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Volume 38 No. 1<br />

<strong>February</strong> <strong>2023</strong><br />

DEDICATED TO THE AMBULANCE SERVICE AND ITS SUPPLIERS<br />

FURTHER<br />

DETAILS ON<br />

PAGES<br />

3 & 17<br />

www.dsmedical.co.uk<br />

ds_medical


O)stJohn<br />

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Scan to learn more:


CONTENTS<br />

CONTENTS<br />

<strong>Ambulance</strong> <strong>UK</strong><br />

4 EDITOR’S COMMENT<br />

6 FEATURES<br />

6 How long are we prepared to wait and see if the NHS<br />

improves?<br />

8 Predictive clinical utility of pre-hospital point of care<br />

lactate for transfusion of blood product in patients<br />

with suspected traumatic haemorrhage: derivation<br />

of a decision-support tool<br />

16 NEWSLINE<br />

27 IN PERSON<br />

31 COMPANY NEWS<br />

FURTHER<br />

DETAILS ON<br />

PAGES<br />

3 & 17<br />

This issue edited by:<br />

Sam English<br />

c/o Media Publishing Company<br />

Greenoaks, Lockhill<br />

Upper Sapey, Worcester, WR6 6XR<br />

ADVERTISING:<br />

Terry Gardner, Samantha Marsh<br />

CIRCULATION:<br />

Media Publishing Company<br />

Greenoaks, Lockhill<br />

Upper Sapey, Worcester, WR6 6XR<br />

Tel: 01886 853715<br />

E: info@mediapublishingcompany.com<br />

www.ambulanceukonline.com<br />

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Greenoaks<br />

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PUBLISHERS STATEMENT:<br />

The views and opinions expressed in<br />

this issue are not necessarily those of<br />

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3


EDITOR’S COMMENT<br />

EDITOR’S COMMENT<br />

Welcome to this issue of A<strong>UK</strong><br />

We have had, and continue to have, a winter of discontent with waiting times surpassing even the worst<br />

predictions. This morning the Government have promised another 800 ambulances before next winter along<br />

with 5000 extra beds and enhanced community resource. It seems like a logical and well thought out plan<br />

but it fails to address the obvious, its fine to have more physical resource but where are the staff to operate<br />

them? This is a fundamental problem in the NHS currently, recruitment and retention are key concerns and<br />

the situation is not helped by those who fail to listen to the concerns of the frontline staff working in todays<br />

high pressure environment.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

“We should<br />

know that<br />

something is<br />

wrong when<br />

highly qualified<br />

and caring<br />

staff leave<br />

a vocational<br />

career because<br />

they will afford<br />

more and<br />

experience<br />

less stress<br />

by working<br />

in a non<br />

professional<br />

role.”<br />

When I hear of NHS staff having to utilise food banks or hospitals setting up ‘pantries’ to help with the<br />

cost of living issues faced by staff, I am saddened and angry, this is not a problem of <strong>2023</strong> but one which<br />

has festered below the surface for at least the last 10 years. We have watched the pay gap widen yearly,<br />

we have seen the numbers of staff leaving and shortages increase, we have watched unconcerned as the<br />

demand increases year on year and we have heard from the frontline that the situation is worsening.<br />

We should know that something is wrong when highly qualified and caring staff leave a vocational career<br />

because they will afford more and experience less stress by working in a non professional role. Whilst some<br />

may argue that the NHS pension is much better than most private pension schemes and is therefore a<br />

benefit, the age at which this can be claimed continues to rise and I wonder how many of todays staff will<br />

actually reach the end of their careers working in the NHS to enjoy it.<br />

The issues are current, the pressure immense and the only solution is to attract staff to all areas of the NHS<br />

with pay and conditions that ensure recognition of their contribution to our society and provide a living wage<br />

for them and their families. I don’t think that is too much to ask for a service we all pay for and expect to<br />

meet our needs when we have them.<br />

So we roll forward into <strong>2023</strong> and look forward to life’s positives, Easter eggs have appeared on the<br />

supermarket shelves and holiday advertisements are in full flow. Its been chilly the last few weeks but<br />

temperatures are starting to get back to a more <strong>UK</strong> normal. We can but hope that the unrest in the NHS is<br />

resolved and that over the coming months there is peace in Europe again. Here’s hoping all your resolutions<br />

are achieved and best wishes for the year ahead.<br />

Sam English, Co-Editor <strong>Ambulance</strong> <strong>UK</strong><br />

Publishers Statement<br />

For nearly 40 years, thanks to trade support, we have been able to provide <strong>Ambulance</strong> <strong>UK</strong> FREE OF<br />

