend time on
offered by Teesside University visit
placements in GP surgeries and
degree and other qualifications www.tees.ac.uk
hospitals as well as ambulances to learn the core skills of how to AMBULANCE UK - APRIL
assess, manage, treat and refer patients.
AoFAQ supporting Association of First Aiders Membership!
They also learn how to make decisions such as whether a
As an outwardly looking
patient can remain at home or
organisation AoFAQualifications
be sent to hospital or referred to
fully understand that first aid
another healthcare professional
for most training providers
in the community to continue
can form only a part of their
their care at home.
business. To promote quality
82 For more news visit: www.ambulanceukonline.com
NEWSLINE in training, AoFAQ produce
and car crash one day and
Veterans Foundation, was awarded
qualifications for Trainers,
a house fire the next – it’s no
a CBE in the New Year’s Honours
surprise personnel have been
List for his charitable work.
Assessors and Internal Quality Assurers along with supporting
Simon Weston Leamington talk
known to suffer post-traumatic stress disorder.
materials such as Scheme of
His commitment to providing ongoing support is part of TASC’s
Works, Assessment papers
A prominent UK figure and
and trainer presentation
British Army veteran has
“Ambulance staff do an incredible
general profile-building of the
powerpoints.
pledged his patronage to a
job of supporting the public
charity to raise awareness of the
national ambulance charity.
tirelessly week in, week out, and
support available for ambulance
they deserve recognition and
service personnel and their
support in return.
families too.
AoFAQ as a big and welcoming plus for AoFA Training Provider
Simon Weston CBE, a former
members are offering 50% off
soldier who fought in the
on their First Aid and 25% off
Falklands War and was left
“TASC provides a fantastic service
Cliff Randall, Chairman of TASC,
on their Health & Safety Training
severely burned when his
which in the short time since
said: “We are delighted to have
PowerPoints. The EFAW for
troopship was hit by Argentine
being established is already doing
someone of such esteemed and
example, is just £60 which
aircraft and set alight, announced
much to ensure there is help at
honourable standing as Simon
his patronage to TASC (The
hand for ambulance personnel –
Weston as our patron.
Ambulance Services Charity) at a
whether that is advice, emotional
talk in Warwickshire.
support, access to rehabilitation,
“The UK Ambulance Service
or even financial help.
receives over 10 million 999
consists of 120 professionally designed slides mapped against the Learning Outcomes and Assessment Requirements. You can even re-brand PowerPoints with your own logo. It’s not just restricted to first aid, but includes health and safety and educational qualifications. Feedback from our existing centres love our PowerPoints, not only does it make training easier and more engaging but equally important it maintains standards which has got to be good for our industry. AoFAQ normally only offer these professionally designed PowerPoints and lesson plans to their Centres but since opening the shop they have decided to offer these to all training providers. Have a look now at our new store, “shop.AoFAQualifications.org”. All PowerPoints have been updated to the latest UK
calls a year and employs 70,000
The Coventry-based charity was established last year and helps
“Being rescued and requiring the
people across the NHS and
to provide vital advice, support
help of the emergency services has
private sectors which underlines
and a range of services to serving
altered the way I think about things,
how much we rely on their help.
and retired ambulance staff, their
and it is my honour to continue to
families and dependents.
support The Ambulance Services
“With Simon giving the charity
Charity as patron.
his high-profile support, we
The public speaker has a
look forward to continuing to
history of supporting the cause
“I am looking forward to raising
developing and raising awareness
after having been patron
the profile of the charity and
of TASC as we work with
of the Ambulance Services
supporting them in any way I can
ambulance services personnel
Benevolent Fund – the charity
– it’s certainly a cause that I am
across the UK.”
which preceded TASC – and at
committed to backing.”
his show in Leamington, Simon
If you would like to support or
raised awareness of TASC and
Simon, who also lends his
find out more information about
its important work at the charity’s
backing to a number of other
the charity, please contact 02477
stand at the Royal Spa Centre.
causes including Care After
987922 or visit:
Combat and The Falklands
www.TheASC.org.uk
“What we know about the ambulance service personnel is that they provide an essential service which saves lives every single day of every year,” Simon said. “And yet, in comparison to other emergency services, much of their work goes under the radar.
