ambulance today winter 2012

Ambulance

Also Inside:n Jo Webber on Falls strategy

n Caring at Christmas - supportingambulance care in India and thePhilippines

n RCA Ambulance Redesign Update

n UNISON’s Hope Daley saysprotect staff from violence

Also Inside:n Jo Webber on Falls strategy

n Caring at Christmas - supportingambulance care in India and thePhilippines

n RCA Ambulance Redesign Update

n UNISON’s Hope Daley saysprotect staff from violence

TO RECEIVE AMBULANCE TODAY FREE OF CHARGE TO YOUR EMAIL BOX JUST VISIT:WWW.AMBULANCE TODAY.CO.UK AND GO TO SUBSCRIPTIONS

FOR AT MODTAGE AMBULANCE TODAY GRATIS TIL DIN INDBAKKE KAN DU BESØGE:WWW.AMBULANCETODAY.CO.UK OG KLIK PÅ SUBSCRIPTIONS

WIL JE AMBULANCE TODAY GRATIS VIA EMAIL ONTVANGEN, GA DAN NAARWWW.AMBULANCE TODAY.CO.UK EN VUL JE GEGEVENS IN BIJ 'SUBSCRIPTIONS'

SUPPORTING ANDIMPROVINGPARAMEDICPRACTICEDavid Davis explains the role of the College of Paramedics

SUPPORTING ANDIMPROVINGPARAMEDICPRACTICEDavid Davis explains the role of the College of Paramedics

Winter 2012 - Issue 5 | Volume 9

This Issue issponsored across Europe by:This Issue issponsored across Europe by:

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

TODAY

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

Produced in partnership with

supporting ambulance staffacross the UK



Editor’s Comment

3December 2012 | Ambulancetoday

Early in the New Year, the Helen HamlynCentre for Design will be holding aconsultation day in London which will form avital part of its ongoing project to redesign theA&E ambulance. The aim of the day is to bringambulance people from a number of countriestogether to share their views on differentaspects of the potential vehicle’s design withboth ambulance builders and experts in asmany areas of clinical technology as possible.

The thinking behind the day is very sound. The HHCDteam, led by Research Fellow, Ed Matthews, firmlyembrace the notion that good design should never befoisted on the end-users but should instead be arrivedat by specifically encouraging the users of any newdesign to enter a dialogue with the design team which,in its very process, helps them crystalise and thenexpress their own sometimes initially vague ideas onwhat it is that they really want from the future design.It’s not rocket science, it’s just the simple common-sense understanding that in most scenarios the bestpeople to tell you what a new or improved productshould consist of are obviously the people who willeventually use it.

If it seems that this year has been a relatively quiet onefor the ambulance redesign project the honest answeris that, yes, on one level it has been. Like many otherambulance projects, many of the people we havewanted to consult with have been a bit busy withanother project – the 2012 Olympics! But having saidthat, rest assured that, a bit like a duck in water, lots hasbeen going on just below the surface, even if thingshave seemed a bit calm above the waterline. TheHHCD team and myself have attended quite a few keyambulance events and have also engaged in animpressive number of one-to-one meetings withambulance builders and associated technologysuppliers. So, if this is a project that you’re still interestedto find out more about, or, better yet, if you have yourown clear views on how the ambulance of the futureshould look, please feel very welcome to contact me byeither phone or email and I’ll be delighted to pass onyour views to the team who, I am very confident, willbe equally delighted to get back to you to hear yourideas in more detail.

For those interested by the way, the HHCD (part ofthe Royal College of Art) ambulance redesign projectwon a major and very prestigious design accolade thisyear when it was awarded the British Design Council’sTransport Design award; so, with your help and input, I

am confident that 2013 will see it take great stridesforward.

Another group of people who have only the bestinterests of the ambulance community at heart is theCollege of Paramedics (CoP) and inside this editionyou’ll find an interesting article by David Davis theirDirector of Communications, offering you a clear andconcise briefing on the role of the College and theadvantages of membership it offers to paramedics. Asmany of you know, the College of Paramedics began asthe British Paramedics Association and it has beenachieving great things for frontline ambulance workersin recent years - especially in the areas of ContinuousProfessional Development and Curriculum Guidance.Currently the College has almost 4,400 members but,with over 18,000 paramedic registrants in the UK it’squite clear that they can achieve even more on yourbehalf if more of you take the plunge and swell theirgrowing ranks. So, if you find yourself with a few sparemoments between hectic shifts this Christmas, take myadvice and spend a few moments browsing theirwebsite. I’m confident that if you take a good lookaround and then maybe have a chat with one of yourwork colleagues who is already a proud member of theCollege of Paramedics, you’ll quickly decide that joiningup is one New Year’s Resolution that you’ll spend allyear feeling proud of.

Oh and to avoid confusion, you’ll see the name ‘DavidDavis’ crop up on two major articles in this edition. Thisis not a Christmas BOGOF offer. The second DavidDavis, also a Director of Communications, writesexcellently on the forging of links between the UK andRomania on behalf of the Independent AmbulanceAssociation (IAA). Both gentlemen are highly-experienced and highly-regarded in their respectivefields. It just seems to be the case that the monikor‘David Davis’ seems to fall frequently on highly-giftedcommunicators!

Ambulance Today will be working closely with CoPthroughout the coming year and it will be our aim tobring you as much news and information as possible ontheir behalf so, again, if there are any issues you’re keento tell them about please feel free to email me and I’llbe happy to pass your messages on.

Best wishes for a Merry Christmas and aHappy New Year,

Declan HeneghanEditor, Ambulance Today

New Year’s Resolutions:1: Help design a better ambulance 2: Join the College of Paramedics

Declan HeneghanEditor, Ambulance Today

Proud Supporters of the AmbulanceServices Benevolent Fund

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



EDITOR: Declan Heneghan email: [email protected]

CORRESPONDENCE: All correspondence should be sent to: The Editor, Ambulance Today,

41, Canning Street, Liverpool L8 7NN

DESIGN & PRODUCTION: Wordplay Graphics email: [email protected]

FOR ADVERTISING ENQUIRES CALL: +44 (0)151 703 0598 OR +44 (0)151 708 8864

COPYRIGHT: All materials reproduced within are the copyright of Ambulance Today. Permission for reproduction of any images or text, in full or in part, should be sought from the Editor.

PUBLISHER’S STATEMENT: Ambulance Today magazine is published by Ambulance Today Ltd, 41 Canning Street, Liverpool L8 7NN. The views and opinions expressed in this issue arenot necessarily those of our Editor or Ambulance Today. No responsibility is accepted for omissions or errors. Every effort is made to ensure accuracy at all times. Advertisements placed in thispublication marked "CRB Registered" with the organisation's "CRB Registration No." means that the Organisation/Company meets with the requirements in respect of exempted questions under theRehabilitation of Offenders Act 1974. All applicants offered employment will be subject to a Criminal Record Check from the Criminal Records Bureau before appointment is confirmed. This willinclude details of cautions, reprimands or final warnings, as well as convictions and information held by the Department of Health and Education and Employment.

Support the Ambulance ServicesBenevolent Fund throughout 2013by visiting their website at:www.asbf.co.uk and making adonation.

Or make a payroll donation through‘Pennies from Heaven’ at:www.penniesfromheaven.co.uk

Don’t forget to specify that you’dlike your donation to go to the ASBF

www.ambulancetoday.co.ukIssue 5, Volume 9 : December 2012 Next Issue: March 2013

VISIT OUR NEW-LOOK AMBULANCE TODAY WEB-SITE AND REGISTER FORYOUR FREE ELECTRONIC COPY AT: WWW.AMBULANCETODAY.CO.UK

This Issue is Supported by :CONTENTS

P7 - Let’s stamp outviolence againstambulance staff!Unison’s Ambulance SectorLead, Hope Daley, wantsemployers to take a proactiveapproach to tackle this mostpressing workplace issue

P9 - Supporting and improving paramedic practiceDavid Davis, Communications Director of the College ofParamedics, explains its role and why all UK paramedicsshould join up

P18 - Have your say on ambulanceredesign projectEd Matthews, Project Lead on the Helen HamlynCentre for Design’s ambulance redesign project,announces consultation day

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

P24 - Caring at ChristmasBe kind this Christmas! John Dale asks for support for Filipinoambulance and Roy Williams asks the same for India

P27 - Romanian ambulance follows IAA leadDavid Davis of the Independent Ambulance Association on hisrecent visit to speak on public/private ambulance development

P34 - London Trauma, Cardiac Arrest and AirAmbulance Gathering

Read about London’s first-ever and highly-successful combined trauma, cardiac arrestcare and air ambulance conference

Also Inside:P42 - Out & AboutThe latest news from services aroundthe UK

P46 - Products & SuppliersNewsLatest in new products, services &technology

I N S IDE YOUR W INTER I S SUE :

Places are available NOW on our 2013 coursesOur IHCD-accredited Blue Light Driving coursesare open for booking from 4th-22nd February and from the 4th-22nd March

Also available are IHCD FPOS (First Person onScene) and HSE approved FAW (First Aid at Work)courses which are both available on a monthlybasis.

Ambulance Technician Level 3 BTEC courses areavailable throughout the year

To book your place or for further informationplease contact Ian Rose on: 01737 649 946

Places are available NOW on our 2013 coursesOur IHCD-accredited Blue Light Driving coursesare open for booking from 4th-22nd February and from the 4th-22nd March

Also available are IHCD FPOS (First Person onScene) and HSE approved FAW (First Aid at Work)courses which are both available on a monthlybasis.

Ambulance Technician Level 3 BTEC courses areavailable throughout the year

To book your place or for further informationplease contact Ian Rose on: 01737 649 946

December 2012 | Ambulancetoday 7

Ambulance staff have always provided front-line services but now they are findingthemselves in a true battle zone as workrelated violence continue to rise and this is setto worsen as we approach the festive season.Christmas is one of the busiest times of theyear for ambulance staff and many are use tobeing spat on, punched, kicked, bitten, slappedor worse on a more regular basis during thisperiod.

Figures from the 2010/11 NHS Staff Surveyrevealed that whilst employers have putmeasures in place to minimise the risk,incidents of violence continue to occur and inmany ambulance trust physical violence frompatients, relatives and members of the publiccontinue unabated as 7% of NHS staff werevictims of assault during that year.

Yet, despite this, the government iscontinuing with an agenda of cuts that willthreaten initiatives to prevent these attacks andthe ability of the police to find and prosecutethe perpetrators.

Cuts to public services mean that it isworkers such as Paramedics who often bearthe brunt of frustration and anger from thepublic and the problem is not limited toEngland. In Scotland attacks on ambulance staffhave soared 30% in the past two years –reaching an average of almost one a day and inthe past year, workers were subjected to 297assaults a significant increase on the previoustwo years when there were 219 attacksreported.

In Wales, there has been an increase in thenumber of emergency workers who have facedviolence at the hands of the public. WelshAmbulance Service staff members suffered 218physical assaults and 110 incidents of verbalabuse over a 3 year period including twoincidents where ambulance staff were attackedwith a weapon. And in Northern Ireland therehas been a sharp rise over the last few years inthe levels of violence against NHS staff thatrequired police assistance.

The Health and Safety Executive (HSE)highlights some risk factors for violentbehaviour which include impatience; frustration;anxiety; resentment; drink, drugs and inherentaggression/mental health problems andworking alone.

Ambulance staff face these factors on a dailybasis and is set to get worse particularly as thecuts faced by many ambulance trust starts tobite.

UNISON wants to see employers taking aproactive approach to tackling this problemwhich is leading to injuries, sickness absenceand high levels of stress. Prevention of violenceis crucial but also key is appropriate supportand follow up investigations to prevent furtheroccurrences. They also need to encourage staffto report incidents and near misses so thatrisks can be properly assessed and appropriateaction identified.

For these reasons, the reporting andrecording of violent incidents should beestablished as part of an overall strategy thatcan be seen to be tackling this serious work-related risk. UNISON members are concernedthat under-reporting is hiding the true extentof the problem and reports often exclude"routine" threats or many instances of insultingbehaviour. Under reporting exist for a numberof reasons. Staff will not report incidents unlessthey are confident about how their report willbe received by management. Many have thefear, and some the experience, thatinvolvement in a violent incident will be seen astheir failure. Others may be distressed by theexperience and believe that reporting it willadd to that distress, particularly where no clearpreventative measures are in place.

Employers must take urgent action to ensurethat ambulance staff are protected. It is nogood saying that some of these assaults werethe result of a patient’s medical condition, staffhave a right to a safe working environment.And it is up to the employer to provide it byassessing risks and managing t hem.

UNISON has campaigned for many years forviolence against public sector workers tobecome a specific offence. It is an outrage thatambulance staff continue to be assaulted whilstcarrying out their duties, and urgent action isneeded to prevent and deter these attacks. Itis right that the police have special protectionunder the law from assaults, but this should beextended to all public sector workers includingambulance staff.

Violence meted out to staff cost money thatwould be better spent delivering patient care

Happy Holidays

2012 has been a difficult year for many of usand is set to be tougher in 2013. On behalf ofUNISON I would like to thank all of ourmembers, stewards and reps for all of the workthey have put in this year. Enjoy the festivebreak, when you can and I look forward toworking with you all in 2013.

Wishing you and your families a happy,healthy and safe Christmas.

EMAS/UNISON Learning Agreement

The Learning Representatives in UNISONEMAS (East Midland Ambulance Service)Branch are proud to announce the officialsigning of a Learning Agreement reachedbetween the Trade Unions and EMAS. It isbelieved that this is the first such agreementin the Country to be signed between anAmbulance Service and a Trade Union.

The agreement will be signed on 17thJanuary 2013 at East Midlands AmbulanceService, Trust Headquarters in Nottingham bythe Chief Executive of EMAS along with theUNISON Learning representatives who ledthe negotiations, and representatives from theassociated Unions.

This special event will run between 12 and2.00pm. EMAS management, UNISONmembers and UNISON at a National andregional level along with Union learn (thelearning and skills organisation of the TUC)will be there to show their support for thissignificant achievement in employee learningdevelopment.

This agreement will outline thecommitment of EMAS and the Trade Unionto work together to help source and signpostmembers to learning opportunities ofinterest and relevance to them. These mayinclude work or personal interests to helpfrontline crews in their day to day experiencewhilst also aid towards a better patientexperience.

UNISON in EMAS believes in investingback into its membership and this is only thestart of good things to come. There is agrowing team of UNISON Union LearningRepresentatives (ULR’s) and they are activelyseeking to recruit other ULR’s to help spreadthe word of learning opportunities open tomembers.Lee Goddard. Union Learning Representative. UNISON EMAS Branch.

UNISON Update

AmbulanceTODAYUnison Comment

HOPE DALEYis UNISON’s AmbulanceSector Lead. Read on to findout about the key policyareas UNISON will beaddressing on your behalf intheir fight to prevent themany threats to ambulanceservices across the UK.

Let’s stamp out violence against ambulance staff !