CHARGE in the knowledge that those receiving our dedicated bi monthly publication enjoy having<br />

something to read during their free time however, return on investment seems to be the buzz word<br />

amongst <strong>Ambulance</strong> Service Suppliers these days, therefore if you enquire about a product advertised,<br />

please mention <strong>Ambulance</strong> <strong>UK</strong> as it will help us confirm to the trade that we are reaching the right<br />

people and providing advertisers with value for money. In respect of our current edition we would like<br />

to thank the following companies for their support as without their contribution towards our print and<br />

postal costs this issue would not have been published - Bluelight <strong>UK</strong>, CSS Europe, DS Medical,<br />

Eberspächer, Intersurgical, Ortus, Synergy business solutions, Vimpex, St Johns Western<br />

Australia.<br />

Terry Gardner<br />

Publisher<br />

4<br />

For more news visit: www.ambulanceukonline.com


FEATURE<br />

HOW LONG ARE WE PREPARED TO<br />

WAIT AND SEE IF THE NHS IMPROVES?<br />

By Ivor Campbell<br />

Waiting times, waiting times…oh how we’re all waiting for the time<br />

when waiting times improve and we can feel confident that the<br />

NHS is working again.<br />

The reality is, however, that without meaningful change, waiting times<br />

are likely only to become longer – at least in the short term.<br />

Besides, there are other metrics that may be more accurate in<br />

measuring quality of care, such as the time patients wait before being<br />

clinically assessed; how long critically ill patients wait before their<br />

treatment is completed; and the proportion of patients who return to<br />

A&E within seven days of their first attendance. Other measures, such<br />

as the time a patient waits to see a clinician, are also now recorded.<br />

Even if they improved, would that necessarily mean we had a properly<br />

functioning health service, or that patients were receiving a better<br />

standard of care?<br />

What is beyond question is that waiting times have become the standard<br />

against which the performance of the NHS and social care service are<br />

measured. With the publication of every new set of statistics, so the<br />

fulmination of the commentariat becomes louder and more hectoring.<br />

Once patients are inside the system, governments continue to rely on<br />

waiting times as a key measure of clinical performance.<br />

There’s a six-week target for the eight key diagnostic tests and<br />

investigations; a 12-week target wait for new outpatient appointments; a<br />

12-week treatment time guarantee; and a waiting target of 18 weeks for<br />

an outpatient appointment, diagnostic test (if required) and treatment (if<br />

appropriate).<br />

Most public angst is reserved for waiting times for A&E departments<br />

because they are the gateway through which most patients enter the<br />

system. A logjam there, can lead to knock-on delays for the ambulance<br />

service, primary care, community-based care, and social services.<br />

In October 2022, the NHS recorded its highest ever waiting times for<br />

A&E admission, with more than one in three patients having to wait<br />

longer than the four-hour target.<br />

Again, we obsess over whether these times are being met and handwring<br />

over the deluge of statistics highlighting missed targets and,<br />

axiomatically, over further evidence of a broken system.<br />

At the end of September 2022, we learned that 7.1million people in<br />

England were waiting to start routine hospital treatment – up by 100,000<br />

on the previous month and the highest number since records began in<br />

August 2007.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

In Scotland, the situation was worse, with 61.9% of patients attending<br />

casualty departments in the week up to November 27 admitted or<br />

discharged within four hours.<br />

As a result of those failures, we learned that, in the same month, four<br />

patients waited more than 20 hours in the back of ambulances outside<br />

Royal Shrewsbury Hospital, in England.<br />

The average wait for category two, 999 calls for an ambulance —<br />

including for chest pains and strokes — in England and Wales is now 60<br />

minutes, compared with a target of 18 minutes.<br />

When Matt Hancock was Health Secretary, he became so frustrated at<br />

the amount of attention paid to the four-hour waiting target for A&E that<br />

he called for it to be scrapped because, he said, it was longer deemed<br />

to be ‘clinically appropriate.’<br />

While Hancock might be a better guide to the flavour of marsupial<br />

genitalia than to the functioning of a health service, he may have a point<br />

