//1
Wo rkin g
toge
ther
New Integrated Urgent Care Service launches in Thames Valley Autumn Twenty Seventeen
Autumn 2017
//3
Launch of new Integrated Urgent Care Service for the Thames Valley 4
SCAS Receives Gold Award for supporting The Armed Forces 12
Transforming Non-Emergency Patient Transport in Sussex 22
Two Very Handy Men 16
Oxfordshire Crews Visited by Cardiac Arrest Survivors 42
Autumn 2017
Launch of new Integrated Urgent Care Service for the Thames Valley
//5
Autumn 2017
//7
On 5 September, SCAS was delighted to launch the Thames Valley Integrated Urgent Care (IUC) Service for patients across Berkshire, Buckinghamshire and Oxfordshire. The Thames Valley IUC Service builds on the success of SCAS’ NHS 111 service and helps people access a wide range of clinical care through a single call, including dental, pharmacy and mental health services. SCAS is leading a collaboration of NHS providers (Berkshire Healthcare NHS Foundation Trust, Oxford Health NHS Foundation Trust and Buckinghamshire Healthcare) and was awarded the contract for the service in July 2017 following a competitive tender process undertaken by 10 clinical commissioning groups in the Thames Valley. Transforming Thames Valley NHS 111 into Integrated Urgent Care Nationally NHS 111 services across the country are being transformed into Integrated Urgent Care (IUC) services in order to support a whole system
“If I have an urgent need, I can phone a single number (111) and they will, if necessary, arrange for me to see or speak to a GP or other appropriate health professional – any hour of the day and any day of the week.”
approach to reduce pressure on A&E departments and 999 services. The intention is to close more calls in the patient journey earlier in order to “consult and complete” with the patient rather than the previous NHS 111 model of “signpost and refer”. This requires a new way of operating by utilising a greater diverse clinical workforce to be able to support callers directly, providing advice from the most appropriate clinical resource on the first call. In simple terms: “If I have an urgent need, I can phone a single number (111) and they will, if necessary, arrange for me to see or speak to a GP or other appropriate health professional – any hour of the day and any day of the week.” This is an essential component in working across a landscape of multiple providers and services who by working cohesively can offer optimal urgent care provision for patients who cannot access in-hours primary care services or be managed through self-help options.
Autumn 2017
The IUC service will provide: • • •
An NHS 111 call handling and initial assessment process for callers and users A clinical assessment advice and treatment service Robust pathways of care with supporting governance processes which ensure safe transfer of patient care where additional or specialist care is required
Our vision is to simplify the patient journey whilst enhancing their experience. This means our alliance will be working in partnership with other healthcare providers across the Thames Valley to deliver a common vision: “Our aim is to ensure that the population in the Thames Valley is supported to be well and healthy in their own homes and communities, by delivering a connected system, designed and delivered
//9
around local people, located in their neighbourhoods.” Integrating access to GPs into the new service As part of the new Thames Valley Integrated Urgent Care service mobilisation we have extended our call centre technology into one of the partners in the alliance – Berkshire Healthcare NHS Foundation Trust – to ensure seamless delivery across our virtual network. Callers dialling 111 with complex clinical needs, who require review, referral to acute or other specialties can now be passed to a dedicated GP clinician based in Berkshire Healthcare’s Wokingham hub who is working with our service. During July we were able to pilot this service over three days, putting through a small volume of our callers to the GP
“Our aim is to ensure that the population in the Thames Valley is supported to be well and healthy in their own homes and communities, by delivering a connected system, designed and delivered around local people, located in their neighbourhoods.”