We are often asked why paramedicsneed a professional body and what isunique about its role in comparisonto the regulator (the Health andCare Professional Council [HCPC]formerly the Health ProfessionsCouncil [HPC]). We are also askedwhy paramedics should join theirprofessional body when they arealready represented by a tradesunion. So what is the role of theprofessional body and what does theCollege of Paramedics do torepresent the interests ofparamedics?This article is the first of several thatwill appear in Ambulance Todaywhich aim to address thesequestions. Readers’ questions areinvited, and they will appear inAmbulance Today along withresponses.

THE ROLE OF THEPROFESSIONAL BODYThe paramedic profession is relatively newhaving only been established at the turn ofthe Millennium; so it is understandable thatparamedics might raise questions about therole of the professional body. This isdescribed below, but first it is essential todescribe the role of the regulator:

The RegulatorAs part of the essential legal frameworksurrounding a registered profession, aregulator has to be identified or establishedwith certain key duties focusing uponprotection of the public, which are definedby statute. The regulator’s role is to protectthe public and it does this by:A: Setting standards, defined in the

‘Standards of Proficiency,’ (HCPC2007) and the ‘Standards of ConductPerformance and Ethics,’ (HCPC 2008)for the profession and approving

education programmes that lead toregistration. The regulator can and,indeed does, take action againstprofessionals who do not meet thestandards it has set;

B; Holding and maintaining a register ofprofessionals who meet the standardsset by the regulator and who arepermitted to use the protected titlesto identify themselves.

There are some parallels with the medicalprofession but also some differences. Forexample, the General Medical Council(GMC) sets the standards and maintains theregister for doctors whilst each arm ofmedicine has its own professional body suchas the Royal College of Surgeons or theCollege of Emergency Medicine; additionallythere is the British Medical Association,

which provides a trades union type offunction for doctors. Paramedics along with16 other health and care professions are allregulated by the HCPC. The HCPC is astatutory body which is independent of the16 professions it regulates. Supported by

primary legislation, its primary purpose istherefore to protect the public by settingstandards and holding professionals toaccount where necessary. In order topractice as a paramedic within the UK,paramedics must be registered with theHCPC. Read more at www.hpc-uk.org

The Professional BodyAll professions have established professionalbodies, for example the Royal College ofNursing (RCN) for nurses; the RoyalCollege of Midwifery (RCM) for midwives;the Royal College of Speech and LanguageTherapists; etc. The HCPC describes therole of professional bodies as:n Promoting the profession (both to the

HCPC and more broadly)

n Representing members’ interests inrelation to profession-specific issues(rather than for example pay andconditions)

n Developing the curriculum framework

n Developing post-registration education

n Continuing professional development(CPD)

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

The Professional Body and theTrades UnionsIt is worth reflecting on the similarities anddifferences between these organisations andnote that some professional bodies alsoprovide trades union functions; such as theBritish and Irish Orthoptics Society. Inregards to paramedics, the College andunions may share concerns over issues such

Why do paramedics needa professional body?Director of Communications for the College of Paramedics, David Davis, argues the case for why a strong Collegeis needed to improve and protect paramedic standards in the UK. This article marks the start of a series ofeditorial features that Ambulance Today will be running throughout 2013 to spread awareness of the College’svaluable role so if you have any views or comments on its content please feel free to contact the editor at the emailaddress shown at the end of this article and we will be happy to pass your thoughts on to the College’s Council

December 2012 | Ambulancetoday

Focus on The College of Paramedics

9

as pensionable age and the recentconsultation on emergency driving laws. Inother ways, the organisations are quitedifferent. It has to be remembered thatthere are only just over 18,800 paramedicregistrants in the UK and the professionalissues that arise are often quite unique tothat relatively small workforce. Whilst thetrades unions represent its membership onpay and conditions and other matters of anindustrial nature, the College of Paramedicsfocuses on professional issues unique to theparamedic profession and in issues wherethe trades unions might not, such asdetailed above.

Issues relevant to the ParamedicProfessionThe following are examples of issues thatare either frequently raised by paramedicsor which have been pursued by the Collegealready:n Why do Ambulance Foundation Trusts

not have a mandated paramedicpresence on their boards?

n Airway management has been a matterof concern to paramedics over recentyears. How can the evidence base beinterrogated and interpreted byparamedics, often in the face ofalternate views, to enable theprofession to ensure that it plays aleading role in shaping its own clinicalpractice both at national level and inambulance organisations?

n How should specialist paramedic rolesbe increased and expanded to meetthe needs of and enhance patient carein a range of situations and to avoidhospital attendance for urgent andunscheduled care cases?

n What will be the role of paramedicsand how will the profession developgiven the recent establishment of anew medical sub-specialty in pre-hospital emergency medicine?

n How will the future professionalrelationship between paramedics andmedicine evolve? This is an importantquestions as it will influence the impactof paramedic practice upon patientcare, the degree of autonomy andparamedics’ scope of practice, all ofwhich link to the career framework,agenda for change and much more.

n Taking independent paramedicprescribing forward, on the patternestablished with pharmacy and asrecently achieved by physiotherapists,in order to meet patient needs anddeliver excellence in clinical care.

n How can paramedic students access

the NHS bursary scheme in the waythat is common for all other alliedhealth professions?

n How do paramedics influenceworkforce development, throughfunctions like the Local Education andTraining Boards (LETBs) and HealthEducation England (HEE) to ensurethat the future provision of theparamedic workforce can meetemergent and continuing changes inpatient needs?

These examples represent just some of thecurrent and important topics affectingparamedic practice, which are being takenforward vigorously by the College ofParamedics. In the past, paramedics mayhave complained that they are eitherpowerless to influence improvements ortoo remote from certain issues for them tobe relevant. The challenge for paramedicsnow is to act in an effective and compellingway to influence all of these issues in aprofessional and not organisationally ledcontext.

ENOUGH INFORMATION ORSTILL ASKING ‘WHY JOIN THECOLLEGE OF PARAMEDICS?’As previously identified there are currentlymore than 18,800 paramedics registeredwith the HCPC in the UK. The College ofParamedics has almost 4,400 members andhas enjoyed positive growth in itsmembership over the last two years andnow has around 15 percent of all paramedicregistrants in the UK are College members.This figure stood at 10 percent two yearsago.This is probably not an unusual situation fora profession established relatively recentlyand it is even less unusual because theCollege of Paramedics, unlike some otherbodies, is not also a trades union; andtherefore not seen by many members as

‘essential’ as a high number of paramedicsmay already be union members. But ifparamedics want to influence importantdecisions that affect their profession, theyneed to be sure that they have aprofessional body that is seen to berepresentative of the paramedic registrantsin the UK so here are some more reasonswhy the UK’s paramedics should thinkabout joining the College:

Parity with other professionsParamedics frequently complain that theirprofession does not have the same standingas others such as nursing, midwifery, andphysiotherapy for example. It has to beremembered that the other professionalbodies have been around for a long timeand have travelled a journey in which theyhave established strong bases and structuresbecause they have proportionately largememberships (some at almost 100 percentof all registrants). This has enabled them toestablish credibility and gain respect so thatwhen they take up issues, the public andemployers pay attention because they know

they are voicing the opinions or concerns ofthe majority of registrants, and that they arethe authoritative source for opinion. Highuptake of membership means they are well-resourced organisations that are able todirect dedicated and expert effort to theprojects and causes they see fit to pursue.Growth over recent years has meant theCollege of Paramedics has been able torecruit and employ a part time workforcebut it also relies on a network of electedCollege officials who are all paramedicregistrants and give their time in a voluntarycapacity to provide advice on professionalissues. Having a substantial and representativemembership means that the College is in astrong place to achieve Royal CollegeStatus, which is important for futureengagement.



11

RecognitionA common complaint amongst paramedicsis that they feel their profession in general isnot always recognised, particularly by themain employing organisations which mayhave appointed clinicians from otherprofessions to senior posts, and because asalready mentioned, there is no mandate fora paramedic to be present on an AmbulanceService NHS Foundation Trust board.This is probably too complex to address inthese few paragraphs but it is worthpointing out that whilst the paramedicprofession has come a long way in a shorttime, it also has some way to go in itsdevelopment and establishment. It is easyto turn around the question of recognitionby asking paramedics whether theythemselves recognise the importance ofhaving an effective professional body. Recognition also applies to how otherprofessions see paramedics. Because othersare well-resourced and well-structured, theyexert significant influence over education,training, and ongoing professionaldevelopment provision. It is obvious thatthe paramedic profession does not yet havethose sorts of footholds and leverage; butgrowth has been consistent since 2010 witha 70 percent increase in membership, whichindicates the professional body is increasingin significance and that footholds andpotential leverage continues to bestrengthened.

Contemporary examples of influenceNHS Ambulance service trust are grapplingwith the challenge of right service, rightplace, right time and this is visible ininitiatives to appropriately manage low-acuity non-urgent cases, quite rightly aimedat avoiding unnecessary hospital attendance.These initiatives have been developed tovarying degrees with different approachesacross the country, but all paramedics knowthat the risk in deciding not to takesomeone to hospital is much higher thanthat for conveyance. While many wouldwillingly expand their scope of practice tomeet these objectives, they want to be surethat all training is sufficiently well-structuredto give them the skills and knowledge theyneed. The same goes for specialisedcourses targeted at the critically ill orinjured patient.The College of Paramedics has developednew sections to address these areas in itsthird edition of its Curriculum Guidance and

Career Framework and whilst it expectsthat these will be accepted as best practice,there is no absolute requirement foreducation providers and employers toadhere to it. This would probably not bethe case for other well-establishedprofessions which over time have builtmemberships and reputations which meantheir guidance is the single most importantbenchmark against which all programmeswould be expected to comply.In 2011, the medical profession followed arigorous process in developing a newmedical sub-speciality in prehospitalemergency medicine (PHEM). Whilst theCollege of Paramedics will always supportany initiative that enhances patient care andservices, it also believes that the professions’lack of standing and experience in suchmatters may have contributed to somequestions being left unanswered regardinghow the identified need in these patientservices could be addressed in the widercontext. Could paramedics fill part or theentire new role? Will it require doctors at allstages and in all situations, or could doctor-led remote advice combine with expandedparamedical services in all or some cases?This is not a criticism of PHEM, but doesdemonstrate that a relatively smallprofessional body is highly unlikely to exertinfluence when important decisions arebeing taken which will inevitably determinethe allocation of resources and potentiallyaffect the role of paramedics.

SummaryThe College of Paramedics has establishedapprovals processes and strong relationshipsin the higher education sector and isproactive in continuing professionaldevelopment, mentorship programmes andother professional activities. It is keen topursue charitable status and when fullmembership reaches 51 percent of the UKregistrants it will also pursue status as aRoyal College.Paramedics have many issues which occupytheir thinking about their profession. TheCollege of Paramedics addresses as many ofthose issues as possible but has to do sothrough careful allocation of its resources. Itcould concentrate on continuing to growmembership – but whilst doing solely that,there will be important matters that comeand go without the input of the profession.It could continue to address the main issuesas they arise as it has done for the past 10years, but that means membership maygrow at a slower rate than is needed toensure the development of the profession.Members fees for the College ofParamedics are amongst the lowest of allprofessional bodies and in many casessignificantly less, so it really is good value formoney too!

FINALLYIt is hoped that this short article hasaddressed some of the questions in relationto the College of Paramedics which arefrequently raised by paramedics. In the nextissue of Ambulance Today, there will be anoverview of the structure the College, itskey position-holders, and the activities it hasbeen engaged in and how it hasrepresented the interests of paramedics. Inthe meantime, if you have any questionsabout the College of Paramedics you wouldlike to ask or comments you would like tomake, please send them to AmbulanceToday editor, Declan Heneghan, at:[email protected]

Follow us on Twitter:@ParamedicsUK or#CollegeofParamedicsVisit us on Facebook:http://www.facebook.com/CollegeofParamedics?fref=ts



13

Biography: David Davis

CommunicationsDirector for the Collegeof Paramedics, DavidDavis, is also the NHSPathways Clinical Leadfor South East Coastambulance service.David represents the

profession at a range of nationalstakeholder groups, including the NationalClinical Governance Group for NHSPathways. In addition, David is currentlyseconded for part of the week asNational Clinical Lead for Allied HealthProfessionals at the Department ofHealth, Informatics Directorate.David joined SECAmb in 2001 and

was registered as a paramedic in 2004.David’s clinical and managerial specialitiesinclude prehospital management of strokecare and he was the College’s strokelead for a number of years. Playing anactive role in stroke developmentnationally and regionally, David’s work hasfeatured in a number of high profilepublications, including the NHS 60thCommemorative Brochure and thesecond of the Darzi Reports where hewas featured as a clinical leader. Davidremains a Clinical Associate of the NHSStroke Improvement Programme.In his spare time David is currently

trying to finish an MSc in Management &Leadership for Clinicians, as well as beinga member of the Journal of ParamedicPractice Editorial Board!

Once again, the London TraumaConference excelled, putting on fourdays of inspiration, insight, ideas &education and featuring theprofession’s most celebrated traumaleaders. Delegates, including doctors,ambulance teams and nurses, travelledfrom over 20 countries to attend theconference. Topics were current,relevant, well thought out andprovoked lots of discussion amongst itsaudience and on the twittersphere,where the event’s official hashtag,#LTC2012, was trending.

Commenting on the conference,Professor David Lockey said: ‘Onceagain we assembled a great line up oftrauma professionals, at the very top of theirchosen specialities from both the UK andoverseas, for the UK’s premier traumaconference. Delegates travelled from all over theworld to attend the conference, feedback wasoutstanding and enquiries for bookings havestarted rolling in for next year’s conference,which will be held on 10-14th December.”For the first year ever the Cardiac Arrest

Symposium, which was sold out, was held aspart of the conference. Topics included pre-hospital Cardiac Arrest, Cardiac Arrest in theyoung, Sudden Cardiac Death, Cardiac Arrestin sporting events and Mr Mark Whitbreadgave an insight into the future of CardiacArrest for paramedics. Key note address wasgiven by Prof. Maaret Castren and therewasn’t a dry eye in the house following a talkfrom cardiac arrest patient, Chris Solomons,who bravely shared his experience.Delegates were treated to the first ever air

ambulance symposium, which was hosted bythe Norwegian Air Ambulance. Led by Prof.Hans Morten, this day gave insights into

important areas of theair ambulance arenalooking at airambulances of todayand the future of airambulances, which wascovered by Dr GarethDavies. Mr GrahamChalk gave anoverview of thedispatch of airambulances intrauma, Prof. HansMorten covered pre-hospital thrombolysisin Stroke, Prof.Wolfgang Voelckelgave an insight intohead trauma and DrAnne Weaver sharedthe progress ofcarrying blood onboard London’s AirAmbulance, ninemonths on.Other days covered pre-hospital care,

major incidents and trauma issues with aneponymous lecture held in honour of thecontributions of Douglas Chamberlain tocardiac arrest management and The PeterBaskett Memorial Lecture was given byProfessor Michael Parr, from LiverpoolHospital, Sydney, who discussed, ‘The highly

performing Trauma System: How good can weget?. Keynote speakers were ProfessorMaaret Castren, Dr. Gareth Davies, Dr.Stephen Solid and Professor Jim Ryan. Breakaways, both enjoyable and

educational, included the Trauma ResearchForum hosted by Prof. Karim Brohi and CoreTopics in Trauma, for junior doctors, nurses,paramedics and medical students. Anotherfirst for the conference was the thoracotomymasterclass, which was hosted by MajorThomas Konig. Following theory whichcovered the history of thoracotomy and postthoracotomy care, the audience were treatedto a thoracotomy moulage by a doctor andparamedic from London’s Air Ambulance. Asever the stand-up science evening, led by DrGareth Grier, was hugely entertaining andpopular and even attracted medical studentswho presented their research to the panel ofexperts and sceptical audience.