that the practice has its limitations.<br />

The King’s Fund think tank has pointed out that even measuring the<br />

proportion of patients seen within four hours is problematic. Two<br />

separate departments could process the same proportion of patients<br />

within the timescale but have different average waiting times.<br />

Last November it was reported that two women from the North of<br />

Scotland, waited more than three years for an appointment with a<br />

psychiatrist. When Nessie Simpson was eventually seen by a mental<br />

health practitioner, she had to travel 65 miles away from her home in<br />

Fort William.<br />

Most people would agree that having to wait three years for an<br />

appointment, or to sit for more than 20 hours in an ambulance outside<br />

an emergency department, are failures of the system.<br />

But is it necessarily the case that the speed with which a physician gets<br />

through appointments with patients should be the sole criterion upon<br />

which the success or failure of the system should be decided?<br />

A doctor who spends more time with a patient and notices an underlying<br />

issue that has been overlooked by a colleague, who spends less time with<br />

each patient, is obviously doing his or her job more effectively, even if that<br />

means they are costing more in time and resources.<br />

Waiting time statistics don’t show how often someone turns-up with a<br />

minor complaint that is masking something more serious and which is<br />

subsequently detected by a diligent clinician.<br />

Diagnostics is increasingly focused on the personal side of healthcare.<br />

While newspaper headlines fixate about people sitting in ambulances<br />

6<br />

For further recruitment vacancies visit: www.ambulanceukonline.com


FEATURE<br />

or on trollies outside of A&E departments, that is only a fraction of what<br />

hospitals do.<br />

Acute, emergency care may be seen as the ‘sharp-end’ of the health<br />

service, but fewer people die from falling over when drunk or getting<br />

their head stuck in a saucepan than from heart disease, cancers, and<br />

strokes, which take more time to treat and rely on expensive and timeconsuming,<br />

long-term testing.<br />

Intranasal mucosal<br />

atomisation device<br />

At the heart of the dilemma over how to fix the health service is the question<br />

of where best to distribute scarce resources. We have too many patients<br />

with too few resources and our options are therefore to reduce the number<br />

of patients or to increase resources and the latter is not currently viable.<br />

Fewer patients would enter the system if more of them paid for their<br />

treatment privately or if those with less serious conditions avoided<br />

visiting their GP.<br />

In the republic of Ireland, a GP appointment costs around €60 –<br />

with exemptions for pensioners, children under six and people on<br />

low incomes. Patients are also charged if they visit an emergency<br />

department without a GP’s referral.<br />

The Irish system may be unpopular among some, but at least it stops<br />

people turning up because they need a packet of paracetamol.<br />

Its advocates point-out that it prevents misuse of GPs’ time, allowing<br />

them to focus on those who are genuinely ill and that the service<br />

remains free to those who cannot afford to pay.<br />

Critics say such charges, if introduced in the <strong>UK</strong>, would undermine the<br />

founding principle of NHS, of care being free at the point of delivery to<br />

everyone, regardless of their means.<br />

We need to have a grown-up discussion about what would be<br />

acceptable and it may come down to cost. Would those of us who<br />

could afford to, be prepared to pay £20 to see a doctor? Possibly.<br />

Would they be prepared to pay £200? Probably not.<br />

Around 12% of healthcare treatment is already delivered privately. That used<br />

to be called privatisation by stealth but now it is accepted as being part of<br />

the system. People recognise that having the money and spending it on<br />

their health is worth potentially having an extra 10 years of living, pain free.<br />

There are already anomalies of private healthcare existing within the<br />

system. Only the poorest people now receive free dental and ophthalmic<br />

care and private companies routinely provide services for the NHS.<br />

Medication can be quickly<br />

and painlessly delivered with<br />

the DART intranasal mucosal<br />

atomisation device, helping the<br />

patient remain calm in a high<br />

stress situation.<br />

Scan the QR code to find out more:<br />

The system was devised in the late 1940s and, while it has been<br />

revised, many of us are still treated by a system that would be familiar to<br />