to demonstrate the benefits to patients of this additional clinical input and to our commissioners the technical capability of our systems. The GP is able to close a greater number of calls directly. Following this we installed a physical technical link to the Berkshire Healthcare NHS Foundation Trust hub in Wokingham, allowing our telephony network to be extended into their site. This has allowed us to install our call centre telephones onto desks within their building for use by the GP – essentially allowing them to appear as virtual extensions on our network. We are able to see the GP on our call centre wallboards and telephony system as if they were sat in the same room as the rest of our clinical resource. We aim to provide enhanced support, for appropriate calls, using the GP to the following groups: •
Patients under five years of age
• • • • •
Patients over 85 years of age Elderly and frail patients Complex clinical calls Review of Green ambulance dispositions Provide enhance clinical support to NHS 111 clinicians
For the first week in September, we passed 105 calls across to the GP in Wokingham with the vast majority (80%) being closed with telephone advice or prescriptions. A small number of patients were seen by local out of hours providers, their own GP and specialties within the hospital where appropriate, if they required a face to face clinical assessment. Each morning the SCAS clinical navigator on duty (a new role deployed as we have additional pharmacists, mental health practitioners, dental nurses as well as GPs to stream calls to) holds a skype video
Autumn 2017
or conference call with the GP based in the Wokingham hub. This is helping us to build relationships with the five GPs currently providing input into the service. There are several examples of improved patient care that demonstrate the benefits of this new service where four out of five patients referred to the GP have their calls closed with either advice or an onwards prescription. Such examples have included: •
A patient was surprised to be able to speak to a GP about their complex problem and their call was closed within the service
•
A concerned parent was able to discuss a vaccination reaction with the GP as they couldn’t get an appointment at their own GP surgery and the call was closed with advice
•
A young female patient with abdominal pain and bleeding rang the service and was able to be referred to an emergency sameday gynaecology clinic by the GP, avoiding the need to go to A&E
•
A teenage patient with complex symptoms that were not clear to the NHS 111 clinician was passed to the GP and the patient was referred to a specialist neurology department with a suspicion of a rare puberty onset diagnosis
Feedback from the 111 clinicians on this addition to the new service is that they value having the GP available to be able to send complex patients to or seek further clinical advice. Next steps The new Integrated Urgent Care service
//11
is a developmental service which allows for further innovations and changes to be introduced throughout the life of the contract including the use of text messaging and on-line symptom checkers. We are now working to migrate the GP onto our IT platform to improve interoperability as well as allow the sending of automatic referrals to the other out-of-hours GP services in the Thames Valley. This will improve further the service already offered and move to a single solution for all staff working within our clinical assessment service.
Tweet us @SCAS999
Autumn 2017
On 8 August, the Ministry of Defence today announced that SCAS was one of 33 organisations to receive the Ministry’s Employer Recognition Scheme (ERS) Gold Award; its highest badge of honour for organisations which have signed the Armed Forces Covenant and demonstrated outstanding support for those who serve and have served.
//13
SCAS Receives Gold Award for supporting
The Armed Forces
Autumn 2017
//15
SCAS is one of only two ambulances services in England to have received the prestigious Gold Award.
The ERS Gold Awards recognise employers who actively support the Armed Forces community in their workplace and also encourage others to follow their lead. The award scheme, which attracts entries from companies in every part of the country and in the private and public sectors, has seen a rapid increase in participation since it launched in 2014. SCAS is one of only two ambulances services in England to have received the prestigious Gold Award. Philip Astle, Chief Operating Officer at SCAS, who retired as a Colonel after a 25-year career in the Infantry, said: “We are delighted to be recognised with this prestigious award. In my role it is very satisfying to not only find myself meeting so many ex-Services personnel whose skills and experience we are able to use to benefit patients in our region, but also I am extremely proud that the Trust has such a positive and flexible approach to allow
our reservists and cadets to continue their valuable service to our Armed Forces. “At all levels of our organisation, from actively supporting Armed Forces Day to training Cadet Forces, positively recruiting ex-Armed Forces personnel to encouraging more of our staff to become Reservists, we are incredibly proud of our longstanding relationships with and support for our Armed Services.” Defence Secretary, Sir Michael Fallon said: “These companies have shown the gold standard of commitment to supporting members of the Armed Forces, veterans, and their families. They have taken meaningful steps to ensure the Defence community are not disadvantaged by the sacrifice they make in helping keep this country safe. The actions of these employers make it crystal clear that regardless of size, location, or sector, employing people with military skills is good for business.”
Autumn 2017
//17
Two Very Handy Men
Employers often have a mandatory requirement for staff to have first aid certificates, or there to be a designated first aider on site. Thankfully, not many first aiders will ever need to put their skills to the test. However, that changed for two workmen in July.
Autumn 2017
//19
“The blood was just pouring out of his leg and it was all over the kitchen floor. Paul rang 999 immediately and once we’d let the ambulance service know what was happening we did what we could to help him.”
Morgan Healan, a plumber, and Paul Wells, a builder, arrived at a residential property in rural Buckinghamshire on Tuesday 11 July no doubt thinking it was going to be just a normal workday. Both men live in London and work for Garrard Construction and their company had been commissioned to carry out some insurance repair work on the property through Contractor Connection at Crawford & Company. “We arrived on site as normal after a bit of a drive up the motorway”, remembers Morgan. “Got our tools and materials out, put the radio on and got on with it. The owners were a lovely couple in their early 60s and that morning, the wife said she was going out and the husband said he had a couple of small DIY jobs to do himself around the house so we left him to it.” Paul continues, “It was the middle of the day, around 12.30, a song had just finished on the radio and it was then we heard the home owner shouting for help.”