Resuscitation Council changes. encounter is rightly recognised and
www.aofaqualifications.org
supported, yet ambulance service
AMBULANCE UK - APRIL
“The distress that soldiers For more information go to:
personnel are often expected to Email: customersupport@
deal with their experiences with
aofaqualifications.org
little support in terms of helping them handle their experiences.
Call our Operations department on 01908 610093 who will be
“It’s a heck of a thing when you
pleased to assist.
can be dealing with an assault
Simon Weston, who has joined TASC (The Ambulances Services Charity) as patron, with Jean Hayes and Jenny Armour from TASC.
83 Life Connections - The Affordable CPD Provider: www.lifeconnections.uk.com
IN PERSON another positive step as we look to put in place
News
Trust appoints new Deputy Medical Director
a stable and permanent leadership team that will drive forward patient care.” The appointment follows the announcement in
The ambulance service’s stride towards
January of Lindsey Stafford-Scott as Director
a stable and permanent leadership team
of People and Culture, who will join in April,
continues with the appointment of a deputy
and Kevin Smith as Director of Finance and
medical director.
Commissioning. Dr Davis will work alongside interim Medical Director Dr Andy Carson whilst
Dr Tom Davis will join the East of England
the Trust looks to recruit a permanent Medical
Ambulance Service NHS Trust (EEAST) on
Director.
Monday (29th February). News
A practicing GP, Tom joins from NHS South Sefton Clinical Commissioning Group (CCG) where he was the Primary Care Transformation Lead. Tom has a broad range of NHS experience having worked for CCGs, NHS 111, GP practices and hospitals.
ShowMed appoint new Director Northampton based event medical provider ShowMed has made a new appointment to their Executive Team. Andrew Howes formerly Lead Nurse at Peterborough City Hospital will join the UK’s leading supplier of medical cover to the events industry in June as Director of Clinical Care and Training. Andrew who has worked for the company for 9 years as a Senior Nurse will lead on all operational matters for the company. Andrew said “ShowMed have always been a very professional company with outstanding clinical standards. Having worked for them as a Pre-Hospital Care Nurse I am relishing this challenge to move onto the next level. I will be looking at different models of service delivery at events and shaping the future of training at mass gatherings.”
Tom said he was “delighted” to be taking on the role: “I look forward to meeting as many of the staff as possible over the coming months. Already I have met members of the organisation who have inspired me with their passion, dedication and enthusiasm to do the best for the patients they serve. As the NHS faces a challenging time it is vital we promote the excellent care and experience AMBULANCE UK - APRIL
patients receive on a daily basis. I am certain that together we can build on this and aspire to make EEAST a leading mobile healthcare provider in the future look NHS.” The Trust’s Chief Executive Robert Morton said: “I am delighted that Tom is joining our service. Tom brings a wealth of skills and experience which will help us as we transition to different ways of working and treating patients. This is
“ShowMed has been at the forefront of providing emergency care at sporting and music events for the past 16 years and is leading the way amongst CQC registered private providers in its use of technology systems to deliver care; so I am keen to be bringing my experiences to the table.” Allan Withers, Managing Director at ShowMed said “We are very pleased to have Andrew on board to assist us with our plans both in terms of business growth and service delivery.” ShowMed was formed in 2000 by Allan Withers; a former Ambulance Service Manager and Paramedic. The company has provided medical cover at concerts across the UK by major bands such as Foo Fighters, The Prodigy, Swedish House Mafia, U2, Red Hot Chili Peppers, Madonna, and many more. From 2006 to 2008 the company was the
sole medical provider at Wembley National Stadium. Currently, ShowMed are contracted to the Ricoh Arena, West Bromwich Albion, SSE Arena in London, Lancashire County Cricket Club and The Royal Albert Hall to provide medical cover at all their events. Currently Showmed has 275 staff ranging from Doctors, Paramedics, Nurses through to first aid staff. News