patients in the 1950s.<br />

How it will change in the next few years – if it changes at all – will<br />

depend upon public tolerance of a steadily worsening service. In the<br />

meantime, we will all have to wait and see.<br />

Ivor Campbell is Managing Director of Stirlingshire-based Snedden<br />

Campbell, a search company for the medical technology industry.<br />

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7


FEATURE<br />

PREDICTIVE CLINICAL UTILITY OF PRE-HOSPITAL POINT OF<br />

CARE LACTATE FOR TRANSFUSION OF BLOOD PRODUCT IN<br />

PATIENTS WITH SUSPECTED TRAUMATIC HAEMORRHAGE:<br />

DERIVATION OF A DECISION-SUPPORT TOOL<br />

J. E. Griggs 1,2* , R. M. Lyon 1,2 , M. Sherriff 4 , J. W. Barrett 2,5 , G. Wareham 1 and E. ter Avest 1,3 on behalf of Air<br />

<strong>Ambulance</strong> Charity Kent Surrey Sussex<br />

Scand J Trauma Resusc Emerg Med (2022) 30:72 https://doi.org/10.1186/s13049-022-01061-x<br />

Abstract<br />

Introduction<br />

Pre-hospital emergency medical teams can transfuse blood products<br />

to patients with suspected major traumatic haemorrhage. Common<br />

transfusion triggers based on physiological parameters have several<br />

disadvantages and are largely unvalidated in guiding pre-hospital<br />

transfusion. The addition of pre-hospital lactate (P-LACT) may overcome<br />

these challenges. To date, the clinical utility of P-LACT to guide prehospital<br />

blood transfusion is unclear.<br />

Background<br />

Over the past decade pre-hospital critical care teams and helicopter<br />

emergency medical services (HEMS) have developed transfusion<br />

protocols and operational capability to transfuse blood products to<br />

patients with suspected traumatic haemorrhagic shock [1, 2]. Clinical<br />

gestalt in combination with clinical variables such as systolic blood<br />

pressure (SBP) and shock index (SI) are used to quantify the severity of<br />

haemorrhagic shock and guide transfusion with blood products, both in<br />

the pre-hospital- and the in-hospital phase of care [3].<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

Methods<br />

A retrospective analysis of patients with suspected major traumatic<br />

haemorrhage attended by Air <strong>Ambulance</strong> Charity Kent Surrey Sussex<br />

(KSS) between 8 July 2017 and 31 December 2019. The primary<br />

endpoint was the accuracy of P-LACT to predict the requirement for any<br />

in-hospital (continued) transfusion of blood product.<br />

Results<br />

During the study period, 306 patients with suspected major traumatic<br />

haemorrhage were attended by KSS. P-LACT was obtained in 194<br />

patients. In the cohort 103 (34%) patients were declared Code Red. A<br />

pre-hospital transfusion was commenced in 124 patients (41%) and inhospital<br />

transfusion was continued in 100 (81%) of these patients, in 24<br />

(19%) patients it was ceased. Predictive probabilities of various lactate<br />

cut-off points for requirement of in-hospital transfusion are documented.<br />

The highest overall proportion correctly classified patients were found for<br />

a P-LACT cut-point of 5.4 mmol/L (76.50% correctly classified). Based<br />

on the calculated predictive probabilities, optimal cut-off points were<br />

derived for both the exclusion- and inclusion of the need for in-hospital<br />

transfusion. A P-LACT < 2.5 mmol/L had a sensitivity of 80.28% and a<br />

negative likelihood ratio [LR−] of 0.37 for the prediction of in-hospital<br />

transfusion requirement, whereas a P-LACT of 6.0 mmol/L had a<br />

specificity of 99.22%, [LR−] = 0.78.<br />

Conclusion<br />

Pre-hospital lactate measurements can be used to predict the need<br />

for (continued) in-hospital blood products in addition to current<br />

physiological parameters. A simple decision support tool derived in this<br />

study can help the clinician interpret pre-hospital lactate results and<br />

guide pre-hospital interventions in the major trauma patient.<br />

* Correspondence: Jogriggs@aakss.org.uk<br />

1<br />

Air <strong>Ambulance</strong> Charity Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill RH1 5YP, <strong>UK</strong><br />