The workmen’s training, quick thinking and calmness under pressure had meant that they had got the patient lying down on the floor, had correctly raised the wound above the level of the heart and had applied direct pressure to it to reduce the blood flow. Though the bleeding had slowed, the initial bandage was still soaked. Georgette’s initial inspection confirmed that the cut was very deep, right down to the artery at the back of the knee and that the patient needed stabilisation, followed by a rapid transfer to hospital.
With Morgan and Paul working in different rooms upstairs in the house, the home owner had gone into the living room climbed on to the sofa to change a light bulb, lost his footing and fallen. As he fell his leg had struck a thick, bevelled edge of glass on the couple’s living room coffee table causing a very deep cut to the back of his leg, behind the knee. He had struggled to the kitchen from where his shouts alerted the two workmen once the music faded quietly as the song had finished.
are emergency first aid trained and have a well-stocked emergency first aid kit no matter where they are working.
Morgan remembers being shocked at what they found. “The blood was just pouring out of his leg and it was all over the kitchen floor. Paul rang 999 immediately and once we’d let the ambulance service know what was happening we did what we could to help him.”
She adds, “Having disturbed the dressing, the wound quickly started bleeding again “On my arrival”, recalls Georgette, “I was with more velocity. For the second time that day, Paul applied direct pressure met with the patient lying on the floor whilst Morgan helped me collect more with one leg elevated on a chair and Paul applying pressure with a bandage wrapped equipment as I prepared to put a special bandage on the wound. We have special neatly around his leg. The atmosphere dressings for blood loss, similar to what was completely calm and the three men is used in the Military; one that helps were chatty. Had it not been for the the blood to clot and another one which copious amounts of blood on the floor, applies pressure to a wound. I applied I may have believed this was something much more minor.” both of these with the help of Paul, whilst
Fortunately both Garrard Construction and Crawford & Company ensure that all staff working for them or on their behalf
The information provided by Paul over the phone had meant that the call was categorised as a Red call, a potentially life-threatening emergency due to the severe bleeding, by Emergency Call Taker, Seonad McHugh. Specialist Paramedic, Georgette Eaton, was on duty that morning and was despatched to the scene in a rapid response vehicle by Emergency Despatcher, Dan Boon.
Autumn 2017
Morgan continued to reassure the patient. I then called on Morgan’s professional advice. As a plumber, he was much more used to working with fluid than me, and together we worked out that there was at least 750ml of the patients’ blood on the floor. Despite the new dressing, the patient had lost quite a bit of blood and the wound was still bleeding. With him starting to feel unwell, I put a small needle into his vein to give him a drug which helps to clot the blood when there is an injury. I also gave him some pain relief.” Having already asked for an ambulance to transport the patient to hospital, Georgette was impressed that whilst waiting for its arrival, Morgan and Paul continued to reassure the patient, chatting about this and that, as she continued to monitor and make sure there was no more blood loss. They had already informed the patient’s wife of the ‘little fall’ and so when she arrived, she was understandably quite shocked. However, Morgan went straight to reassure her whilst Paul and Georgette stayed with the patient. “We had to tell his wife a white lie”, adds Paul. “We didn’t want to panic her so we phoned and told her he’d had a little fall and she should get back home. She was understandably shocked when she came in as the kitchen wouldn’t have looked out of place as a murder scene in a Hollywood movie!” Once the ambulance arrived, the couple were taken to the John Radcliffe Hospital in Oxford where the patient received 17 stitches and was discharged home the following day. There are many people – even with first aid training, never mind those without – who, on being confronted with so much
//21
blood, may not have helped or if they did, wouldn’t have reacted as quickly or done such a brilliant job as Paul and Morgan. Had they not acted as quickly as they did, the patient would have lost a lot more blood. Morgan and Paul performed above and beyond what would ever be expected of a first aider and Georgette was convinced that their actions saved the patient’s life. Georgette adds, “Without Paul and Morgan’s first aid help, the only thing the patient could have done on his own was to put a tourniquet around the leg to stop the bleeding. The problem with that is, whilst it might have stopped him ‘bleeding out’ it could also have potentially meant he lost the leg due to the restricted blood flow.” “We had a first aid kit with us and we’ve done all the company training”, said Morgan, “but never used it for anything other than minor nicks or cuts. I thought we had a good first aid kit before the incident but we’ve certainly upgraded it now!” In recognition and appreciation of their quick thinking and action, Georgette nominated them for an award from South Central Ambulance Service and Paul and Morgan, along with Keith Woodwards from Crawford & Company, met up with her again at the Trust’s Headquarters at the end of July where they were also presented with a thank you gift from Keith on behalf of Crawford & Company. Lee Sadowski, UK Managing Director, Crawford Contractor Connection, said: “At Contractor Connection, we pride ourselves on the quality of our contractor network but Morgan and Paul of Garrard Construction exceeded even our high expectations as their rapid response
proved crucial when a homeowner had a near fatal accident. The prompt first aid and calm reassurance provided by Morgan and Paul meant they were able to stem blood loss, keep the homeowner calm and effectively saved the homeowner’s life. We are proud to have them as part of our network of contractors.” Since the incident, Morgan and Paul have met the couple again and the patient continues to recover well. “Though his wife has now banned him from climbing any furniture in the future and the coffee table has long gone”, adds Paul.