London Ambulance Service appoints new Medical Director London Ambulance Service is pleased to announce that Dr Fenella Wrigley has been appointed Medical Director following a national recruitment process. Fenella has been undertaking the role on an interim basis since January 2015. Prior to that Fenella was Deputy Medical Director, having joined the Service in 2008 as Director for Control Services. Chief Executive, Dr Fionna Moore, said: “Fenella brings a wealth of clinical experience from both the pre hospital setting and as an A&E consultant. She is committed and passionate about providing the best possible patient outcomes for Londoners. “We are delighted Fenella has accepted this role on a permanent basis.” Fenella will continue to work clinically one day a week as a consultant in emergency medicine for Barts Health NHS Trust. She said: “It is a privilege to work as part of the NHS both at London Ambulance Service and for Barts Health. “The Service has had a challenging year and it is vital we continue we continue to promote excellent care and patient experience, develop all of our staff and work closely with stakeholders and the wider NHS. “I look forward to working together to continue to improve our clinical outcomes and develop our role as a leading mobile healthcare provider.” Fenella led on the development of urgent care within the London Ambulance Service, overseeing the introduction of a Clinical Hub in the control room. Staffed by clinicians it provides clinical support to ambulance crews at the scene as well as telephone treatment for patients.
84 For further recruitment vacancies visit: www.ambulanceukonline.com
IN PERSON AAA News
Hanna Sebright Becomes Chair of Influential and Dynamic AAA Board of Directors The Association of Air Ambulances (AAA) is delighted to announce that Hanna Sebright was duly appointed as the new Chairman of the Association at their Annual General Meeting held on Monday 7 March 2016. A large gathering of representatives from across the European HEMS sector, attended the AGM which saw former Chairman Bill Sivewright hand over his reign to Hanna after a three year period in charge.
Steve Wheaton, Assistant Chief of West Midlands Ambulance Service was also appointed Vice Chair, with Paula Martin, CEO of Cornwall Air Ambulance and Andy Moir, Head of Air Ambulance Service of Scottish Ambulance Service being appointed to the Board of Directors of the AAA. Clive Dickin National Director commented: “The AAA represents the majority of air ambulance charities and NHS ambulance services in the UK, this representation is possible through democratic process and it’s a real privilege to have such a dynamic and influential Board to work with.” Following the AGM, the Association held its quarterly Members’ Forum and provided attendees with important updates on a range of key topics.
Before signing off, Bill highlighted some of the Association’s achievements and explained how 2015 had been a great year for patients due to amazing developments in pre-hospital care, the procurement of more advanced equipment, better governance and the sharing of knowledge of members. He subsequently described how the Association had become a conduit in representing the sector and listed the numerous successes, making it the most successful year yet.
Nigel Hare, Vice Chair of the AAA Operational Subcommittee gave a thorough and detailed review of the scheduled roll-out of the ESMC / Ambulance Radio Programme and explained the importance of member’s engagement with all parties involved. Nick Campion, Independent Secretary to the Judges, provided some really informative hints and tips on how to submit a good entry into the AAA Awards of Excellence and encouraged people to think about their entries now.
Bill Said: “Over the past four years, it has been my privilege to hold the position of Vice Chair and then Chair. Although I cannot claim the credit, I look with pride on what we have achieved during that time. We have seen our Association truly come of age and the recognition by key Government departments has helped us secure funding and significant influence with both national and international regulatory bodies.”
Clive Dickin, AAA National Director talked about the All Party Parliamentary Group for Air Ambulances (APPGAA), giving key dates for 2016 and providing an update on the lobbying of Government. Other topics were covered including the benefit of membership affinities, structure and personnel changes within the AAA Subcommittees and future plans for National Air Ambulance Week.