Full list of author information is available at the end of the article<br />

© The Author(s) 2022.<br />

Clinical variables, however, have several disadvantages in guiding<br />

pre-hospital transfusion. First, evidence-based cut-off values to guide<br />

transfusion are lacking. As a result, pre-hospital transfusion trigger<br />

thresholds vary [3, 4]. Second, physiological parameters cannot reliably<br />

determine the degree of occult and temporal haemorrhage as they are<br />

highly influenced by autoregulatory responses [3, 5, 6]. Third, changes<br />

in blood pressure are a late sign of a haemorrhagic shock and by using<br />

SBP or SI as transfusion triggers the transfusion decision point (TDP)<br />

may be delayed beyond the critical window for effective resuscitation<br />

[7]. Finally, other causes mimic the clinical signs of haemorrhagic shock<br />

and may confound decision-making, such as traumatic vasoactive head<br />

injuries [8]. As a result, the sensitivity and specificity of clinical variables<br />

to predict in-hospital transfusion are limited [4, 9–11].<br />

Pre-hospital point of care lactate measurement (P-LACT) has the<br />

potential to overcome some of these shortcomings. Lactate formation<br />

in major trauma patients is the result of tissue hypoperfusion, resulting in<br />

anaerobic glycolysis. Haemorrhage and inadequate ventilation following<br />

a traumatic injury can lead to hypovolemia, hypoxaemia and end-organ<br />

hypoperfusion, resulting in anaerobic glycolysis and lactate formation.<br />

Furthermore, lactate is formed as a result of adrenergic responses to<br />

pain and stress [12–15]. Unlike SBP and SI, P-LACT changes are not<br />

balanced by counter-regulatory mechanisms and can be measured early<br />

at the point of injury [12]. Previous studies have shown that P-LACT<br />

can be used to predict both the need for resuscitative in-hospital care<br />

in trauma patients and the outcome of traumatically injured patients<br />

[1, 9, 10]. To date, the clinical utility of P-LACT to guide blood product<br />

transfusion remains unclear [3, 16].<br />

In this study, we aim to investigate how P-LACT can be used to predict<br />

8<br />

For more news visit: www.ambulanceukonline.com


FEATURE<br />

the need for (continued) in-hospital blood product transfusion in patients<br />

attended by HEMS with suspected major traumatic haemorrhage.<br />

Methods<br />

Study design<br />

We performed a retrospective analysis of all trauma patients with<br />

suspected major haemorrhage attended by Air <strong>Ambulance</strong> Kent Surrey<br />

Sussex (KSS) in whom a P-LACT was measured between 8 July 2017<br />

(when lactate measurements became available to the service) and 31<br />

December 2019. We aimed to investigate the relationship between<br />

clinical variables and measured P-LACT values with the need for<br />

(continued) in-hospital blood product transfusion.<br />

Study setting<br />

KSS HEMS cover three counties in the southeast of England, a region<br />

of 7200km 2 with a resident population of 4.5 million, and a transient<br />

population of 8 million. Two doctor-paramedic teams respond 24/7 in<br />

either a helicopter or rapid response vehicle from one operational base,<br />

attending approximately 2000 patients per year. Tertiary trauma care in the<br />