“We had a first aid kit with us and we’ve done all the company training”, said Morgan, “but never used it for anything other than minor nicks or cuts. I thought we had a good first aid kit before the incident but we’ve certainly upgraded it now!”
Autumn 2017
//23
In April 2017, SCAS took over as the provider of the Non-Emergency Patient Transport Service (NEPTS) in Sussex. This was not the usual contract mobilisation following a tender process commissioned by local CCGs. SCAS was asked to step in to recover the service following significant and ongoing problems with the existing private provider.
Transforming Non-Emergency Patient Transport in Sussex
This meant there were some significant challenges that needed to be overcome, exacerbated by the fact that the mobilisation had to be completed at short notice. There are a large number of elements that are needed to be in place to provide a high quality patient transport service, including property, vehicles and, most importantly, staff. SCAS is experienced at successfully mobilising these contracts, but the short timescales made this one an especially challenging process. The other major challenge we have faced since the service launched is that we are seeing significantly more patients than we were led to believe would be using the service when we were going through the planning stages. This has obviously put a strain on the service, but we have been working with the commissioners to address this and to make sure that all
necessary resources are in place to provide a high level of service to our patients. How has the service performed in the first few months? As expected, the start of the contract has been difficult, and this has been reflected in our performance against the contract key performance indicators (KPIs). Whilst we are never happy to miss a target, because we are aware that every delayed journey impacts on one of our patients, we are satisfied that the hard work put in by all our team members is seeing a steady improvement in performance levels. This improvement in performance across the first three month period is reflected across all the contract KPIs, except one around confirming bookings with patients.
Autumn 2017
//25
Overall 75% of those who responded said that they were either ‘very satisfied’ or ‘satisfied’ with their experience of NEPTS at the time of completing the survey.
Even with the issues with mobilising the contract, the performance over the first three months of the service has still been better than the first three months for the same period in 2016 under the previous provider. What do patients think? Healthwatch in Brighton and Hove, East and West Sussex, visited health services in the area over three weeks in May and June 2017, and spoke to 218 patients, carers and some staff about their experience of using NEPTS. The feedback from patients is summarised below: Satisfaction and recommendation of patient transport Overall 75% of those who responded said that they were either ‘very satisfied’ or ‘satisfied’ with their experience of NEPTS at the time of completing the survey Arriving on time 82% of patients said they arrived on time for their appointments, with 18% arriving late. Booking transport 42% of patients found the process of booking NEPTS easy to do and a positive experience
Vehicles Responses to questions on the vehicle and journey experience were overwhelmingly positive. Everybody commented that the vehicles that picked them up were clean and tidy, and in 95% of cases vehicles were suitable for their individual needs. “This is the first time we have worked together on a Sussex wide review and the findings offer both the new provider and the lead commissioner valuable insight into how the service is embedding and providing early warning signs where improvements need to be made.” Sussex Healthwatch Dr Sarah Richards, Chief of Clinical Quality and Performance, High Weald Lewes Havens, Clinical Commissioning Group, said: “We welcome the report and would like to thank Healthwatch for their hard work on behalf of local patients. Overall, we are pleased to see that the majority of patients spoken to said they were satisfied with the quality of the service and this reflects the fact that the quality of the service has generally improved.
Autumn 2017
//27
Like us on Facebook
“However we recognise that it is still not where SCAS and the CCGs want it to be and we will continue to work together to ensure the progress that has been made carries on. We will be looking closely at the recommendations highlighted in this report to see where further improvements can be made.” Paul Stevens, Director of Commercial Services at SCAS, said: “We are pleased that the majority of patients are happy with the service that we are providing, but we are in no way complacent. Mobilising the new patient transport service in Sussex at short notice was challenging, we have seen an unexpected increase in demand for the service but despite this, performance
against targets is improving steadily and we expect this to continue. “The fact that patients are telling Healthwatch Sussex that their experience is overwhelming positive is very satisfying, demonstrating the commitment of our staff to deliver the quality of service to the people of Sussex that they expect and deserve. We will continue to listen to patients, our commissioners and local partners, identifying any areas where improvements need to be made so we can continue to build on this good start to the new service.” A second, Sussex-wide Healthwatch patient survey is planned to be repeated in December 2017.