London Trauma Conference 2013 will takeplace on 10-14th December at the RoyalGeographical Society in Kensington, formore information and bookings visitwww.londontraumaconference.com andfor enquiries [email protected] call 0844 335 0377. For updatesthroughout the year, including photos,videos and blog posts please visit thewebsite or follow @LDNtrauma.

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

London Trauma Conference a Huge Success!

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

Professor Sanjay Sharman

Pictures by Paramedic, Lee Parker

Dr Gareth Grier

Mr Jerry Overton


AmbulanceZorg Limburg-Noord iscommitted to improvingperformance and meeting aGovernment set target of respondingto 95% of A1, life threatening callswithin 15 minutes. Havingimplemented all recommendationswithin the National Ambulance Plan,the ambulance service found that itstill couldn’t meet this particulartarget and A1 performance is fallingbelow the required standard at 89%. Optima was asked to provide an

independent evaluation of the number ofresources required to achieve the targetperformance in the region. André Lemmen, Director, AmbulanceZorg

Limburg-Noord explains “Having doneeverything we can to optimise our service andperformance given our current resourcelevels, we felt that we may be falling short ofthe required number of ambulances or notmaking best use of our existing ambulances,and we may need to review the best locationsfor our vehicles. We needed to fullyunderstand the situation and providecompelling supporting evidence to accuratelypresent our case for making any changes.”

Optimising resources and locationsOptima addressed this question using

Resource Location Optimiser (RLO), theoptimisation module of Optima Predict™.RLO is used to identify the locations thatmaximise the coverage of call demand byusing historic incidents. The whole geographywas assessed meaning that new locationsthat would improve performance wereidentified. In order to provide a highly accurate

model, RLO takes into account a number offactors:n Coverage is calculated using the tuned

road network, meaning that coverage is

based on historic ambulance journeydata, and accounts for time of day, dayof week, lights and siren and non-lightsand siren travel

n Incidents are covered by a resource ifthey can be reached within a targetresponse time

n A workload factor considers how busya resource is likely to be; once aresource reaches the workload factor, itcannot respond to any additional calls.This leads to the RLO putting multipleresources to cover busy locations

n Resources are provided as an input tothe model and resources are added untilthe coverage reaches the target level

Challenging environmentThe Limburg region provides the

ambulance service with some particularchallenges. Bordered by Germany andBelgium, the long and narrow region isdivided by a river. There are relatively fewbridges crossing the river, leading toincreased journey times and congestion.Optima’s RLO analysis considered a

number of different options for locating theambulances, with each option thenmodelled using a variety of resources to

show how 95% performance can beachieved.The options included:

n Only using existing bases

n Using completely new locations

n Using a mix of existing and new locations

André Lemmen said “The final reportfrom Optima gave us some solidrecommendations for improving our A1performance. It clearly shows that we ideallyneed three additional resources and weneed to make some changes to ourtemporary and permanent locations aroundthe region to maximise our coverage. It hasgiven us a convincing case to present to ourstakeholders to implement these changesand secure more funding.”

Moving forwardOptima’s full report has now been

accepted by governing bodies andAmbulanceZorg Limburg-Noord is in theprocess of putting together a detailed planbased on Optima’s findings, for approval andimplementation. Optima Predict is being used in-house to

carry out further detailed modelling,providing a unique evidence base that otheranalytical tools cannot match. This willidentify further options for Dutchambulance services to continue to improveservices and maximise efficiency andeffectiveness in these challenging times.Optima Predict is also now fully installed

and providing critical new strategicinformation in Scotland, South Central andEast of England as well as 43 otherambulance services in 9 countries aroundthe world.

For more information, please call +44 1189 036602, [email protected] visit www.theoptimacorporation.com

Optima helping optimise resources and deliver improved performancein the Netherlands for AmbulanceZorg Limburg-Noord


Focus on Dutch Ambulance Care

17

Coverage and Demand – New BasesComparing the coverage between the baselinescenario on the left and the optimised new basescenario on the right.

AmbulanceZorg Limburg-Noord faces some specific challengesAmbulanceZorg Limburg-Noord faces some specific challenges

Ed Matthews,Project Lead onthe Helen HamlynCentre forDesign’s‘Redesigning theA&E Ambulance’project isarranging a

consultation day at the RCA inKensington early in 2013. Theconsultation exercise is intended toprogress the project towardsprototype construction and ensurethat ambulance providers in boththe UK and across Europe have anearly opportunity to contributeideas on the vehicle’s eventualdesign.

“We’re delighted that Dr Anthony Marsh,Chairman of the Association of AmbulanceChief Executives (AACE) and CEO of WestMidlands Ambulance Trust has found sometime amongst his many commitments toopen the day, alongside prominent, alreadycommitted supporters of the ambulanceredesign project, and long-term supportersof the Royal College of Art (RCA)”, hecommented, adding: “It’s essential that wereceive clear feedback from all parts of theambulance service and, because AACE iscommitted to ensuring that ambulance staffat all levels have a voice in determiningambulance delivery across the UK, AnthonyMarsh’s presence and influence will help usgather the input we need.”

Mr Matthews continued: “We’re consciousthat Ambulance staff might feel that theproject has gone a little quiet since welaunched the Demonstrator Unit last year.The main reason for this is that many of theambulance people whose input is crucialhave understandably had a large chunk of2012 dominated by their responsibility for

Olympics delivery. We can relate to thissince our own college was used as a mainworld media base throughout the event.However, the fact is that beneath the quietexterior we’ve been extremely busy –there are many complexities attached toachieving our next objective, which is tobuild working prototype vehicles, put themto the real test of working in frontlineservice, and develop the design forcommercialization.”

“Our launch event was very successful andthe audience of clinicians, industry experts,NHS leaders and manufacturers respondedvery positively to the proposed newtreatment space. Former LAS Chief, PeterBradley, lent his personal support to help usto progress as far as possible towards thenext development stage prior to his moveback to New Zealand, and wiselynominated their fleet lead, Nick Pope, tocontinue LAS’s support after he steppeddown as CEO. Nick has given us excellentsupport and, despite strenuous 2012delivery commitments, he’s been there forus whenever we’ve needed his advice. Wecan’t thank him enough for this.”

Stressing the need for consultation, Edadded: “We’ve continued to develop ourdialogue with ambulance staff, both in theareas of clinical effectiveness and thebusiness case. As before, we’ve consistentlyfound that people from all sections of the

ambulance community are open-mindedand enthusiastic in their support for thedevelopment of a vehicle better designedto reflect the major changes in clinicalscience that, over recent years, haveinfluenced the way in which patient care isdelivered. It became clear to us that amajor consultation event was needed tobring together the key stakeholders, whoseknowledge and experience needs to be fedinto the development programme so wecan ensure that the end result matchestoday’s clinical, financial and operationalrequirements.”

He finished: “A number of your readersmay be aware that we’ve put a lot of timeinto building up a database of the peoplewhom we need to invite to the event.These will include individuals from both thepublic and private sectors, and we’reputting together a series of presentationsto make it absolutely clear what theproposed design is, and the clinical benefitsthat it can deliver at a manufacturing costthat is the same, or maybe even a little less,than that of current vehicles. We’ll also bediscussing the operational impacts, in termsof training, new technologies, changes toexisting systems, and the business case”.

The event is planned for late February,2013, and invitations will be sent outshortly.

If you would like to find out moreabout the project or if you would like your ambulance service ortechnology provider to be involved in the consultation day, please email Ed Matthews at:[email protected]

Have Your Say onAmbulanceRedesign Project


Focus on RCA Ambulance Redesign Project

18

helen hamlyn centre for design

helen hamlyn centre for design

Lord Darzi and Lady Helen Hamlyn - leading supporters of the project

A stumble or trip can knock theconfidence of the most active andindependent person, but theimpact of a fall on someone whomay already be vulnerable –isolated, frail or otherwise in poorhealth – can be devastating.

The numbers are shocking, as you can seefrom the ‘Falls in numbers’ infographic onpage 21.n Falls are one of the leading causes of

mortality resulting from injury inpeople over 75 in the UK.

n One in three people over 65 and halfof people over 80 will suffer a fall eachyear.

n Half of those with hip fracture neverregain their former level of functionand one in five die within threemonths.

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

But just as we don’t have to accept falls asan inevitable part of aging, nor must weaccept as inevitable the burden which fallsplace on the health and social care service.

Ambulance services are often the firstpoint of contact when an older person falls,and so are ideally placed to take a lead rolein developing the collaborative approachwhich evidence points to being the bestway to reduce falls, and lessen theirdevastating impact for individuals and forthe health service.

Picking up the piecesFalls account for approximately up to 25per cent of ambulance call-outs for theover�65s, and cost around £115 percall�out. Every year, over 500,000 olderpeople attend UK emergency departments

following a fall. And falls and fracturesamong the over-65s take up 4 millionhospital bed days each year in Englandalone, costing an estimated £2 billion.

But the impact of falls reverberates farbeyond physical health and wellbeing andtheir effect simply cannot be measured instatistics, performance measures orfinancially. The psychological impact of fallingcan be devastating. Having a fall candrastically lower levels of confidence andindependence in older people, and these

consequences – along with increasedisolation and depression – often slow downrecovery.

Working together, community healthservice providers and the ambulanceservice can play a crucial part in thedelivery of comprehensive care pathwaysfor falls and fractures.

Making the case

The Department of Health has estimatedthat a falls prevention strategy could reducethe number of falls by 15 to 30 per cent.

But while ‘slipper exchanges’ an otherinitiatives have undoubtedly had somedegree of impact, overall, studies haveshown that these policies have not beenentirely successful. Many patients stillexperience disjointed care as falls andfracture services are not integrated and notenough is done to stop people falling again.

Working with service leaders fromambulance trusts and the urgent caresector, and their counterparts incommunity-based services, the NHSConfederation has drawn togetherevidence that demonstrates a clear case forinvesting in rehabilitation and preventionfalls services that link up organisationsacross health and social care.

We want to see a concerted drive – fromthe national level through to the most local– to tackle falls. The ongoing reforms in theNHS, including the establishment of Healthand Wellbeing Boards which will look at thewider local inter-agency picture, are theperfect time to seize the chance to get thehealth service, social care and localauthorities working together.

There are mechanisms available in the NHSreforms to make joint working possible butthey will require leadership from nationalto local level to really work.

Joining forces todrive down fallsJoining forces todrive down falls

CEO of the AmbulanceService Network, Jo Webber, presents acompelling case forinvesting inrehabilitation and fallsservices that link uporganisations acrosshealth and social care

CEO of the AmbulanceService Network, Jo Webber, presents acompelling case forinvesting inrehabilitation and fallsservices that link uporganisations acrosshealth and social care

By Jo Webber, Director Ambulance Service NetworkBy Jo Webber, Director Ambulance Service Network


Focus on Need for a National Falls strategy

19

EVS EuropeEmergency Vehicle Seating

Infection ControlSeamless Anti-BacterialAmbulance Seating

Contact us for furtherinformation and brochures

1 Chilford Court, Rayne Road, Braintree, Essex Tel: 01376 552399 Email: [email protected]: www.evseurope.com

Since 1993 EVS Ltd. has created more safetyseating products than any one else in theambulance industry by investing in researchand development and dynamic testing

The EVS Child Seat for Van Conversions"n Seat can be swiveled

and stowed flat against the wall

n Tested to M1 Standardsn Easy-to-use cable

release system with 8 positions available on Fixed or Swivel Base

n Seamless construction for removal of blood-borne pathogens

The EVS 1860 isour newest additionto the range ofambulance seating

Joined up care:

n Health and wellbeing boards need toensure services and commissioning forfalls are joined up.

n Organisations across public health, theNHS, social care and local governmentshould share data.

n Organisations should use the NHSpatient number to keep track ofpeople who fall and assess the carethey receive

n Health and social care budgets shouldbe shared or aligned to supportjoined-up falls services.

Commissioning

n The NHS Commissioning Board andPublic Health England will need toenable clinical commissioning groupsto work together to deliver a range ofintegrated falls services across healthand social care locally.

n As part of local authorities’ publichealth mandate, councils shouldprovide falls prevention informationand support services.

n Falls should play a major part of theneeds assessment undertaken bycommissioners.

Mechanisms to deliver better care:

n Falls and fracture indicators should bepart of the Adult Social CareOutcomes Framework and newambulance performance measures.

n NHS trust quality accounts shouldprioritise reducing the number of andharm from falls

n Commissioning quality and innovation(CQUIN) targets should include anindicator for reducing falls andavoidable admissions that encouragesorganisations to work together.