News
Trust Chair re-appointed to drive further service improvements The NHS Trust Development Authority (NHS TDA) has confirmed the re-appointment of Sarah Boulton as Chair of the East of England Ambulance Service NHS Trust (EEAST) for a further three years. Sarah joined the Trust as Chair in March 2014, having worked at NHS Board level for many years. Prior to this she was Chair of NHS Midlands and East Strategic Health Authority. Sarah has a background in business and finance having worked as a business and management lecturer and more recently as a management consultant advising on strategy, change and board development. Sarah said, “When I joined two years ago the Trust was at the start of a turnaround process. The progress the service has made over the last two years has been impressive despite the current pressures on the service. Whilst there is still more work to be done, I would like to thank all the staff and managers for their dedication and commitment to improving patient care.” She continued, “This is an exciting time to be in the ambulance service as we look at how we can deliver more care in the community, further develop the clinical skills of our staff and make positive cultural changes within the service.” Mark Cubbon, Portfolio Director at the NHS Trust Development Authority, said: “We are delighted that Sarah has been re-appointed as Chair of East of England Ambulance Service NHS Trust. Since Sarah has been in post, she has supported the Trust to deliver good quality patient care for the local community and we look forward to continuing to work with Sarah in the future.” Non-executive appointments to NHS Trusts made by the NHS TDA are subject to the Code of Practice of the Commissioner for Public Appointments.
YAS News
Chairman steps down after six successful years
AMBULANCE UK - APRIL
Sarah Boulton has been appointed from 10 March 2016 until 9 March 2018.
Ms Della Cannings QPM announces she will step down from her role as Chairman
85 Do you have anything you would like to add or include? Please contact us and let us know.
IN PERSON of Yorkshire Ambulance Service NHS Trust (YAS) on 9 May 2016 after six years at the helm. This will allow for the NHS Trust Development Authority to start a recruitment process for a new Chairman. Sir Peter Carr CBE, Chair of the NHS Trust Development Authority, said: “The Trust has made substantial progress in the face of difficult challenges and Della’s strong leadership of the Board has helped direct these changes for the benefit of patients. “The NHS is indebted to her for the significant personal contribution she has made and giving her time and expertise to Yorkshire Ambulance Service and the wider ambulance community. “The ambulance service and the community it serves owe a debt of gratitude to her for her dedicated work.” The Chief Executive of Yorkshire Ambulance Service, Rod Barnes, said: “Della has been an inspirational and tirelessly hard-working Chairman who leaves behind a legacy of considerable success and achievement. “She has changed the culture of the organisation for the better and redefined our relationship with our local, regional and national partners in the NHS, other emergency services and, most crucially, with patients and local communities. “On behalf of the rest of the Board and the wider organisation, I would like to thank Della for the major contribution she has made to Yorkshire Ambulance Service over the past six years and wish her well for the future.”
AMBULANCE UK - APRIL
Under her leadership, the past six years have seen major advances at Yorkshire Ambulance Service. The performance of the Trust has improved considerably across a broad range of quality indicators, and has achieved and sustained financial stability. Measured against a range of key indicators, including emergency response times, the Trust is amongst those in the top performing quartile of ambulance services across the country. She has led the modernisation and diversification of services, including the expansion of services such as NHS 111 and West Yorkshire Urgent Care, updating of estate, fleet and increased use of technology and greater integration with the wider health economy and with other emergency services. The expansion of involvement with volunteer Community First Responders, a marked increase in the provision of community Public Access Defibrillators, the creation of the YAS Forum to ensure closer working with
the 5000+ membership of the Trust and the delivery of Restart a Heart to 30,000+ schoolage children are just a few of the initiatives under her leadership.
care and compassion that I see in colleagues here each day. All the people who work here make a great difference to the lives of so many Londoners and will continue to do so.