facebook.com/SCAS999
Autumn 2017
Reading Pride
//29
On Saturday 2 September, diversity, culture and entertainment all came together in Reading – and that was just the SCAS team members and volunteers! From across the country, members of the LGBT community descended on Reading for the annual Pride event and helped ensure an amazing day out and a fantastic festival that the whole family could enjoy and take part in. The event organisers at this year’s Reading Pride had extended the festival’s capacity to 5,000 and the limit was reached with ease. With two stages welcoming both local artists and others from across the UK, Pride brought together a diverse range of communities and cultures that without such events, would not
get the opportunity to meet, mingle, share each other’s beliefs and values, and strengthen a community spirit that a very small minority would seek to destroy. Plus with the first UK Muslim drag queen and Mr Leather UK in attendance, it was pure fun for all who attended. With support from Lead Community Response Manager, Nic Morecroft, Berkshire’s Community First Responders were out in force at Reading Pride once again, providing first aid and medical support to festival goers. This year, the CFR team was also able to provide hands on CPR training to a large number of members of the public thanks to the introduction of a new family of Annie Manikins brought along by the Shinfield and Whitley CFRs.
Autumn 2017
//31
Kirsten Willis, Head of Operations for Berkshire West, said: “It was amazing to see such a wide range of families, couples and friends of all ages and from all backgrounds and cultures joining together to learn and understand what they can do when an emergency presents itself.” Members of the SCAS LGBT Network joined the Pride parade through Reading town centre, enjoying interacting with the many local residents and businesses that supported the parade as it made its way through the streets and to the finishing enclosure at King’s Meadow. Under the ‘Love Unites’ theme the 2017 event was undoubtedly the biggest and best Reading Pride so far. “Anyone who was at Reading Pride this year will know what an enjoyable day it was”, adds Nic Morecroft. “And if you didn’t make it we’d love to see you at Reading Pride 2018 which, it is rumoured, will be at a new local site with the largest ever capacity due to just how popular this event has now become in the local calendar.” Find out more at www.readingpride.co.uk
Under the ‘Love Unites’ theme the 2017 event was undoubtedly the biggest and best Reading Pride so far.
Autumn 2017
“This year I took inspiration from Rich and Dan and decided to put together a charity walk of our own; one that would be challenging, demanding and have a final leg where friends and colleagues could join us and walk with us to the finish line”
//33
Mental Health and Wellbeing Awareness Walk Rob Gilley, Paramedic and Clinical Mentor based at our Didcot Resource Centre, undertook a sixday walk through the South Central region in August with colleagues Kyla Hawthorn, Theresa HowardBirt and Steve Dobson, to raise awareness of mental health and wellbeing for emergency and essential service personnel. Here’s his diary of an exhausting and inspirational trek. “This year I took inspiration from Rich and Dan and decided to put together a charity walk of our own; one that would be challenging, demanding and have a final leg where friends and colleagues could join us and walk with us to the finish line. I sat down with
Steve earlier in the year and we started looking at a route that would get us walking through the four counties that SCAS covers. The route we created was around 200 miles and would pass various stations relating to the emergency services on the way. On Sunday 20 August we travelled down to Gosport, ready for an early start but not before tucking into a substantial amount of KFC. On day one we set off from Gosport and Fareham inshore rescue station at 06.00, walking through Southampton, visiting HART and Southern House HQ. We finished the day just outside Winchester, camping and tucking into ration packs kindly donated by HART.
Autumn 2017
//35
Day 3 Day 1
Day 2 Day two started at 06.00 with some pretty sore blisters as we headed towards Newbury. This was a tough day as the feet were starting to get sore with the constant pounding; we also had to adjust the planned route a few times as roads/paths weren’t passable or safe to walk on. Another night of camping for the four of us and a heart to heart in the boy’s tent as to whether Steve could carry on with his feet looking in really bad shape. Day three was regroup day; after fuelling with king size pot noodles for breakfast and sorting feet out, we headed for Watlington. We had to cut the original route down for the day, due to the time available to us and the time taken to sort everyone’s feet out. However, we continued on and had a really positive day walking together, arriving at the campsite by sunset.
Day four saw us heading from Watlington to Bicester; the others were really suffering with blisters at this point, despite using a wealth of dressings and padding, but we managed to get through the day and finish at Northern House in Bicester. As a well-deserved and much needed reward for the day’s efforts, we tucked in to pizza and kebabs that evening which is up there as one of my favourite eating moments ever! After some top grub the night before we thought we would start the fifth day by filling up at breakfast too, care of Tesco. The staff were brilliant and we were given some extra supplies to help us along the way. From Bicester we headed to Kidlington Ambulance Station and on to the John Radcliffe Hospital. That evening we had some additional treatments to sort out; the tired muscles ready for the final leg the following morning.