Focus on Need for a National Falls strategy

21

In a country where, for all itsbeautiful scenery, communities andindividuals can find themselvesexperiencing a health crisis in themost inaccessible locations, far frommajor treatment centres, theEmergency Medical Retrieval Service(EMRS) makes a world of difference!Their Critical Care Practitioners(CCPs), a new and challenging rolefor paramedics, help ensure that allpatients, no matter how remotelylocated, can have the emergencydepartment resuscitation room orintensive care department broughtdirectly to them, before being swiftlytransported to the right treatmentcentre for their specific condition ortrauma. CCP Neil Sinclair reports.After 10 years’ experience as a

paramedic working in various environments,I felt the need to find a new clinicalchallenge. I had previous knowledge of theEmergency Medical Retrieval Service(EMRS) so when I heard they were creatingthe new role of ‘Critical Care Practitioner(CCP) for nurses and paramedics, I knewthe opportunity to be actively involved inretrieval medicine was exactly the challengeI was looking for. Along with fourparamedics and one nurse I am now 12months into a secondment with the EMRSin the role of Critical Care Practitioner.The EMRS is an NHS-funded

service based in Glasgow and ourservice provides critical care toacutely ill and injured patientsacross Scotland in a variety oflocations and environments.Retrievals are either fromthe pre-hospital environment(primary retrieval) or from aremote and rural health carefacility (secondary retrieval).“Retrieval is the deployment of

a critical care team to a seriously ill

or injured patients’ location to undertakeresuscitation and stabilisation prior to safetransfer to definitive care”Secondary retrievals are necessary due to

the unique geography of Scotland, there aremany remote healthcare sites situated onthe west and north coast. These retrievalstake place from a variety of health carefacilities including district nurse practices,remote GP surgeries, community hospitalsand rural general hospitals. The patients whoarrive at these facilities are often critically illand, with limited equipment and specialiststaff available, these patients can easilyexceed the local critical care capability. Theservice provided ensures that these patients

have equity of access to theappropriate level of care, bybringing the emergency

department resuscitation roomor intensive care departmentto the patient - regardless oflocation.Primary pre-hospital criticalcare is provided across thewest coast area of Scotland.In these circumstances we

respond as the EMRS TraumaTeam. Within the greater Glasgow

area this is done in one of the servicededicated response vehicles, whilst furtherdistances are reached by helicopter in aHelicopter Emergency Medical Service(HEMS) configuration. The team isdispatched by the ambulance servicecontrol centre, or after requests forassistance from the ambulance cliniciansonscene.Transportation of the patients in remote

areas is predominantly done by air and theservice works closely with the ScottishAmbulance Service, utilising their fixed wingand rotary aircraft. At times, due to aircraftdemand and adverse weather conditionswe utilise military or coastguard helicoptersto provide transport, ensuring the servicecan deliver care regardless of theunpredictable Scottish weather.“Flying at low level in a militaryhelicopter in the dark at 3am makesme appreciate the magnitude of thejob we’re involved in”The service is consultant-led and

delivered and has two teams available 24hours a day. Each two-person team iscomprised of a consultant from emergencymedicine, intensive care or anaesthetics andeither a senior trainee doctor from one of

Flying High to Raise the Clinical BarFlying High to Raise the Clinical Bar

Focus on Role of Scotland’s Emergency Medical Retrieval Service

22 December 2012 | Ambulancetoday

the same specialities or one of the criticalcare practitioner team.Working alongside nurses in the same

role is a new experience for me and theother paramedics, making us a truemultidisciplinary team. The CCP team is ledby CCP Stuart Daly, a nurse with extensiveemergency department, critical care andpre-hospital experience. This defiesconvention for UK practice with nurses andparamedics sharing the same role – bothactively involved in pre-hospital andinhospitalintensive care level of patients. TheCCP team draws clinical skills from a richbackground and from many different areas,resulting in significant knowledge andexperience that each of us can bring to theteam. We also train together regularly andlearn from each other to provide optimalpatient care.“It took time to become

comfortable with dealing with thecomplexity of intensive care levelventilated patients”The challenge of being part of a team

practising retrieval medicine has completelymet my desire for further challenges. The

mix of work from primary and secondaryretrievals is potentially one of the mostdiverse and challenging paramedic roleswithin the UK.At present this role differs from other

advanced paramedic roles in the country asit moves away from sole autonomouspractice and focuses on integration into amedical team. This leads to additionalopportunity as working under thesupervision of a consultant allows us topractice and gain experience in skills whichare usually reserved for medical staff.Interventions the team will regularly have

the opportunity to practice Include:

n Emergency anaesthesia and ventilation

n Advanced analgesia and sedation

n Chest thoracostomy

n Invasive monitoring

n Use of a large variety of non JRCALCdrugs

An example day I experienced recentlystarted with an emergency tasking by roadto a primary mission to a crane collapse inthe city centre, with several critically injuredpeople who required critical careinterventions. Directly afterwards, we weretasked to attend a secondary retrievalmission which, due to its location, required ahelicopter flight to a small island off thewest coast to an isolated GP surgery. Onceon-scene we had to perform an emergencyanaesthetic to a tiring asthmatic in the GP’ssmall treatment room.

I had not accounted forbefore joining EMRS was the value ofworking one-on-one with a consultant, thisleads to an apprentice-style education withexposure to levels of clinical leadership andteaching I have not experienced before.The clinical exposure, leadership and

education I have received has led to anevolving knowledge and skill set in acutemedicine and trauma. This has greatlyincreased from my previous paramedic skillset. The unique workload and the way inwhich knowledge and skills are gained makeme feel it would be difficult to have learntthe same from a book or a course.

“After exposure to advancedtreatment and assessment in manyenvironments, it is apparent howimportant it is to do the basics well”The future holds opportunities for a

wider scope of autonomous practice for theCCP team as our experience, knowledgeand extended skills grow. The present goal isfor the CCP team to work towards beingable to independently manage single organfailure patients.The role of critical care practitioner with

the EMRS provides an excellent opportunityfor both the advanced paramedic and nurserole, bringing us together in an appreciationof both skill sets and allowing us to be themost effective retrieval team members.

If you would like Ambulance Today to focuson your specialist ambulance project, emailus at: [email protected] you are in the world we’ll behappy to spread the word!


Biography: Neil Sinclair

Neil Sinclair Joined theScottish AmbulanceService (SAS) in 2003as an ambulancetechnician and qualifiedas a Paramedic in 2006whilst working inEdinburgh city centre.

Throughout his career he has gained avariety of experience and clinical skillsworking in ambulances, rapid responseunits, cycle response units, helicopter andfixed wing aircraft across Scotland.Neil has specialist interests in pre-hospitalcardiac arrest management andprehospital clinical governance standards.He counts his current position as aCritical Care Practitioner with theEmergency Medical Retrieval service ashis greatest professional challenge todate and the highlight of his career so far.

Focus on Role of Scotland’s Emergency Medical Retrieval Service

Former Two Shires AssistantAmbulance Chief, John Dale, hasbeen a popular figure in UKambulance circles for three decades.But while many are aware of thecontribution he has made toambulance care in the UK as thefirst ambulance leader to developNHS Direct services in 1998/9, fewbut his closest friends are awarethat John has also dedicated muchof his boundless energy in recentyears to the creation of FIESTA UK(Filipino International EmergencyServices Training Association) acharity which provides much-neededambulance training and resourcesupport to the inhabitants of the7,000 islands that make up thePhilippines – one of the mosteconomically deprived andenvironmentally-challengedcountries on earth. Below Johnexplains how you can help him makea big difference to his Filipinofriends this Christmas by offeringthem invaluable support -no matterhow big or small.The Philippines is steeped in history and

alive with natural phenomena. Possessingsome of the most breath-taking beaches inthe world and some of the most beautifulscenery it also however suffers from morethan its fair share of natural disasters.Typhoons, hurricanes, landslides,earthquakes, volcanic action, tsunami andflooding are all sadly commonplace naturalphenomena that blight the lives of itsmostly poverty-stricken population. Add tothis man-made disasters, such as shantytown fires; ferry disasters and major busand vehicle crashes, and you soon realize itis a country that needs good, reliable

ambulance and rescue services far morethan most. Sadly though in many placesacross the Philippines such services are indesperately short supply.The ambulance service in the Philippines

is divided into a number of categories. Inthe country’s two main cities – Manila andCebu – as across most other areas –private ambulance companies provideservices to either designated privatehospitals or on behalf of insurancecompanies. These ambulances tend to bewell-equipped and staffed by American-style paramedics. Davao is the country’s third city on the

southern island of Mindanao and this city

has taken on itself the task of providing anambulance service for its residents. Thisservice is well co-ordinated, equipped andstaffed and is run alongside the fire servicewith whom they share a joint 911 centrewhich also deals with calls for the police.Central 911 also provide a Search andRescue Service. All services provided fromCentral 911 are free of charge to thepublic.

You can find more information on this service at: http://www.youtube.com/watch?v=iBn-OLxP5xM)

On the island and city of Cebu anotherorganisation providing free ambulance, fireand rescue services is the EmergencyRescue Unit Foundation (ERUF). Thisservice operates out of a number of basesin the adjoining cities of Cebu, Mandaue,Talisay and Lapu-Lapu. ERUF is effectively acharitable foundation and although itreceives some funding from the CityGovernment it is strongly reliant onsupport from other countries including the

Dreaming of owning an ambulance and with just one stretcher and one cervical collar at their disposal… This is the harshreality of ambulance care in the Philippines!

Some response cars donated by Dutch Ambulance supportersSome response cars donated by Dutch Ambulance supporters


Focus on ambulance care in the Philippines

24 October 2011 | Ambulancetoday

FIESTA UK TOTHE RESCUE!

Caring at Christmas

US, the Netherlands and the UK.In Cebu the telephone number to ring is

161 and this goes direct to the ERUFcentral control room in Cebu City. TheFoundation runs stations in three locationsand each is equipped with Fire, Ambulanceand Rescue capability. The staffing iscomprised of both EMT and Paramedics,some of whom are paid and others ofwhich are volunteers. ERUF is the onlyrescue unit in the whole country with ahost of multi-response capabilities and aninternationally qualified complement torespond to Urban Search and Rescue,

Technical and High Angle, Haz-Mat and DiveRescue. Its training school is qualified toteach all these subjects as well as training itsown EMT’s and Paramedics. It is one of twocentres in the South East Asia Regional areathat is qualified to teach Prehospital TraumaLife Support and its trainers visit othercountries to provide training. ERUF has alsotrained many villages in disasterpreparedness and awareness.Davao and Cebu along with the private

services in the Capital provide the bestcover for the Philippines. However there areover 7000 islands in the Philippine chain andmany places have little or no ambulancesupport for the population. While there aremany embryonic services across thecountry, some fail and the majority of themstruggle to succeed or to even stay afloat.In the City of Mati in the extreme South

of the Mindanao Island and about two and ahalf hours from Davao, is a volunteer servicethat has been in existence for over ten

years. It has over two hundred volunteersand covers the City of Mati and the nearbysmaller town of Lupon. The City HealthOffice staffs an ambulance between thehours of 9 to 5, Monday to Friday but allother cover is provided by a charity -Dreams Rescue 166. Dreams provide thisservice with their volunteers during theevenings, nights and at week-ends. Thetrouble is that Dreams do not even own anambulance of their own and have to borrowthe City vehicle… when this 8 year oldvehicle is available! When the ambulance isnot available Dreams’ volunteers use pick-uptrucks and cars to transport their patients. Dreams have been in operation for over

10 years and are now being trained to theUK Green Book standard by the CityMedical Director. Resources are scarce andthe ambulance they borrow is equippedwith no more than a single stretcher andone cervical collar! The dedicated Dreamsvolunteers even have to supply their ownfirst aid kits, masks and gloves purchasedfrom shops in the town. They do thiswillingly though because they realize that nomatter how meagre their resources may be,their presence alone is of the utmostimportance to those whom they seek tosupport.Dreams have received help and support

from Davao Central 911 and, thankfully, it isnow starting to receive a little support fromthe UK. By the time this article goes to pressthey will have received some more collars, abag and mask, yellow reflective jackets andtabards and some other equipment in a firstbox of support items from the UK. The localHospital is also getting a Lifepak 10 Defibtrainer courtesy of Wessex Medical Ltdwhich one day may be used to trainambulance staff.So as we in the UK take a deep breath

and prepare for Mad Friday, missed familytime over the Christmas holidays and theescalating Winter Pressures, I’m sure thatyou’ll agree that our dedicated and deeplycommitted fellow ambulance workers atDreams Rescue 166 in Mati not onlydeserve our deepest respect but also, morevitally, as much practical support andencouragement as we can possibly givethem.

So if you’d like to support ambulance care in the Philippines by donatingequipment, medicines or cash please email me at: [email protected] can also visit us at: http://fiestauk.homestead.com/Homepage.html

John Dale,ChairmanFIESTA UK (Filipino InternationalEmergency Services Training Association)


Caring at Christmas Focus on ambulance care in the Philippines

Focus on Sinclair Voicenet

WorkforceManagementEnhancesOperationalEfficiency

WorkforceManagementEnhancesOperationalEfficiency

Founded in 1967, Sinclair VoicenetLimited is the UK’s longestestablished specialist provider ofmultimedia interaction recordingsolutions to the public safety sector.They enable control centres tocapture, store and manage voice, textand computer screen activitiesrelating to multi-channel interactionsby telephone, chat, email, SMS andradio. The company also providesquality management, interactionanalytics and workforce managementsolutions that improve performanceand operational efficiency.Many Ambulance Services are evaluating or

implementing Workforce Managementsystems as they look for new ways to meetgovernment targets. These highly configurablesystems provide an effective and efficient wayto forecast staffing needs, schedule staff andtightly control costs. They help to proactivelymanage daily events and quickly respond tochanging conditions to maintain a high level ofcustomer service. In addition, automatingmanual processes reduces the requirementfor administrative time and enhances theproductivity of both supervisors and callhandlers.

North East Ambulance ServiceThe North East Ambulance Service

(NEAS) has recently awarded SinclairVoicenet a major contract to supply andinstall a NICE IEX Workforce Managementsystem. The new solution will be deployed atthree contact centres across the North Eastof England where 300 agents handle over 1.5million calls every year. It will allow real-timescheduling of staff and resources to reducethe reliance on overtime working andenhance the operational efficiency of theservice.According to Tom Howard, Head of

Contact Centres for NEAS: “After conductingan extensive tender process, we awarded

Sinclair Voicenet this contract as it not onlyoffered the most appropriate system, but italso shared our vision of what we wanted toachieve. The company also demonstratedthat it could meet our requirement fordelivering the highest levels of support bothduring deployment and on an on-going basis.” The robust and stable solution from Sinclair

Voicenet meets resilience requirements withall databases and applications replicated on aseparate server at a remote location. TheNICE IEX Workforce Management systemalso has a powerful multi-site functionalitywhich could be utilised in the planning andmanagement of operational resources.

“The NICE system will automate existingspreadsheet-based planning processes withinthe Contact Centre and replace the GRS(Global Rostering System) tool traditionallyutilised by Ambulance Services,” continuedTom Howard. “This will deliver significantcost savings, allowing us to make furtherinvestments in future strategies.”

Quality ManagementQuality Management is another technology

being deployed by public safety organisationsof every size to increase caller satisfaction,improve call handler effectiveness andoptimise control centre processes whilstcutting costs. It delivers essential operationalinsights to improve efficiency and ensurecompliance with internal procedures andregulatory processes.The performance of call handlers can be

tracked in real-time with flexible recordingrules, automatic monitoring of KPI targets,real-time alerts and root cause analysis tools.It is easy to select which calls to evaluateusing advanced query tools with automatedscoring, graphic visualisation and a wide rangeof search criteria including data generatedfrom speech analytics, desktop analytics andcustomer feedback. This enables managers toquickly identify and take immediate action toresolve immediate quality issues such as

knowledge gaps or process inefficiencies.

Technical SupportHigh levels of technical support are

essential to ensure that systems continue tooperate at maximum efficiency to meet thedemands of the mission critical environmentsin which they are used. Sinclair Voicenet has aflexible, responsive and proactive approach todelivering the highest level of service tocustomers and the fact that over 90% of itscustomers are supported on full maintenancecontracts is a clear demonstration of thecompany’s commitment to serviceexcellence. It provides a range of supportagreements including 24/7 coverage to meetthe requirements of Ambulance Servicesnationwide. This has recently been extendedto users of CyberTech recording equipmentthat are looking for an alternative technicalpartner that offers a more proactiveapproach to supporting their recordingplatforms moving forward.

About Sinclair VoicenetSinclair Voicenet was one of NICE Systems’

first Platinum Partners and is the onlycompany in the EMEA region to qualify as aNICE Master Distributor, the ultimate level ofaccreditation. It is also regarded by NICESystems as the UK’s leading expert in thedeployment of NICE services and solutionsand often provides additional support toother approved NICE resellers.