Della has also been a Board member and the Chairman of the Association of Ambulance Chief Executives (AACE) Council.
I am handing over to Heather Lawrence whose experience within the NHS and at Monitor will be of huge benefit to the Service. I wish everyone at the Service every success in the future. I have recently taken up the role of Commanding Officer of the Engineer and Logistic Staff Corps (advisors to the MoD) but I will always look back and remember my time here with pride and affection.”
The AACE Chairman, Dr Anthony Marsh, said: “Della has done an outstanding job and has made a huge contribution to the ambulance sector in our country for which she should feel rightly proud.” Della Cannings QPM said: “Yorkshire Ambulance Service (YAS) is a vital portal for the public to access and receive health services and the most important thing is that our communities receive high quality services. It is our frontline and support employees who ensure these are delivered – I thank all the staff for the excellent care they provide, often in challenging circumstances with ever increasing demands. I have been privileged to be alongside such caring staff exhibiting high quality clinical skills that are supported by such a variety of experienced staff. “I am proud to have been part of the organisational transformation of YAS and positioning it to undertake the next stage of change with regards to increasing integration of services across health and social care and with other agencies, taking forward a challenging estates modernisation programme and increasing its effectiveness and efficiency.” News
Service Chairman Richard Hunt to leave at end of financial year Chairman Richard Hunt CBE, has announced that he will be leaving the Service at the end of the financial year on 31 March 2016, after seven years in the role. Heather Lawrence OBE, has been appointed by the NHS Trust Development Authority to take up the post from the beginning of April. Richard said: “It has been a great privilege to have been the Chairman of The London Ambulance Service and I offer my sincere thanks to all colleagues across the Service, for their hard work and support to me over the past seven years. We have been through some difficult times recently, but I believe that we are now seeing progress and improvements for both patients and our people. I am incredibly proud to have been part of the Service, and of the
86 For more news visit: www.ambulanceukonline.com
Chief Executive, Dr Fionna Moore, MBE added: “Richard has made an exceptional contribution to the Service and has been incredibly supportive towards everyone who works here, and especially to me, as the new Chief Executive. He will be greatly missed. We look forward to welcoming Heather, her knowledge and experience will be invaluable as we focus on improving our Service to patients”. Heather Lawrence brings with her over 40 years of frontline NHS experience from being a nurse, to running one of the most successful trusts in the country. Heather is currently a non-executive director at Monitor, the regulator for NHS foundation trusts, and was previously Chief Executive of Chelsea and Westminster Hospital from 2000 to 2012. The Trust was one of the first in the country to gain NHS Foundation Trust status in 2006. Heather said: “I have a great respect and admiration for the people who work for the Service, and I am looking forward to getting out to meet them and see first-hand the challenges they face every day. I will work with Fionna, her team and the Board, to support them in making The London Ambulance Service a world class organisation.” Andrew Hines, Associate Director of Delivery and Development (London) NHS Trust Development Authority said: “I would like to thank Mr Richard Hunt CBE for his hard work and dedication during his seven years as the chair. Richard has provided strong leadership and has been passionate about delivering emergency services that Londoners can rely on. “Heather Lawrence will bring a wealth of experience and insight across a broad range of environments, including the NHS at the highest level, which will benefit the Trust greatly. This is not only great news for the Trust and its staff, but also for Londoners.”