Day 5
Day 4
Autumn 2017
//37
However, you learn to look objectively at the situation, adopt a new strategy and cope with what has happened.
Day 6 Day six: ‘The Final Leg’. Colleagues from across the emergency services, friends and family joined us for the last part of our walk. Around 75 people joined us to walk back to Didcot where three of us are based. Those participants who took the coach were treated to some fabulous chocolate treats specially made for the day by the very talented Clare England whilst Dave England safely drove them all to the start line. At 09.00 we started our journey back home in good spirits and with the buzz of crossing the finish line ahead. We were sent on our way courtesy of a siren blast from the fire crew based at Abingdon fire station, who also gave up their time to help give out water at the halfway point.
At the finish line in Edmonds Park, we were greeted by friends, family and the mayor of Didcot. We had also set up an emergency service and family fun day for the local community to enjoy. I was filled with so much emotion; it was great to be home with my family and to see everyone safely cross the finish line. So what have I taken away from this challenge now it’s all over? I guess the most important point is that you can set out with a plan in mind and no matter how well you prepare, things do happen that you weren’t expecting or are worse than you originally thought they would be.
It will never cease to amaze me how many people leant their support in so many ways. These are my family, friends and colleagues; all these people were there when I needed them. We should learn that this is the case in other aspects of life too and reach out to them if we are struggling. We managed to raise more awareness of mental health and wellbeing for emergency and essential service personnel, highlighting the Mind Blue Light programme and the Samaritans services. We’ve also talked about the importance of raising awareness and using the resources we have within our own services. Thank you once again to everyone who played their part and made the
walk and emergency service day a complete success. Finally, remember that there is always someone you can turn or reach out to when you need it... you don't have to face things alone. Never more was this true in those moments we all had on the walk. As a team we battled on to achieve a total of 136 miles; a truly rewarding experience.” Rob, Kyla, Theresa and Steve have raised over £2,000 for the Mind Blue Light Programme, The Samaritans and This Is My Hand (a not-for-profit organisation). If you would like to donate, you can do so at https://www.justgiving.com/ crowdfunding/TIMH999WALK2017
Find out more about This Is My Hand at www.thisismyhand.com
Autumn 2017
//39
Organ donors save lives
Organ Donation Week
Caitlin and her family are keen supporters of organ donation.
Share your decision to be an organ donor with your family, and ask what they want too. organdonation.nhs.uk or call 0300 123 23 23 NHSOrganDonor
Liesl Bowes
OPS033
Autumn 2017
//41
Organ Donation Week, which this year ran from 4-10 September, is a campaign organised nationally by NHS Blood and Transplant to get people talking about organ donation. There are currently around 6,500 people in the UK on the active waiting list for organ donation – including around 150 children and teenagers. Research conducted by NHS Blood and Transplant shows that around four in every five people definitely want to donate their organs or would consider doing so – but only just over a third of us have joined the NHS Organ Donor Register. As a result, there are simply not enough donors and that means that every day, three people on Five reasons to donate the transplant waiting list die. During Organ Donation Week, SCAS shared the stories of people whose lives have been saved through organ donation, as well as hearing from families who have lost a loved one but been able to carry out their loved ones wishes to become a donor. The theme for the campaign was ‘Let’s talk about it’ as only 47% of families agree to donation going ahead if they are unaware of a loved one’s decision to be donor. This rises to almost 91% when the decision to be an organ donor is known to other family members.
Five reasons to donate
Patients are dying while organs are going to waste
One organ donor can save or transform up to nine lives
Organ donation saves lives but there is a shortage of donors. You can make an extraordinary difference.
2
1 Even if your organs can’t be used, you could still help others by donating sight
4
3 Leave your family feeling proud that you saved lives
5
We hope that we have played a small part in getting more people talking about organ donation with their families.
Find out more and sign up today at www.organdonation.nhs.uk
Autumn 2017
//43
Oxfordshire Crews Visited by Cardiac Arrest Survivors
Stephen Davies
Terry Penn
Autumn 2017
//45
During the summer, SCAS crews in Adderbury and Didcot were delighted to receive visits from two patients who survived a cardiac arrest and visited our resource centres to say thank you to some of those staff who helped save their lives. In both cases, the patient suffered their cardiac arrest in a rural part of the county but thanks to both receiving excellent bystander CPR almost immediately whilst our staff were travelling to the incident, along with excellent care once they got there, both men have made a complete recovery. Stephen Davies Stephen had no previous history of heart problems, with nothing showing up in previous health checks and he neither smoked nor drank alcohol. He did however, have a stressful job
within Formula 1 that often meant long hours and by his own admission did very little exercise and had a fondness for cake! Late on the evening of Sunday, 2 July, Stephen was in bed at home in Hook Norton on the second floor bedroom when he suddenly became ill with chest pains, collapsing shortly afterwards. Wife Mandy immediately called 999 with her call being picked up by Emergency Call Taker, Sian Falkner, in our Bicester Clinical Coordination Centre.