Sinclair Voicenet LtdTel: 01355 900 000Email: [email protected]: www.sinclairvoicenet.co.uk


According to the latest availableinformation the RomanianGovernment’s healthcare budget ofabout €5 billion is the lowest of all33 EU countries, bar two; spendinglittle more than €250 a person, it isunsurprising the country'shealthcare system is considered oneof the worst in Europe, ranking againthird bottom in the EuropeanHealthcare Consumer Index.To halt the slide the Government has

tried to introduce reforms which wouldencourage heavily controlled privatizationof the state health system, particularly theemergency services but this provokedstreet riots and the proposals werewithdrawn.Fermenting the crisis has been the

political unrest with a succession of healthministers who have come and gone, thelatest is Vasile Cepoi who resigned onOctober 1 following a corruption row thatsaw him accused of conflict of interest andthe pocketing of EU funds. Deputy health minister Raed Arafat – a

popular figure as the founder and owner ofSMURD, an emergency rescue servicewhich complements traditional stateambulances, has taken over the day to dayrunning of the ministry but only on atemporary basis.While all this upheaval continues, the

private medical system has moved aheadwith large investment in the construction ofspecialist hospitals. For as RazvanStefanescu, Director at Romgermed, one ofthe investing companies, says:”Unfortunately, whether we are in a crisisor not, people get sick, so unlike other

industry, health has not really beenaffected.”Much the same can be said for Romania’s

public ambulance services. Together withSMURD they have exclusive rights forresponding to all 112 emergency calls forwhich they receive the bulk of the €150million allocated for all ambulances servicesleaving just 2.5% or around €3 million forprivate ambulances.The Association of Private Ambulance

Services in Romania was set up in 2009 tofight for a larger share of the state budget,claiming its allocation is simply not enoughfor handling its task – handling around700,000 calls covering 24 million kilometersa year. For many of the estimated 50companies, this means operating at a loss.Lucian Florea, ASPAR’s Vice President

argues: “Like the IAA, we do not want tocompete with the state; we say that theintroduction of private ambulances in thenational emergency system will lead to less

intervention and the development of thesystem with zero-cost from the state”.As in Britain, most of the companies are

small relatively local operations.For example, Florea runs Neuromed

Ambulance which is part of the NeuromedCenter for Diagnostic Imaging; it wasfounded in 1998 in Timisoara, as one of thecountry’s pioneers in the use of magneticresonance (MR) and computedtomography scanning. Its fleet of 11ambulances transports hospital patients toand from the clinic.The country’s largest private ambulance

company is BGS Medical, which has a fleetof 270 ambulances and employs 650trained medical people in Bucharest andPloiesti; it meets the patient transportneeds of public and private hospitals as wellas corporations.Another leading service is Axis, with its

main stations in Deva and Bucharest and agrowing network of smaller bases in the

Romanianambulance

companies lookto follow IAAstrategic lead

Private ambulance companies in Romania are seeking a bigger share of the national healthcare budget and are looking to what’shappening in Britain for a strategic lead to combat critics who claim that increased privatisation will destroy the state system.The author of this article is David Davis, Director of Communications at the Independent Ambulance Service and the onlyforeigner invited to speak at a recent conference in Poiana Brasov organised specifically for government and independenthealthcare executives to debate the public/private issue.


Focus on the Independent Ambulance Association

27

AXIS home care doctor’s car


Focus on the Independent Ambulance Association

28

countryside. It employs more than 150people and has a fleet of 60 vehicles, someof which are operated by doctors who treatpatients at home.ASPAR openly admits that the IAA has

achieved more in nine months in Englandthan it has in three years in Romania inreducing the tension between the public andprivate ambulances and is studying the IAAstrategy of more constructive campaigning.The conference attracted more than 120

executives; the speakers presented bothsides of the ‘privatisation’ argument,provoking follow up debates betweendoctors, hospital and ambulance managerswhich became more and more heated, attimes boiling over with some delegateswalking out.In my presentation I explained how the

IAA’s strategy of working with thegovernment and healthcare regulators wasstarting to help foster a wind of change in

the relationship between the NHS andprivate ambulance companies.As a result of the recently introduced

NHS reforms some healthcarecommentators were suggesting in 5 yearsBritain will have a national ambulanceservice, bringing together as businesspartners the best skills and resources of theNHS and the independent sector.The positive experience of the IAA since

it was formed less than a year ago reflectedthe early signs of this new relationship andwe believe “that in a relatively short periodof time this mutual historic and unjustifiedmistrust will be replaced by a professionalworking relationship built on the mostimportant principle of all - the patient comesfirst”.The audience remained respectfully silent

to my comments until several delegates roseto say that the IAA approach and what washappening in Britain would be right forRomania. Representatives of the state runBucharest ambulance service clearly didn’tagree.More people came up to me during the

conference breaks, clearly it was easier forthem to speak to me face to face thanrather in open forum.Lilian, a 17 year state ambulance veteran

and manager of a station located outside ofBucharest told me: “Emergency ambulanceservices must stay under public control butprivate companies should be permitted torespond to 112 emergency calls if they arenearer to the patient. When a major incidenthappens and there are not enough stateresources, private companies are not evenasked for help. That’s not right for thepatient”.Without identifying her by name I planned

to mention Lilian’s point of view to theHealth Minister, Dr Cepoi at a meetingplanned for later in the week. Unfortunatelyhe resigned his post a few hours earlier.Politics move as fast as the ambulances(state or private) in Romania.

The Independent Ambulance Associationwas launched on 19th January 2012 andgaining the support of more than 45member companies in less than a year ithas achieved recognition by the publicand private healthcare communities as theleading trade association for the regulatedindependent ambulance industry. It is anot for profit organisation,owned,managed and run for its members with allrevenues devoted to activities in theIAA's best interests.

David Davis�Director of CommunicationsContact | [email protected] | M: 07831 558 745T: +44 (0)207 566 3858�Devonshire House, 60 GoswellRoad, London, EC1M 7AD �Web | Twitter |Facebook

Speaking up for regulatedindependent ambulances

Biography: David Davis

David Davis: Before launching theIndependentAmbulance Associationin January 2012 Davidhad a distinguishedcareer in the media,including reporting for

The Times, vice chairman of Edelman, the world's largest public relations firmwhich he helped to create, and inbusiness television as InternationalPresident of New York-based MedialinkInc. He is an experienced healthcaremarketeer and spent more than 2 yearsas head of communications at MedicalServices Ltd, a leading independentambulance company.

This year marked my 27th visit toIndia but it’s been four years since Ilast visited New Delhi, so, as you canimagine, I was anxious to see howthe capital had changed. In the leastdecade alone its population hassoared from around nine-and-halfmillion people to nearly seventeenmillion inhabitants so I wasinterested to see whether or not itsambulance care system had beenable to even slightly keep up with thisgrowth and provide anything like areasonable and accessible ambulanceservice.My first ‘shock-of-the-new’ came

immediately on landing. I was pleasantlysurprised to see how smart the recently-refurbished airport looked – long-gonewere the four rickety immigration booths,which always signaled an interminably longwait before passing through passportcontrol. This time I almost glided throughone of 20 very new-looking passportcontrol stations now in operation, clearly apart of the legacy of the recent 2010Commonwealth Games. Work on creatingefficient systems is still needed though as,once through immigration, the wait tocollect my luggage was as long as ever. Oncethrough the arrivals terminal it was good tosee the big improvement to the pre-paidtaxi rank, a real asset as it helps visitors toavoid the usual haggling-culture which issuch a big feature of travel on the Indiansub-continent and can be really tiring andstressful when you first reach yourdestination.

On the hour long drive with my friend,Ashutosh, to the east of Delhi, where I wasstaying, the traffic was much heavier than onmy last visit - not too much of a surpriseeither as the latest figures for new cars inthe capital were an average of about 1000new cars joining the traffic-jams every day,alongside the 55,000 (and growing daily)auto rickshaws which operate around thecity.Thankfully the terrible disruption that the

city had witnessed in preparation for theCommonwealth games was no longerevident. The new dual carriageway, whichhad been built for the athletes and manyvisiting V.I.P.'s to transfer directly to thestadium and avoid the chaos of the citytraffic, was now in little use. Crawling alongin the bumper-to-bumper traffic I was alsoable to see many deserted blocks of flatsand half-built unused hotels. Ashutosh wasthe first of many to tell me that the gameswere poorly attended and, in all honesty, aflop in terms of offering economic or socialbenefits to the mainly poor population ofthe city. Too much endemic corruption was

mentioned to me too many times - a lot ofthe hotels I was told were still waiting forclients to pay over a year after the Gameshad packed up. I could see that whileoutwardly India had changed, sadly the samecould not be said of the desperate socialconditions that keep much of the localpopulation barely subsisting in the sparsestyet most overcrowded of environments.During the next 10 days both in New

Delhi, Agra and Hyderabad, I saw many ofthe new Force 10 emergency ambulancesthat have been steadily growing in India'scities whizzing around, each one with itsown very large livery proudly promotingannouncing the ‘108’ emergency number.

NWAS Volunteer First-Responder, Roy Williams, has been making annual volunteering pilgrimages to India for nearly 30 years.Using resources he has personally fundraised, his mission has been to travel to remote jungle communities to teach basic first-aid to isolated village communities; but, such is Roy’s dedication and so strong are the relationships that he’s built-up over theyears, that he’s also helped establish a village school and donated to the start-up of an eye-care clinic. This year Roy returnedto check out ambulance care in its capital, New Delhi, to see how ambulance care has been developing in India’s second mostdensely populated city, before heading off to a remote rural region to see how the other half received ambulance care.


Roy Returns to India

29

A Tale of Two

ambulanceServices!

Caring at Christmas

Even after the acquisition of 70 newambulances in August this year by the city’sCentralized Accident and Trauma ServiceNew Delhi’s vast population is still onlyserved by just over 100 ambulances.Compare this to London whose populationof just under 9M population can rely on afleet of over 250 A&E ambulances, suppliedby London Ambulance Service - and thisfigure, of course, doesn’t take into accounttheir 180 rapid response cars, their non-urgent patient transport fleet and numerousother specialist vehicles, let alone all theother ambulances run by numerousindependent providers - and you get anidea of just how under-served this bustlingcity is in terms of ambulance cover.Nevertheless it seemed that every few

minutes an ambulance would come intoview with flashing lights and loud hornsblazing; however, their status as anemergency vehicle on blue lights carriedlittle weight to other road-users as theystruggled through the dense traffic, withabsolutely no other driver showing even theslightest interest in giving way to them orletting them pass by unobstructed. For allthe extra consideration they received theymay as well have been ice-cream vans!Ironically, due to this prevailing air of total

indifference I was able on a few occasions

to have pleasant chats with some crews andwhat an impressive bunch of ambulancepeople they were. Although poorly paid,they were intent on being as caring andprofessional as their training, theirequipment and their demanding workingconditions allowed. Time and again they toldme how proud they were to be ambulanceworkers and how pleased they were that atleast the numbers of ambulance vehiclesout on the busy city streets are growing.While traffic made achieving response timesan impossible dream they stressed that at

December 2012 | Ambulancetoday30

Roy Returns to IndiaCaring at Christmas


least their patients would receive some sortof professional clinical care en route tobeing treated at a local hospital. And eventhough the hospitals are, by and large,similarly overburdened they assured me thatthe desire to provide a good level of clinicalcare to incoming patients was a priority forall involved. When you bear in mind that agovernment-employed ordinary ambulancedriver without any special training would goout with a nurse for an 8 hour shift 6 days aweek and earn a salary of just £125 to£140 per month, you realize just howdedicated these people are.Later on though when I travelled high up

to the mountain resorts to avoid the 40+

temperature. A different story unfolded.After an 18 hour train ride followed by agruelling two hours steadily rising up a steepmountainside in a taxi I arrived at thebeautiful small town of Pachmarhi,1,200.metres above the state of MadhyaPradesh. When I arrived at 04.30. I wasunable to locate one of the only tworickshaws in the town, so I had to walkfurther uphill for three miles to locate myhotel, only to be told on arrival that check-in time was at 12.00 Noon. A small amountof rupees changed hands during a brief,quiet but polite conversation and, lo andbehold, I found myself settled in my roomwithin a matter of just minutes. Money talksany language in India and this I say, not as acriticism, but only as an acknowledgementthat in a country so blighted by poverty,recognizing the need to accept this culture,is a regrettable necessity.My small 12 bedroom hotel was bliss

with beautiful gardens and, best of all,because of the remoteness of its location, Iwas for most of my four night stay the onlyresident. Service, as always in such places inIndia, was low-key, friendly and efficient.With three good meals a day and all this forthe equivalent of £18.00 per night, sterling,you soon begin to realize just how wide thegap in living standards often is between usin the developed Western world and ourpoorer cousins in places like rural India.After settling in to my hotel I was keen

to travel the three miles into the smalltown, to have a chat with the localsregarding ambulance response times awayfrom the bigger cities. Initially it was difficultto find a person with enough English todiscuss ambulances, and, while I have pickedup smatterings of regional dialects duringmy many years as a guest/volunteer inIndia, I do not delude myself that I amfluent. However I looked out forsomebody carrying a briefcase - always aclue that the case’s owner is likely to have adecent command of spoken English – Isoon found my briefcase-carrier and after a

friendly introduction we were soon satoutside a café, sharing coffee andinformation on local healthcare services.When I asked my new friend aboutambulance care in the region I was notsurprised at his response. Yes he knew ofthe ‘108’ ambulance service, and yes, theyalso had it in this region. However, as hewas keen to stress, to access it here youhave to pay. I pressed him to tell me whatwould happen in this small town if a life-threatening call occurred? He thought for awhile and then simply said he would call hisown doctor back in the city where he lived,some 150 miles away, and he wouldarrange things. But how would this carepresent itself I asked? My friend was unableto answer at first, but then he said thatmaybe if he asked, somebody would takehim to hospital which was some distanceaway. He had no more to add. This was thestate of ambulance care in this mostremote rural region of India. As is the casein New Delhi there are no governmentemployed paramedics to call on – these areonly supplied by private hospitals. Andwhile the standard of care in India’s oftenlarge private hospitals is often excellent,since they are staffed by very-well traineddoctors and nurses, are very clean andoften boast the best in medical equipment,these services can only be accessed by thefortunate few who are wealthy enough toavail themselves of their services. But whilethere are quite a few goverment hospitalsin New Delhi, with the largest, Lok Nayakhospital, having nearly 1600 beds, this isn’tthe case in the rural areas where hospitalcare is much scarcer and much morerudimentary. Hence the reliance on city-based healthcare.Thankfully when I eventually flew home

to Manchester I was suffering nothing morethan a little jet lag and a renewed faith inthe notion that, no matter how much wegrumble about the imperfections ofhealthcare here in the UK, we do well toremember that, quite apart from the muchhigher quality-of-life even our poorestcommunities enjoy day-to-day, with accessto amenities such as education, good roads,clean water and emergency services, whenit comes to our NHS, for better or forworse, it remains the jewel-in-the-crown ofour society. Which perhaps makes it all themore important that we do whatever wecan to support and encourage our fellowambulance workers who are struggling toprovide care in places like India!