AUK_August_AUK_August_2013 11/10/2013 10:53 Page 254 AUK_August_AUK_August_2013 11/10/2013 10:53 Page 254
THE CLASSIFIED SITE For For further further information information or or to to make make aa reservation reservation please please contact contact
Terry Terry or Rachel
Tel: Tel: 01322 660434 Fax: Fax: 01322 666539 email:
info@mediapublishing info@mediapublishing company.com company.com or or by post to: Media House, Media 48 High Street 48 Swanley Kent BR8 BQ Kent
Life Connections Connections 2014 Life Exmed Study Study Day Day Exmed
Theme:Difficult DifficultAirway AirwayCourse Course EMS™ EMS™ –– An An introduction introduction Theme: TH Thursday15 15TH May 2014 2014 Thursday May KetteringConference ConferenceCentre, Centre,Kettering Kettering NN15 NN15 6PB 6PB Kettering
TIME: A.M TIME: A.M
PRESENTATION PRESENTATION
TIME:P.M P.M TIME:
08.30 - 09.00 08.30 - 09.00
Registration Registration
12.00 - 12.30 12.00 - 12.30
Skill Stations Skill Stations Rotation 2 Rotation 2 Lunch, Exhibition Lunch, Exhibition Skill Stations Skill Stations Rotation 3 Rotation 3 Skill Stations Skill Stations Rotation 4 Rotation 4 Airway Self Scope Video Airway Self Scope Video Tea/Coffee, Exhibition Tea/Coffee, Exhibition Practical Moulages Practical Moulages Wrap up Wrap up CPD certificate provider CPD certificate provider
Delegate Rate: £72.00 (inc VAT) Delegate Rate: £72.00 (inc VAT)to visit over 60 trade stands. includes: delegate bag, refreshments and the opportunity includes: delegate bag, refreshments and the opportunity to visit over 60 trade stands.
Only 7 places remain available!! Only 7 places remain available!!
AMBULANCE UK - APRIL
09.00 - 09.15 Introduction & History of the Course 09.00 - 09.15 Introduction & History of the Course 12.30 - 13.30 09.15 - 09.45 The Airway Algorithms 12.30 - 13.30 09.15 - 09.45 The Airway Algorithms 13.30 - 14.00 09-45 - 10.30 Prediction of the Difficult Airway 13.30 - 14.00 09-45 - 10.30 Prediction of the Difficult Airway 10.30 - 11.15 BVM and Laryngoscopy 10.30 - 11.15 BVM and Laryngoscopy 11.15 - 11.30 Tea/Coffee, Exhibition 14.00 - 14.30 11.15 - 11.30 Tea/Coffee, Exhibition 14.00 - 14.30 11.30 - 12.00 Skills Stations (4 rotations/30 min. each) 11.30 - 12.00 Skills Stations (4 rotations/30 min. each) 14.30 - 14.45 Group 1 BVM, ETI 14.30 - 14.45 Group 1 BVM, ETI Group 2 EGD’s & Rescue Airways 14.45 - 15.00 Group 2 EGD’s & Rescue Airways 14.45 - 15.00 Group 3 Needle & Surgical Airway 15.00 - 17.00 Group 3 Needle & Surgical Airway 15.00 - 17.00 Group 4 Video Laryngoscopy 17.00 Group 4 Video Laryngoscopy 17.00 Topics and Speakers correct at the time of press but may be subject to change Topics and Speakers correct at the time of press but may be subject to change
PRESENTATION PRESENTATION
To register call 01322 660434 or visit: To register call 01322 660434 or visit:
www.llifeconnections.uk.com ifeconnections.uk.com www. For all your equipment needs visit: www.ambulanceservicesuppliers.com
87
Does he need a trauma centre or the local hospital? Twenty-year-old male in a motor vehicle accident. Airbag has deployed. Car has significant front-end damage. Is he bleeding internally? Will he need a trauma centre? These are some of the questions you need to answer on a suspected trauma call, as haemorrhage is the leading cause of death after injury.1 The new trauma parameters on the ZOLL X SeriesÂŽ help you accurately and quickly assess your patients so you can feel more confident in your treatment decisions.
Insight for informed decisions. www.zoll.com/uk/trauma-care Acosta JA, et al. Journal of the American College of Surgeons. 1998;186(5):528-533.
1
Š2016 ZOLL Medical Corporation, Chelmsford, MA, USA. X Series and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. MCN IP 1601 0092-05