Whilst there is a well-established community first responder scheme in Hook Norton, it was nearly 11pm when the emergency call was made and at that time no local CFR was logged on as available. Sian was able to guide Mandy through giving CPR as Stephen was described as unconscious and not breathing. Emergency Dispatcher, Jess Hill, was working on the Oxfordshire desk and began to arrange immediate help. A rapid response vehicle, driven by Paramedic Team Leader, Roan Waddelow, was dispatched from
Adderbury (eight miles away), along with an ambulance crewed by Flavio Bosich and Katie Venvell, which had just come free at the Horton Hospital (nine miles away). With both vehicles dispatched, Jess noticed that there was a SCAS ambulance already in the village dealing with a patient (who was not suffering a life-threatening emergency, unlike Stephen). There were three crew members on that vehicle, so she contacted the crew and asked for two of them to grab that vehicle’s defibrillator and immediately make
Autumn 2017
//47
their way to Stephen and Mandy’s house whilst the third crew member, Emergency Care Assistant Stephen Ansell, stayed with their original patient. Jess’ quick thinking played a vital role in saving Stephen’s life. Paramedic, Chris Hurley, and Student Paramedic, Sophie Logan, arrived at the Davies family home and took over CPR from Mandy. The next to arrive was the ambulance with Flavio Bosich, and Emergency Care Assistant, Katie Venvell. Katie took the couple’s children, Daniel and Tabitha, downstairs to comfort them and make sure they were ok. Paramedic Team Leader, Roan Waddelow had arrived also by now and the team upstairs had to use the defibrillator several times on Stephen before he came round.
Stephen and his family were delighted to be able to visit Adderbury Resource Centre in August and say a heartfelt thank you to some of those involved in his care.
Another challenge to the incident was that the two staircases in the home were spiral ones – difficult, if not impossible to get a patient down on a horizontal board. Fortunately, Jess in the Clinical Coordination Centre had contacted the Fire Service to help get Stephen out of the building. The fire crew that arrived live in the village and knew the family; using a scoop stretcher they were able to manoeuvre Stephen down the spiral staircases in an upright position.
Roan added: “Once in the ambulance the next task was to get Stephen to the PPCI (Primary Percutaneous Coronary Intervention) Unit at the John Radcliffe Hospital in Oxford – a good 40 minutes away even with a critically ill patient. The receiving team at the hospital were very complementary to the crew given the patient’s condition.” Fortunately, the time from the first 999 call to Stephen arriving at the intensive care unit at the John Radcliffe Hospital, was around 90 minutes – the speed of the response and the quality of initial treatment playing a huge part in his survival and good recovery. Following the operation to insert stents, Stephen was kept in a coma for two days at the hospital and discharged home a week later. Stephen and his family were delighted to be able to visit Adderbury Resource Centre in August and say a heartfelt thank you to some of those involved in his care. He said: “I’ve no memory of that weekend but from what I’ve been told, I’ve no doubt the excellent response and care I got initially from everyone at SCAS, and then at the hospital, saved my life. You guys provide a fantastic service and I just wanted to come and say thank you very much to all of you. Keep doing what you’re doing!”
Autumn 2017
//49
Terry Penn On 6 May, Terry Penn and his partner Jenny Gower, were enjoying a day out together on a 40 mile circular cycle ride in Oxfordshire. The couple had driven into the Cotswolds from their home in Eastbury, near Lambourn in Berkshire. Terry had complained during the ride that he was feeling ‘a bit chesty’ but had carried on, thinking it might be hayfever. About 4 miles from where they had parked their van at the start of the ride, however, he stopped and asked Jenny to carry on, pick up the van and come back for him. “I knew then something was very wrong”, said Jenny. “So I refused to leave him and shortly afterwards, he collapsed.” Whilst anyone suffering a cardiac arrest could hardly be described as lucky, there were a number of fortunate circumstances in Terry and Jenny’s case. Firstly, Jenny and Terry had cycled through miles and miles of countryside with no dwellings that morning but had stopped outside a very small row of four houses when Terry began to feel unwell. So having called 999, Jenny then also began shouting for help as she didn’t know where she was and wouldn’t have been able to give Emergency Call Taker, Daniel Paice, who took her emergency call
in SCAS’ Clinical Coordination Centre in Otterbourne, a location. Fortunately one of the residents heard Jenny, came out and was able to provide an exact address in order that Dan’s colleagues, Nikki McIntyre and Claire Milligan, in the Bicester Clinical Coordination Centre, could dispatch available staff and vehicles to the scene of this Red 1 incident – the highest priority emergency. Daniel adds, “I had only recently started as an emergency call taker and this was one of my first solo calls so I remember it well. I’m really glad to hear that Terry made such a good recovery.” Secondly, qualified nurse, Heather Dearden, had been visiting her mother in a local nursing home a few miles from the scene and happened to be driving passed moments after Terry’s collapse. “I saw a lady pounding on a man’s chest so stopped to help”, remembers Heather. “I used to work in the Intensive Treatment Unit at the John Radcliffe Hospital in Oxford, so had done CPR and rescue breaths on patients before – but only with lots of help around and a defibrillator nearby!” With Heather carrying out CPR supported by Jenny, a rapid response vehicle with Clinical Mentor, Dave Howe, and Student Paramedic,
Autumn 2017
//51
Hannah Byrnes, the Thames Valley Air Ambulance with SCAS Paramedic Lee Mayne and Dr Simon Brown on board, a second rapid response vehicle with Paramedic Team Leader, Rob Dalziel, and an ambulance crewed by Paramedic, Alex Cotton, and Emergency Care Assistants, Rebecca Francis and Jordan Clements, all made their way over land and in the air to the small hamlet of Baulking, about eight miles south east of Faringdon.