If you’d like to assist Roy Williams bypassing on ambulance resources orby making a donation towards hisgood work, please feel free to emailRoy at: [email protected]

Roy Returns to IndiaCaring at Christmas

December 2012 | Ambulancetoday32

Wisdom in a bottleDoing night shift one weekend recently, a Monty Python ditty popped into my head. You probably know it:

Thijs Gras’ Letter from Amsterdam

“Heidegger, Heidegger was a boozybeggarWho could drink you under thetable.David Hume could out-consumeWilhelm Friedrich Hegel,And Wittgenstein was a beery swineWho was just as schloshed asSchlegel.There's nothing Nietzsche couldn'tteach yaBout the raising of the wrist.Socrates himself was permanentlypissed...”Apparently wise men are sometimes drunk. Working on an ambulance, one is

tempted to see things differently. A lot ofthe wounds – both physical and mental –we see people inflicting on themselves orothers, are related to alcohol. Again, alsorecently, I went to a decent guy of 37 yearswho fell from his bike and almost scalpedhimself, not only his hair but also his skin:you could see his skull over a length ofabout 6 inches. Next night we went to anotherwise neat couple in their late forties,who fell from the stairs in a hotel, knockingdown a heating radiator and leaving abig crush in the wallopposite the door of roomnumber 9 because the keydid not fit. I tried roomnumber 8 and that dooropened without problems.While we were busy helpingthem, the woman opened upthe sluices at three ends.Quite remarkable bakerCharlie. These people werequite manageable, butdrunken people can be adamn nuisance, especiallywhen they think they aresmart. It is sometimes verydifficult to restrain yourself, alsowhen you deal with them in the controlroom. I trust the experiences of the colleagues

on the other side of the North Sea do notdiffer much from ours. On the television we

see a lot of programs showing the grimmerside of the UK and the problems you havewith the heavy drinking of young people.Is there a solution? Banning alcohol? I do

not think this is realistic. Giving informationand education might help. Raising the taxeson alcohol? It also could have an effect onsome people. Raising the minimum drinkingage – as we have just have done here in theNetherlands? Good idea. Recently themayor of Amsterdam proposed to letdrunken people pay the ambulance tripthemselves (In the Netherlands this isnormally covered by the health insurance). Ido not think this is a good idea. Anambulance crew should be neutral at alltimes and should not judge people. Wemust never be associated with prosecutionand guilt-finding. Now this is quite difficultsometimes, but it is our only certainty andour only guarantee that people keeptrusting us, even when they are drunk. Thistrust is essential in our profession. And let'sface it: if your son or daughter runs intotrouble because they drank too much, youwould like them to be taken care of,because they cannot do it themselves

anymore. People who are drunkare legally unaccountable. I thinkwe all have conflicting thoughts onthis, because when you startdrinking there is a phase whereyou are conscious and can beheld responsible, but you end upin a state where you do notknow what is happening. I alwayskeep in mind that with alcoholintoxication one can end up inIntensive Care, especially youngand inexperienced drinkers.

And yes, of course I mustadmit that, once in a while… inmy younger years… I have alsohad a little to much too. Luckily

for me I did not run into trouble - but witha little or, worse yet, big bad luck, I couldhave ended up in an ambulance (or maybeeven a hearse). Let’s not forget thathundred thousands of people get drunk andwe never hear from them. They go to bed,

they sleep, they wake up (with or without asplitting headache), and sometimes they arehung-over for a day or two - drizzly anddrowsy - but mostly they pick up their livesagain, enriched with that weird experienceof having been drunk. They might damnKing Alcohol, but after a few days they areready to serve him again.So, I ask, what is wisdom? For this we

need the philosophers to guide us.“Know yourself,” Socrates would say.

“Behave consciously, oppose opposition andrealize freedom” Hegel adds. “The mysticalpart is the most valuable”, according toWittgenstein. Heidegger wants us to “neverforget the human experience”, whereasDavid Hume advises us to “look to everysituation like a child, with a freshunprejudiced view”. Nietzsche thinks weshould “create the world and love thepresent”. And Schlegel explains why we will

never overcome the burden of alcohol:“Everything has its circle and keeps comingback.”I am afraid that, as ambulance people, we

are doomed to face drunkards, dumb orwise, nice or annoying, shining or faded,always smelling and unpredictable whenthey open up the sluices at whichever end.So, as Christmas approaches, all we can dois to bear this burden, take care of them,each and every one, and pray for wisdom!

Thijs Gras.

If you would like to swapexperiences on this subject withThijs please email him at: [email protected]


This edition of Ambulance Today goes out to all 25 Dutch Ambulance Regions courtesy of Procentrum PROCENTRUM - LEARN TO FEEL THE DRIVE www.procentrum.eu

Primetech (UK) Ltd specialises in thesupply, installation and maintenanceof pioneering satellitecommunications and relatedtechnology. It offers an unrivalledrange of interoperable solutions forthe ambulance service. Revolutionising two-way communications

for rapid response vehicle capabilities,Primetech is now able to offer Ka-bandtechnology, providing a more cost effective,higher bandwidth communication.

“Imagine a small, mobile VSAT antennasystem that can deliver blistering speeds of8Mbps uploads and 20Mbps downloadsusing only a 3W BUC,” explains HenryWalker, Director of Primetech. “Now imaginethat the bandwidth costs are only a fractionof what is currently available today. This is the

future of ka-band technology – higherspeeds, greater bandwidth, lower powerrequirements and a lower cost-per-bit thanany satellite before.”Primetech’s iNetVu® Ka-75V Drive-Away

Antenna has recently passed its range testsat Eutelsat, which means that it is the ONLYtype approved vehicle mounted systemuseable on the Eutelsat Ka Satellite Network.Because of its adaptability, it can be

mounted on even the smallest vehiclesincluding solo response vehicles which arebeing deployed in increasing numbers byAmbulance trusts. Working seamlessly withthe iNetVu® 7024 Controller, it providessingle push button, auto-acquiring, automaticbeam recognition and fast satellite acquisitionin minutes. It is ideal for any application thatrequires reliable and remote connectivity in arugged environment.This new technology is just the beginning.

Primetech has developed a KASAT Trailer forthe UK emergency services. It is a self-contained, versatile, resilient CommandSupport Unit enabling access to vastamounts of data quickly, reliably and at alower cost. This multipurposecommunications platform can be deployedby any driver on a standard UK drivinglicence using a conventional family saloon.The trailer is based on the world famousSankey trailer, which means that it retains its

off-road capabilities and flexibility, whilst atthe same time meeting the new weightrestrictions. Its mobility means that it isquickly able to reach the scene of an incident,even over terrain which may presentproblems to traditional ambulance vehicles.Henry concludes: “This is a really exciting

time for the industry. This highly advancedtechnology has benefits which will extendthrough the whole of the emergencyservices sector. ”For further information on KA-SAT,the iNetVu® Ka-75V Drive-AwayAntenna and the KASAT Trailer visitwww.primetech.co.uk or [email protected].

Focus on Primetech

An exciting time for Sat-Comms


Focus on

What a momentous year2012 has been; a general feelingof shared pleasure at thecelebration of the QueensDiamond Jubilee fuelled greatlyby the recognition of herunstinting devotion to dutythroughout those sixty years;the huge success of theOlympic and Paralympic Gamesre-enforced the widely heldview that as a nation we knowhow to organise things. It alsogave us an opportunity to provethat we are the best in theworld at various events, bothable–bodied and disabled, andnow the news that a Royal heiris expected. All of thesenational events have had theeffect of giving us something tosmile about and to provide analternative to thinking about theeconomic situation that isproving so hard to repair. Alsowe still have thousands of youngmen and women in our armedservices overseas in constantdanger of death and injury anda great number of people havehad their homes severelydamaged and their possessionsruined due to the recentflooding. What has all this gotto do with the AmbulanceServices Benevolent Fund?Well, I have to say that the Fundhas had a good year in anumber of ways. I get the feeling(no statistics to prove it) thatthere is a growing awareness ofthe Fund. This was particularlyevident at the recentEmergency Services Show atStoneleigh in Warwickshire. I donot believe that I amexaggerating when I say thathundreds of people visited ourstand, so generously provided tous by David Brown the showdirector and Broden Media the

organisers. A great many ofthese visitors supported us bybuying various badges andtaking part in our raffle and asignificant proportion of themalso signed up to make regulardonations to the Fund underthe Give as You Earn Scheme.Kerry London the multi

specialism insurance brokersreinforced their support for theFund by presenting us with acheque for £300 the proceedsof a fund raising scheme thatthey set up at the last show anda further £100+raised at thisshow. It was unfortunate thaton the second day a heavy galeblew up and the giant marqueein which our stand was locatedhad to be evacuated on safetygrounds depriving us of theopportunity to meet manymore people. The coincidenceof my perception of a growingawareness of the Fund and thegrowing numbers of ASBFChampions in various servicesaround the country is, I believe,significant. I take the view that, ifsomeone that you know,respect and see on a regularbasis is telling you aboutsomething and encouraging youto become involved in one wayor another, it is much morelikely that you will respond in apositive manner and I get theimpression that this is the effectthat our Champions are alreadyhaving in their individuallocations. In heartily applaudingthe efforts of the existingChampions I make no apologiesfor seeking to recruit more. Weare a national charity (in fact theONLY national ambulanceservice charity) we supportserving and retired ambulanceservice personnel and theirimmediate families nationally

and we need to be representednationally. I long for the daywhen every ambulance base hasan ASBF Champion. I also longfor the day that everyAmbulance Service ChiefExecutive and all of his or hersenior team members are ASBFChampions and are activelypromoting support for the Fundthroughout the service. Let’sfinish this champion year with aflood of new ASBF Championsfrom all levels in the service. A

Merry Christmas and a HappyNew Year to all.

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

AMBULANCE SERVICES BENEVOLENT FUND.

Proud to be serving, proud tohave served! Relieved toreceive support when dealingwith a personal crisis orperiod of hardship?Your support today will help theASBF to provide that extra helpwhen the unforseen has happened,whatever your role, whetherserving or retired.This support comes at a price ofcourse so we have to attractdonations.To help with this weneed volunteer representatives atall ambulance sites and localities toensure staff are aware of ourexistence and to help raise fundsso that we can continue beingthere for all the unsung heroes ofBritain’s ambulance service whoare asking for our help in theirtime of need.Remember, you may think that anunforseen personal crisis maynever happen to you, but when itdoes, a period of hardship can betough to handle.

WE NEED YOUR HELPTODAY!We need your support NOW toraise funds to develop our Carefor the Carers programe.Can you help the ASBF byvolunteering as a representativesto champion its work, raiseawarness to colleagues about thecharity and to help with thechallenges of fundraising?To find out more please visit theASBF Stand #E6.

For further information about theASBF please visit our website:www.asbf.co.uk Or email theSecretary Simon Fermor:[email protected]

“AFTER OVER 26 YEARS THEAMBULANCE SERVICESBENEVOLENT FUND IS STILLCARING FOR THE CARERS BUT TOGETHER WE WILL MAKE THE DIFFERENCE!.” PATRON: SIMON WESTON OBE.

REGISTERED CHARITY # 800434

WILL YOU CHAMPION THE AMBULANCESERVICES BENEVOLENT FUND IN 2013?

It’s great to end a championyear on a positive note!Chairman of the Ambulance Services Benevolent Fund (ASBF), PaulLeopold, looks back on a year of celebrations and momentoushistorical events, including success for Team GB at both Olympicgames, and reflects on the fact that 2012 also looks like the year whenTeam ASBF is really taking off thanks to increasing support for itswork coming from all sections of the UK ambulance service!

If you have any positiveawareness ideas you’d liketo share with the ASBF orif you’d like to become oneof the growing number ofASBF Champions, helpingus raise awareness andfundraise around thecountry, please get in touchwith us [email protected]

36

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

Yorkshire AmbulanceService NHS Trust hasrecently appointed two newassociate directors. Shelagh O’Leary joined theTrust October 2012 asAssociate Director ofOrganisational Effectivenessand Education whileGraeme Jackson took up theposition of AssociateDirector of HumanResources in August 2012.

Prior to joining YAS, Shelaghwas employed as Service Director(People and Development) forthe National PolicingImprovement Agency (NPIA)where she was responsible forthe leadership, strategic directionand delivery of workforcestrategy, training, education,professional development andassessment and selection services,amongst many other functions, for43 police forces. Having held thisrole since 2007,

Commenting upon herappointment, Shelagh said, “As aresident of Yorkshire, I’m verymuch looking forward to being apart of the Yorkshire AmbulanceService and helping to developservices for our patients andstaff”.

Graeme Jackson was previouslyemployed as Head of Human

Resources for the ScottishAmbulance Service. In this roleGraeme was responsible forleading a similar range of HumanResources-related functions for acomparably sized workforce andhas the benefit of bringing withhim an understanding andappreciation of the context of theambulance service.

Speaking about hisappointment, Graeme said, “I’mam very excited about my newrole with Yorkshire AmbulanceService and am looking forwardto delivering our ambitiousprogramme for transforming theHR function and the way that weempower and support ourmanagers and staff”.

Stephen Moir, Deputy ChiefExecutive at Yorkshire AmbulanceService said, “I am delighted towelcome both Shelagh andGraeme to the team and amlooking forward to workingclosely with them to ensure thatwe enhance our approach to theleadership, management anddevelopment of our staff. As aconsequence of their work andthe teams that they lead, ourpatients will continue to receivehigh quality care. The wealth ofexperience and knowledge thatthey both bring will be a greatasset to the Trust”.

Yorkshire AmbulanceService appoints newAssociate Directors

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

Out & About News


Out & About News

Nearly 100 people from as faraway as Norway attended thefinal Ambulance ServiceNetwork conference inLondon last month to hearfrom speakers includingurgent care minister EarlHowe, King’s Fund SeniorFellow Nigel Edwards anddeputy NHS chief executiveDavid Flory CBE.

Following a warm welcomefrom ASN chair HeatherStrawbridge, 96 delegates heardDavid Flory set out a high-levelview about the challenges facingthe urgent care sector, includingambulance services, in the future.Mr Flory told the conference thatthe public is right to set such highstandards for its emergency careservices, and that all parts of thesector must work together inorder to meet the public’sexpectations.

Mr Flory told delegates, whocame from ambulance trusts allover the UK, as well as from acuteand community trusts, primarycare and the voluntary sector, thatthe ambulance service has a strongtrack record of resilience in theface of challenge, and should takepride in what it has delivered inthe past.

But he warned that failure totransform the emergency andurgent care system would be direfor the wider NHS, given thepartial return to huge pressures onthe ambulance service in some

parts of England, which were thenorm pre-QIPP.

Former acting chief executive ofthe NHS Confederation and nowsenior fellow at The King’s Fund,Nigel Edwards gave delegates thebenefit of his long experience ofhealth policy, with a frank andentertaining presentation on howongoing NHS reforms couldimpact on urgent care.

Mr Edwards spoke about theneed for real behaviour changewithin the NHS, saying that “if weonly change the names on thedoors, nothing different willactually happen”.

Drawing on his extensiveknowledge and contacts, MrEdwards explained that newclinical commissioning groups

(CCGs) seem keen to work withproviders by developing strong,constructive relationships ratherthan implementing rigid processes.He emphasised that one big upsideof ongoing NHS reforms is thefresh ideas and clinical focus whichnew commissioners can bring tothe party. But he warned thatsome of the fundamentalchallenges facing the urgent caresector remain unchanged.

“We must continue to improvethe way we involve the primarycare sector ; we must continue totarget frequent users of 999services; and we must continuewith service redesign,” he said. Hechallenged delegates to be braveenough to break out of existingservice silos, and said that the onlymeasures that should count arethose relating to outcomes whichare important to patients.

Workshops and presentationscovered innovations in technology,looking at telecare and telehealthand how they can benefit patients,as well as children’s urgent andemergency care, patientexperience and the impact ofpublic health on the urgent andemergency care sector. SivakumarAnandaciva, benchmarkingmanager at the Foundation TrustNetwork, led a session exploringwhy patients end up in A&E, andDr Alison Walker and AngelaHarris from Yorkshire AmbulanceService, and medical director ofSouth East Coast Trauma Systems

Iain McFadyen set out the differingperspectives clinicians can bring tothe urgent and emergency caresystem.

Earl Howe, the governmentminister responsible for urgent andunplanned care includingambulance services, rounded offthe day with an address praisingthe ambulance service as one that‘refuses to rest on its laurels’. Theminister told delegates: “I believethat the quality of our ambulanceservice today has never beenbetter, and the people who workin it are highly-skilled andimpeccably professional.”

Ambulance Service Networkdirector Jo Webber said: “This wasthe last ever annual conference forthe Ambulance Service Network,so it was great to see so manydelegates attending, benefittingfrom high quality speakers andtaking advantage of theopportunity to network and sharethoughts and ideas with theirpeers from across the full range ofurgent and emergency careservices. We are not quite in aposition to announce what willreplace the ASN conference nextyear, as we are currently finalisingthe exact nature of themembership offer on how theNHS Confederation can bestsupport the urgent and emergencycare sector going forward. We willbe ready to announce that in earlyin 2013, and Ambulance Today willbe one of the first to know!”.

Last ASN conference superb success

37

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

A leading figure from theNorth East region’s businesscommunity has beenappointed chairman of theNorth East Ambulance Service(NEAS).

Ashley Winter, former chairmanand managing director of PattersonMotor Group, has taken over at thetop of the ambulance service fromTony Dell, who is stepping downafter eight years at the helm.

Ashley said: “I am delighted tohave been appointed to thisimportant and high public profilerole.

“The North East AmbulanceService is one of the leading NHSTrusts in its sector in the UK and thisis an exciting – and challenging - timeto be leading an organisation as itintroduces the new 111 numberacross the region over the next fewmonths.”

Ashley added: “I have a keeninterest in employee and customer(user) satisfaction which are criticalto NEAS success. The Board,

Governors and Members should alsobe significant assets to this process.Raising standards, training and equalopportunities are the bedrock forthe sector and I can add value here.”

The former Patterson MotorGroup boss is well-known inbusiness, charity and education circlesas he has served as President of Tyne& Wear Chamber of Commerce,chair of Business Link Tyneside,Tyneside Training and EnterpriseCouncil and led the transition to theLearning and Skills Council which hechaired in Tyne & Wear.

He was awarded the OBE forServices to Businesses in the NorthEast in 2003 and is currently chair ofthe Community Foundation Tyne &Wear and Northumberland and alsothe Tyne & Wear Enterprise Trust(Entrust); a director of Herbert DoveTrustees and a Trustee of theCharlotte Straker Project, acharitable nursing and residentialhome in Corbridge,Northumberland.

Ashley is currently High Sheriff of

Tyne and Wear until April 2013.NEAS chairman Tony Dell said: “It

has been a privilege to be the Chairof NEAS and I have greatly enjoyedbeing at the head of such a caringorganisation. I am also very pleasedto see the reins being handed overto a businessman with so muchexperience. His previous focus oncustomer care bodes well forcontinuing our strong belief thatpatients have pride of place in our listof priorities.”

The appointment of the chairmanwas made by the Council ofGovernors for the North EastAmbulance Service NHS FoundationTrust. The council comprises 21elected public governors, fourelected staff governors and nineappointed governors representinglocal authorities, emergency services,health and voluntary agencies.

Lead Governor Robert Alabastersaid: “Tony Dell has done so much tobuild a successful Foundation Trustand supported the governors in theprocess during our first year. We wish

him all the very best in hisretirement.

“We are delighted to have madean appointment of an outstandingand high profile member of theNorth East community. Ashley’sappointment was endorsed by thewhole Council and the governorslook forward to working with him intaking the ambulance serviceforward.

NEAS gives Winter a warm welcome!

Nigel Edwards


Out & About NewsVisit the only daily ambulance news site on the net at:www.ambulancetoday.co.uk

The London AmbulanceService is pleased to announcethat Nicholas Martin and JohnJones have been appointed asnon-executive directors of theService.

Nicholas Martin, who has 30years’ experience of working incorporate finance, took up his poston 1 October, replacing MurzelineParchment.

Nicholas said: “It’s a great privilegeto join the London AmbulanceService and a particular pleasure todo so shortly after their excellent

performance during the high profileevents in London this summer.

“I look forward to assisting in theirprogress to foundation trust statusand maintaining and achieving worldclass standards of patient care.”

John Jones has started as anassociate non-executive director, andwill take up his substantive role on 1January 2013, replacing BrianHuckett.

John, who has held a number ofexecutive finance director roles inthe NHS, said: “I’m delighted to jointhe London Ambulance Service at

this exciting time. As an associatedirector I’m more of an observerfinding out about the Service beforeI take up my role formally in the newyear.”

As non-executive directors, theyare members of the Trust Boardwhich consists of a non-executivechairman, five executive and six non-executive directors. The non-executives have overallaccountability for the strategicdirection, performance and the safeoperation of the Service.

The Chairman of the London

Ambulance Service Richard Huntsaid: “I’m pleased that both Nicholasand John are joining the board. Theybring significant experience fromtheir financial backgrounds. John alsobrings knowledge of a foundationtrust process and Nicholas has widecommercial experience from theCity.

“I look forward to working withthem as the Service completes itsfoundation trust application processand positions itself for the challengesof the next five years.”

LAS appointment of new Non-Executive Directors

Thanks to an appeal over thesummer which raised over£14,000, the people of Essexand Hertfordshire are nowbenefiting from some of thehighest standard pre-hospitalcardiac care the World has tooffer with new state of the artequipment on board the Essex& Herts Air Ambulances.

Essex & Herts Air AmbulanceTrust (EHAAT) recently tookdelivery of three brand new ZOLL®

X Series™ Patient Monitors eachworth £25,000 and is the firstHelicopter Emergency MedicalService (HEMS) in the UK to usethis new cutting edge technology inconjunction with ZOLL’s AutoPulse®

mechanical CPR device during flight. Dr Gareth Grier, EHAAT Clinical

Lead, explains: “At EHAAT we aredelighted to have the new ZOLL XSeries monitor as part of ouressential set of equipment. The

monitor allows us to continue tosafely provide life-saving treatmentsfor the patients of Essex and Hertsat the roadside such as the deliveryof an anaesthetic, somethingnormally only available in hospital.We chose this monitor as it willensure that even during the harshestof conditions outside of hospital; wecan easily watch the effect of ourinterventions on patients. Weundertake treatments for the mostcritically injured of patients as soonas possible after an accident orsevere illness, wherever this occurs.When someone’s heart hasstopped, EHAAT provide cuttingedge treatment which has beenpublished in international medicaljournals. We aspire to take thistreatment even further by using theX series monitor in conjunction withZOLL’s AutoPulse device which usesa “Pass Through” feature withdefibrillation. Using this feature,

electric shocks to the heart can bedelivered at a specific time in a chestcompression cycle, where the shockswill be at their most efficient insaving lives. EHAAT has alreadyshown that working together withthe Ambulance Service and firstresponder colleagues we can secureoutcomes for our patients that areamongst the best in the UK.”

The monitors are used in allmedical and trauma cases, both adultand children, attended by the Essex& Herts Air Ambulances, enablingthe Air Crew to continue providingcutting edge, life-saving interventionsto the sick and injured of Essex andHertfordshire whilst ensuring patientsafety and care is kept to the fore-front.

The Charity is delighted thatpeople and businesses responded tothe appeal for the third monitor insuch a positive way and generouslysent in donations of support. A big

thank you to everyone thatsupported the appeal includingOlympus KeyMed of Southend, ITFleet of Colchester, Rotary Club ofBrentwood a Becket andFreemasons from Colvin Lodge,Clacton-on-Sea.

World Class Cardiac Care for Essex & Herts Air Ambulance Trust

Unsung volunteers from thenation’s leading first aidcharity will be honoured at theHouse of Lords next month.

The St John Ambulance MedicalLogistics Unit (MLU) in London hasbeen awarded the VoluntaryAmbulance Service Team of the YearAward 2012 by the AmbulanceService Institute.

The team whose behind thescenes efforts are crucial to thesuccess of many of London’s biggestpublic events - including the LondonMarathon, Notting Hill Carnival andNew Year’s Eve celebrations – willreceive their award from BaronessBrowning of Whimple at a ceremonyon 13 November.

The MLU is a volunteer unit of15 members who operate from awarehouse in Bow, East London.

One of the lesser known buthardest working units within St JohnAmbulance in London, the MLUsupplies equipment, food and

logistical support for major publicevents and state occasions. They area lynch pin of the vast first aidoperations which the charity providethroughout the year – from theNew Year celebrations to tennis atWimbledon and concerts in HydePark.

The London Marathon is one ofthe largest and most complex eventsfor the MLU. This year the unitdevoted more than 1,200 voluntaryhours to the marathon whichinvolved a total of 1,400 St JohnAmbulance volunteers, 55 treatmentcentres and 33 ambulances.

The MLU provided equipmentpacks for all the treatment centresand equipped three large IntensiveTreatment Units at the finish line.The ITUs were equipped with 15hospital beds, 100 stretchers,monitoring equipment, drip andoxygen stands, Advanced LifeSupport trollies as well as variousconsumables such as bandages,

swabs and dressings. Andy Wapling, London St John

Ambulance’s Deputy AssistantCommissioner (Logistics), whonominated the team for the award,said: ‘It’s awe inspiring to witness thetime and dedication given by thissmall band of volunteers to ensuringthat patients receive the best

possible care during some of theworld’s biggest public events.’

‘The team’s work is hugelydemanding but often goes unseen.It’s nonetheless a vital element of

St John Ambulance’s work whichon so many occasions is quiteliterally the difference between lifeand death.’

Honour for behind the scenes heroes of the London Marathon

HEMS Pilot Nicky Smith, HEMS DoctorAdam Chesters and HEMS ParamedicErica Ley showcasing the new life-savingequipment

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

South Western Ambulance Service NHSFoundation Trust (SWASFT) has collectedtwo national accolades from theAmbulance Service Institute (ASI) at anawards ceremony held on Tuesday,November 13th, at the House of Lords,London.

The Trust was successful in winning theinnovations category award and was alsoacknowledged for the contribution made by its staffduring the tragic M5 collision last year.

Innovations Category AwardThe innovations category award was received for

the Trust’s use of tranexamic acid, a drug that canreduce the risk of death from bleeding in traumaincidents.

In December last year, in partnership with theNational Institute for Health Research Collaborationfor Leadership in Applied Health Research and Carefor the South West Peninsula (PenCLAHRC), theTrust was the first ambulance service in the countryto introduce tranexamic acid on all of its vehicles.

Tranexamic acid is a drug commonly used inoperating theatres and in trauma incidents in thearmed forces. In simple terms, the drug inhibits thebreaking down of blood clots, a process which canworsen bleeding in situations such as major trauma.

The internationally recognised CRASH studydemonstrated that, if used within three hours of theaccident, tranexamic acid can reduce the risk ofdeath from bleeding by as much as 30 per cent. Thedrug will undoubtedly save many lives across theSouth West each year.

Professor Stuart Logan from the University of

Exeter Medical School, and who is also director ofPenCLAHRC, commented: “There is often a delayof years between evidence being published and itsuse in practice, but this is a great example of whatthe NHS at its best can do and we are delightedthat the project has won the Innovations award. TheSouth West is lucky in having an Ambulance Trustwith a really innovative approach, a commitment toevidence-based practice and a close partnershipwith the acute trusts and with our research teams.We are delighted that our strong local partnershipresulted in this being the first region to get thiseffective intervention into widespread use.”

Statistics show that since the introduction of thedrug, the Trust has administered the life savingintervention to 74 patients across the South West.The number of patients receiving the medicinecontinues to increase significantly month on month.

Recognition for Trust staff involved in the tragicM5 accident in Somerset in November 2011

On Friday November 4th 2011 seven peopledied with many more sustaining serious injuriesduring one of the UK’s worst motorway disasterson the M5 in Somerset.

The Trust was alerted to the incident at 20:22pmand ambulances arrived at the scene within fiveminutes.

SWASFT committed 42 vehicles and almost 60personnel, including three doctors and many offduty staff who reported for work to help at thescene of the incident.

Staff on duty in the clinical hub that night wereinstrumental in managing the situation and ensuredthat patients at the scene were treated with theright care in the right place and at the right time.

A volunteer with the service also scooped theaward in the special incident category.

Dr James Hickman is a volunteer with theSomerset Accident Voluntary Emergency Service(SAVES) and also attended the ceremony. SAVES isa network of doctors specially trained to deal withemergencies outside of the hospital at the requestof the ambulance service.

Dr Hickman claimed the Special IncidentCategory Award for his ongoing voluntary workwith SWASFT, including attending the tragic crashon the M5.

Ken Wenman, Chief Executive of SWASFT, saidhe was delighted with the awards and added: “I ampleased that the Trust has been recognised for itsinnovation and the part our staff played in managingthe tragic incident on the M5 in Somerset inNovember 2011.

“SWASFT is a forward thinking organisation and Ibelieve our use of tranexamic acid in the field hasdemonstrated this.

“As we all know, our staff are at the heart ofeverything that we do and during the M5 crashmany of them went over and above the call of duty.Staff in the clinical hub that night were instrumentalin making sure we responded with the right care inthe right place and at the right time.”

South Western Ambulance Servicepicks up two ASI awards

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


Out & About NewsVisit the only daily ambulance news site on the net at:www.ambulancetoday.co.uk

On Wednesday, November 21,family, friends, and workcolleagues past and present,from around the Country,gathered to pay their respectsto Peter Kendall, who recentlypassed away at his Bedfordshirehome.

Peter was given a full ambulanceservice funeral which took place at StPeter de Merton Church in Bedford.

A blaze of green uniforms linedthe streets near to and outside thechurch to form a guard of honour.Ambulance service colleagues fromall over the country andrepresentatives from all blue lightservices, voluntary services, localauthorities and NHS partners, paidtheir respects at a very movingservice. The procession arrived at the

church after travelling from the Trust’sBedford Office, was led by twoambulance motorcycle out riders anda vintage ambulance vehicle whichPeter had actually crewed when hestarted in the ambulance service.