induced coma in the critical care unit, he was then transferred to the cardiac ward for five days and then allowed home.
Dave, who arrived on scene first with Hannah, remembers the scene vividly: “We all thought Jenny must have been an unconnected bystander, not the partner of the patient; she was very composed and doing what needed to be done; helping Heather with the CPR on Terry.”
Terry and Jenny brought cards and presents for everyone who helped at the scene and in the clinical coordination centre when they visited SCAS’ Didcot Resource Centre at the end of July. Terry was delighted to tell everyone that in the days previous to the reunion, he had completed a 12 mile walk and a 20 mile bike ride.
Heather and Jenny carried out the emergency first aid so effectively that on the arrival of the ambulance service teams, Terry’s heart had remained in a shockable rhythm. After treating him with medication and using a defibrillator, the team got Terry’s heart going again once he was on the ambulance and they made their way immediately to the John Radcliffe Hospital in Oxford. Jenny was told at the hospital that Terry could have suffered brain damage as a result of his cardiac arrest, which came as a further shock to her. However, after having a stent fitted to clear a left arterial descending blockage, spending a week in an
“He has no recollection of day it happened nor the week or so afterwards”, says Jenny, “but other than that he is completely the same man he always has been. I am so incredibly grateful to everyone for what they did for him.”
And with a few ‘mind you take it easy’ looks from the SCAS team, Terry is quick to reassure them: “I have always been fit and active, had a working life of physical jobs and took up ultra-running when I semi-retired. My consultants have advised me to listen to my body – for example, go for a cycle, but not at the same speed or distance. I have a positive outlook; I’m lucky to be here. You either go through something like this and come out worrying or look at everything as a second chance and be positive; that’s what I’m doing. I’m still here, enjoying life and looking forward to many more years with Jenny . And it’s because of all you guys that I can do that.”
Heather and Jenny carried out the emergency first aid so effectively that on the arrival of the ambulance service teams, Terry’s heart had remained in a shockable rhythm.
Autumn 2017
//53
How are we doing?
Total 999 activity
Non conveyance
Non conveyance %
238,285
101,065
46.34%
Red 1 (8 mins)
Red 2 (8 mins)
Red 19
74.9%
71.7%
94.7%
NHS 111 calls answered
No. of NEPTS journeys
No. of CFR responses
483,967
366,534
7,595
A year to date snapshot
Apr-Aug 2017 What does it mean? Total 999 activity equates to the number of calls which received a SCAS response or were dealt with by our clinical support desks.
Red 2 - Red 2 calls are serious but less immediately time critical and cover conditions such as stroke and fits.
Non conveyance is the number of incidents we responded to where the patient was not taken to hospital.
NHS 111 calls answered is the number of calls answered through the non-emergency healthcare service.
Non conveyance % is the percentage of incidents we responded to where the patient was not taken to hospital.
CFR stands for Community First Responder.
Red 1 - Red 1 calls are the most time critical and cover cardiac arrest patients who are not breathing and do not have a pulse, and other severe conditions.
NEPTS stands for Non-Emergency Patient Transport Service.
Autumn 2017
Autumn
Twenty
Seventeen Please send articles, or ideas to communications@scas.nhs.uk along with any photos or images.
Wo rk
ing t
oge
ther
Copy deadline for the next issue of Working Together is 7 December 2017
find out more
www.scas.nhs.uk
updates and more
www.facebook.com/scas999
follow us for latest news
www.twitter.com/scas999
latest pics
www.flickr.com/999scas