Peter’s lengthy career spannedover 48 years ago and he worked invarious roles and starting inWorcester in the 1960s and 70s,before moving to head of the controlroom in Hereford and Kent. He ismostly known for his role within theresilience and emergencypreparedness team whist being basedat the Bedford Office.

Since 2008 and up until hisunexpected death, Peter wasseconded to the Department ofHealth’s Emergency PreparednessDivision in London, as an AmbulanceAdviser to the National AmbulanceResilience Unit (NARU.

Steven Moore, deputy head ofresilience and special operations, whoread at Peters service said: “Peter wasmy manager for five years and duringthis time I worked closely with himon a number of projects, duringwhich time I learnt a huge amountfrom his vast array of experiencewhich he had gathered during a lifetime of dedication to working in theambulance service and specifically inthe field of emergency planning.”

Chief executive officer, HaydenNewton, who spoke of Peter’slengthy career at his funeral said:“Peter joined the ambulance service48 years ago, originally starting out asa control room manager inWorcestershire before making hisway to the East of England. Most willremember Peter from his days in theemergency preparedness team inBedfordshire and Hertfordshire,where his commitment, hard workand extensive knowledge really cameinto their own. Peter was recentlyseconded to the Department ofHealth, where I know his expertisewas highly valued and appreciated.Respected for his work not justlocally, but nationally as well, Peter wasa long standing friend and colleague

to so many of us and will be verysorely missed.

Mike Shanahan, Deputy Directorof NARU and Mr Kendall’simmediate line manager, said: “Peterwas first and foremost a realgentleman and always found the timeto talk to anyone wanting to speak tohim. Peter’s passion was theambulance service and he gave many,many hours of his own time to thatend. Peter was one of the longestserving members of staff in the UKambulance service and news of hispassing away has shocked us all,including many in the wider NHS andGovernment departments. We wouldlike to extend our heartfeltcondolences to his family and we willall miss Peter immensely.”

East of England Ambulance Service Mourns Peter Kendall

Peter Mulcahy, North WestAmbulance Service’s Head ofService for Cumbria andLancashire, received hisQueen’s Ambulance Medal atBuckingham Palace, on Friday19 October.

Earlier this year Peter Mulcahywas shortlisted for the prestigiousQueen’s Ambulance Medal;awarded to individuals who haveshown exemplary dedication totheir role, and demonstratedoutstanding ability, merit andconduct to their vocation. Onethousand people were named inthe Queen’s Birthday Honours List2012, and Peter was just one of fiveindividuals to have been nominatedfor the prestigious QueensAmbulance Medal, across thewhole of the UK and NorthernIreland.

Peter commented: “Friday was afantastic experience, and one Inever dreamed of happening. I amso proud that after 34 years’service I have received such anaward – and going to BuckinghamPalace was an unexpected bonus!

“I consider it an honour, not onlyon a personal level, but also for

NWAS. It’s recognition for myprofession. As well as thanking thewider NWAS team, I would alsospecifically like to thank my teamsin Cumbria and Lancashire for theirsupport.”

Peter’s role within NWAS isHead of Sector for Cumbria andLancashire, this is an expansive areathat totals 71% of the Trust’s 3000mile footprint. Within his time inthis appointment, Peter has actedas a lead-role in three separatemajor incidents in Cumbria’s recenthistory. The first was the majorfloods in Cumbria in 2000, wherehundreds of local residents had tobe relocated for a number of days.The second in May 2010 when acoach carrying school childrenrolled over as a result of a roadtraffic collision. And thirdly, theWhitehaven shootings on 2 June2010, where 12 people were killedand 45 injured.

In each of these very differentand challenging incidents Peterdemonstrated very clear andstrong leadership. Peter was seenby staff and the community as afigurehead and focal point ensuringmulti-agency and media briefings

were carried out (mainly byhimself) and that the staff involvedwere fully supported during andafter each event with single orgroup counselling. Peter acted wellabove and beyond what wasrequired of him portraying aprofessional and strong leader at alltimes.

Mary Whyham, Trust Chair,added: “The NWAS Trust Board is

delighted that Peter has beenrecognised in the Queen’s BirthdayHonours. His commitment to thework of the ambulance service andin particular, to the people andpatients of Cumbria and Lancashireis outstanding – His award of theQueen’s Ambulance Medal fordistinguished service is welldeserved.”

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

North West Ambulance’s Head of Service CelebratesQueen’s Ambulance Medal with Royals


Products & Suppliers News

41

The long awaited new editionof the UK AmbulanceServices Clinical PracticeGuidelines 2013 will soon beavailable. Since 2006, whenthe last edition was published,there have been importantchanges to ambulancepractice and an enormousamount of work has gone intothe production of thesecomprehensive guidelines.

The Joint Royal CollegesAmbulance Liaison CommitteeGuidelines sub Group and theirnetwork of expert contributorshave been working tirelessly to

ensure that all new information hasbeen passed to the editorial teamand AACE have tasked their clinicalleads NASMeD (NationalAmbulance Service MedicalDirectors) to review the materialprior to printing. This work isdesigned to ensure that this wideranging document is directlyrelevant to Paramedic practice anddraws on the wealth of experienceand clinical expertise available totoday’s ambulance service.

Major changes to this editionmean that there is new guidance onminor illness in children, pelvic,trauma, intravascular fluid therapy,

obstetrics and gynaecologicalemergencies and others. All NHSAmbulance Trusts have placed bulkorders and further copies will beavailable through retailers such asBoundTree Medical, Amazon and SPservices.

Acknowledging that this 500page book is going to be quite asizeable document, AACE & thepublishers are busy cramming thereally important‘how much,where and when’facts into apocket sizedreference guide –hopefullyavailable at aboutthe same time.

Going forward, the challenge forAACE is to ensure that once thepublication is released, updates onbest practice can be provided in atimely manner to ensure that up todate clinical guidance is maintained.An important part of the updatingprocess will be to ensure thatregular feedback is sought from theparamedic profession and a widerange of stakeholder organisationsincluding the College of Paramedicsand the Air Ambulance Association.

The new guidelines will bepublished by Class ProfessionalPublishing and will be availablein early Spring 2013. Moredetails can be found at:www.classprofessional.co.uk

The new Guidelines are coming!

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

South Central AmbulanceService NHS Foundation Trust(SCAS) has won the award forLarge Public Sector Fleet ofthe Year at the Fleet NewsFleet Van Awards 2012presented in London on 5December.

Now in their fifth year, the FleetVan Awards are the benchmarkawards for the light commercialvehicle industry, with trophies formanufacturers, fleet operators andsuppliers.

The fleet awards focus on safety,awarding trophies to those vanoperators that display an obsessionfor keeping their drivers safe andtheir vehicles accident-free.

Commenting on SCAS’ awardthe judges said: ‘SCAS continues tobe one of the safest ‘blue light’fleets in the country due to itsrelentless focus on driver cultureand on minimising accidents. Itapplies best practice in alloperational areas and shares itsideas with other trusts. SCAS isinnovative and classleading.’

Rick Stillman, Head of Fleet forSouth Central Ambulance ServiceNHS Foundation Trust said:‘Winning the Large Public SectorFleet of the Year Award at the FleetVan Awards 2012 is a reflection ofthe work and dedication of ourstaff in Support Services andtestimony to the progress your

local ambulance service is making inour quest for excellence.

‘There is still a lot of work to bedone and improvements to bemade, but this award, following onfrom the trust winning the FleetSafety Champion of the Year Award

and receiving Van Excellenceaccreditation in 2011, clearlydemonstrates that we are headingin the right direction.

‘I would like to thank friends andcolleagues for their continuedsupport and hard work.’

SCAS wins Large PublicSector Fleet of the Year

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

A long-serving South EastCoast Ambulance Service NHSFoundation Trust (SECAmb)paramedic has attendedBuckingham Palace to bepresented with a Queen’sAmbulance Service medal.

Dave Fletcher, received his medalfrom the Queen on Friday (9November) after being named in thisyear’s Queen’s Birthday Honours list.He attended the special investitureceremony with his family and isamong the first to receive the medal,with this being the first year it hasbeen awarded.

Dave who served as a paramedicfor more than 36 years wasnominated for his commitment andpioneering work on resuscitation atSECAmb which led to theintroduction of a new resuscitationtechnique, Protocol C, across theTrust.

The compressions-only CPR,supported by early defibrillation, hashugely improved outcomes forpatients across SECAmb’s region ofSussex, Surrey and Kent.

Dave worked closely throughouthis career with ConsultantCardiologist Professor DouglasChamberlain to improve out-of-hospital resuscitation survival ratesacross SECAmb’s region and fromearly on in his career acquired areputation as one of best pre-hospital

clinicians.Speaking after the investiture he

said: “It was an honour and withmuch pride that I received the awardfrom the Queen on behalf of theambulance service. The occasion wassimply amazing and my family and Iwould like to have the day again sowe can take it all in!

“The award really must go to allmy SECAmb colleagues whose hardwork and dedication has resulted insuch a significant increase in thenumber of patients who now surviveout-of-hospital cardiac arrest. It is theclinicians at the sharp end, the teamsin the control rooms and thecommunity responders that make thedifference. I gave them guidance, theydid the work.

“It also would not have beenpossible without my SECAmb ChiefExecutive Paul Sutton and MedicalAdviser Professor Douglas

Chamberlain who gave me theopportunity and freedom to makechanges to the system.

“My personal reward, over my 38years in the service has been to bepart of a team that gives a life back tofamilies and friends. Only those thathave saved a life can appreciate fullythe pleasure and satisfaction that thisbrings. That, above all, was myreward.”

SECAmb Chief Executive PaulSutton said: “Dave is extremelydeserving of this recognition andaward. I’m very proud that South EastCoast Ambulance Service wasrepresented at Buckingham Palace infront of the Queen and I would liketo thank him both on behalf ofSECAmb and personally for hisdedication and commitment oversuch a successful career. He is theperfect recipient of this newly-established medal.”.”

SECAmb paramedic receives top medal from the Queen


Products & Suppliers News

42

The Emergency Services Show2012 celebrates another highlysuccessful year, as a recordnumber of visitors attended theunique show at StoneleighPark, Warwickshire.

An astounding 5,289 visitorsattended the show representing an18% increase from the previous yearwith just under 600 visitors comingback the second day to take ineverything on display. The showpromoted multi-agency collaborationby bringing together everyoneinvolved in an emergency, attractingthe leading buyers of emergencyequipment and services.

The significant increase in numbersindicated that, even during the

current poor economic climate, theemergency services are stillcommitted to improving public safetywith new innovations and services.Even the inclement weatherconditions didn’t deter visitors whobattled their way through wind andrain to see the extensive range ofproducts and services on show.

Over 400 exhibitors displayedtheir products and services duringthe event of which 100 were new tothe Show. Several exhibitorsdemonstrated live, including the RoadHaulage Association, who re-enacteda road traffic collision recovery. TheEmergency Planning Society held aCBRN Decontamination Workshop,which was designed to help local

authority staff improve theirknowledge and ability to deal withdecontamination incidents.

New to the show this year wasthe Joint Emergency ServicesInteroperability Programmes (JESIP)National Interoperability Summit. Thesummit brought together leaders andstrategic managers from UK Cat 1 &2 responders to the first ever highprofile national summit addressing thiscritically important topic. Topicscovered included, an overview ofJESIP and discussion on the externalchallenges from the worlds of law,academia and the military.

Commenting on the JESIPNational Interoperability Summit, RoyWhilsher, Chair of JESIP StrategicBoard said: “I am very pleased thatwe had such an excellent conferenceand interesting range of speakers tohelp the official launch of the JointEmergency Services InteroperabilityProgramme (JESIP). My aim wasthreefold, to demonstrate thecommitment of government and thethree emergency services to thisexciting initiative, to raise awarenessof JESIP and to provide somechallenge from the speakers toeveryone involved.

He continued by saying: “Therehas been previous interoperabilityprogrammes but this one feels

different with cross departmentgovernment support and a realcommitment to make a difference, Ido not think there has ever been abetter time to launch JESIP. I was verypleased with the Summit, I amenthused by the commitment of allinvolved, but the hard work startsnow. We need to take theemergency services, all theirgoverning authorities and partnerswith us to ensure we achieve thegoals we have set ourselves.”

David Brown, Event Directorcommented: “We are thrilled to haveseen such a significant increase in thenumber of visitors to the event thisyear, especially taking intoconsideration the appalling weatherconditions the UK faced over the twodays of the show.”

“The show is continuing to growyear upon year, and we are verymuch looking forward to planningnext year’s event, as the UK’s leadingmulti-agency show, which is reflectedin another year of recordattendance.”

The Emergency Services Showwill return to Stoneleigh Parkin 2013. You can keep up to datewith show news throughout theyear at www.emergencyuk.com

Another thriving year for the Emergency Services Show

As a leader in innovative technology,Optima has been chosen by Axira in theNetherlands to help the group’s sixambulance services improve responsetargets and patient care.

With the healthcare system in theNetherlands under enormous pressure toreview existing ways of working, six ambulanceservices in different regions of the country haveformed a collaboration to allow collectivepurchasing, training and on-going support oftechnology and other resources. Axira is a co-operation some of the country’s most

innovative ambulance services and the grouphas chosen Optima’s unique modelling andsimulation technology, Optima Predict, to assistwith current operational challenges.

UMCG Ambulancezorg is part of the Axiragroup. Jaap Hatenboer, Manager of Policy andInnovation at UMCG explained ‘Hospitals in theNetherlands are having to close emergencydepartments and merge facilities. The landscapewe are working in seems to be changingconstantly and our service needs to be able toreact quickly and efficiently to thosedevelopments. Optima Predict allows us not

only to accurately understand our currentsituation and processes but also allows us to rundifferent scenarios to see the effect that thismight have on our response times. In just 15minutes, we can model any proposed scenarioto see what we would need to do to react tothis and crucially, what the price tag would be.’

Axira is also using Optima Predict to helpimprove response times and meet performancetargets in certain regions. Whilst one of thegroup’s ambulance services is striving for a 1%increase in meeting A1 call targets, another ishaving to fully examine and re-model its servicedelivery to improve overall performance.

Jaap Hatenboer commented ‘Optima Predictis being employed on a national basis to addressvery local issues. It gives us decision supporttools which are used in the back office but theresults are clearly being shown in the front officeand on the frontline.’

The Optima Corporation works withEmergency Services across the globe.For more information on The OptimaCorporation and its product suite,please call +44 1189 036602, [email protected] orvisit www.theoptimacorporation.com

Six Ambulance Services in the Netherlands areusing Optima Predict™ to further improve servicedelivery in an ever-changing environment

BAUS AT UK Limited

Suite F1, 6 Whittle Road,

Ferndown Industrial Estate,

Wimborne, Dorset BH21 7RU.

Tel / Fax: +44 (0)1202 877497

B.A.U.S. AT Sp. z o.o.ul.

Polna 134-136

87-100 Torun

Poland

Tel: +48 662 020 074

Fax: +44 566 232 055

[email protected]

www.baus-at.com

ambulance today winter 2012

Documents