region is offered at four major trauma centres (MTCs). At the time of the<br />

study KSS carried four units of O Rhesus negative packed red blood cells<br />

(PRBC) in a CRĒDO CUBE (Series 4, 2l Insulation 15, VIP Golden Hour)<br />

and four units of Lyoplas, freeze dried plasma (FDP) on all missions.<br />

Blood products are administered as per KSS Standard Operating<br />

Procedure (SOP) to patients showing signs of severe haemorrhagic<br />

shock. The decision to transfuse blood products is based on clinical<br />

gestalt, considering clinical history, mechanism, physiology and<br />

response to resuscitative efforts. P-LACT is measured as per SOP as an<br />

adjunct to clinical findings to help exclude traumatic major haemorrhage<br />

(cut off < 2.5 mmol/L). Where there is a suspicion of major haemorrhage<br />

and sign of haemodynamic compromise ‘Code Red’ is declared. Code<br />

Red activation enables a titrated transfusion of up to four units of O<br />

Rhesus negative PRBC and 4 units of FDP; administration of 10 mL<br />

Calcium Chloride 10% (after the 2nd unit of PRBC) and Tranexamic Acid<br />

(1 g) through a fluid warmer (Belmont Buddy Lite or Warrior Lite).<br />

In addition, a ‘pre-alert’ to the receiving hospital triggers a predefined<br />

in-hospital major haemorrhage protocol to ensure blood products are<br />

immediately available [17, 18]. Full traceability of blood transfusions<br />

and compliance with Blood Safety and Quality Regulations (2007) and<br />

Medicines and Healthcare Regulatory Agency (MHRA, 2016) is ensured.<br />

Point of care lactate sampling<br />

Lactate was measured from venous blood prior to sodium chloride<br />

(NaCl 0.9%) flush, and drawn into a 2 mL syringe during venepuncture<br />

or after insertion of an intravenous (IV) cannula using the NOVA<br />

StatStrip ® Biomedical Xpress point of care test (POCT) Lactate Meter<br />

system [12]. Samples were taken prior to the initiation of blood product<br />

transfusion. Measurement results were noted, time-stamped and<br />

retrospectively recorded in the KSS electronic patient record system<br />

(HEMSBase 2.0, Medic One Systems Ltd, <strong>UK</strong>).<br />

Outcome measures<br />

The primary endpoint of interest was the accuracy of P-LACT (both<br />

as a continuous variable and at various cut-off points) to predict the<br />

requirement for any (continued) transfusion of blood products inhospital.<br />

Data acquisition<br />

Patient demographics, mechanism of injury and nature of injuries,<br />

presenting physiology, POCT results (including lactate) and treatments<br />

provided by HEMS and other EMS (including blood product) were<br />

retrieved from the dedicated KSS electronic patient clinical record. Inhospital<br />

transfusion data were obtained from electronic health records of<br />

the respective MTC’s and shared with KSS in accordance with existing<br />

data-sharing agreements between KSS and the NHS Trusts.<br />

Ethical considerations<br />

This project was registered with the University of Surrey, and met<br />

National Institute for Healthcare Research (NIHR, <strong>UK</strong>) criteria as a service<br />

evaluation. All the data used for this study were routinely collected as<br />

part of standard pre-hospital and hospital patient data collection. The<br />

project was approved by the KSS Research & Development Committee<br />

and conducted in accordance with Strengthening the Reporting of<br />

Observational Studies in Epidemiology (STROBE) Guidelines [19].<br />

Statistical analysis<br />

Descriptive statistics are given as mean [95% CI] or median [IQR].<br />

Comparisons across groups were made using Fisher’s exact test and<br />

ANOVA Kruskal–Wallis test where appropriate. Sensitivity, specificity,<br />

and positive- and negative likelihood ratios as well as the percentage<br />

correctly classified were calculated for P-LACT values in the range<br />

between 1 and 10 mmol/L. Finally, predicted probabilities [95% CI] of<br />

the occurrence of the defined endpoint were calculated for each of<br />

these values using logistic regression analysis.<br />

Previously published work at KSS in the same patient cohort highlights<br />

an average time from 999 to P-LACT of 66 min [12]. Internal service<br />

evaluation highlights a 999 to hospital time of 1 h 50 min, putting the<br />

HEMS team patient side at between 30 and 45 min.<br />

Study population<br />

Patients were included in the analysis if they had presumed major<br />

haemorrhage as a result of traumatic injuries for which a P-LACT was<br />

measured on scene and for which the patient was transported (by air or<br />

land) to an MTC. Exclusions consisted of patients with traumatic cardiac<br />

arrest (TCA), patients pronounced life extinct (PLE) on scene, patients<br />

with potential haemorrhagic shock from a medical aetiology, patients<br />

transferred to non-MTCs, inter-hospital transfers and patients < 16 years<br />

of age.<br />

Missing values are reported in the results section of the manuscript<br />

according to the STROBE guideline [11]. A p value < 0.05 was regarded<br />

as statistically significant. Statistical analyses were conducted using<br />

Stata 17.0 and SPSS 26.0.<br />

Results<br />

Study population<br />

During the study period KSS attended 306 trauma patients in whom<br />

major traumatic haemorrhage was suspected. 103 of these patients<br />

had signs of haemodynamic compromise for which a Code Red<br />

was declared. Overall, a P-LACT was obtained in a total of 194<br />

patients (47 in whom a Code Red was declared and 147 in whom not).<br />

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FEATURE<br />

Fig. 1 Derived study population and patient inclusion<br />

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In-hospital transfusion was continued- or started in 126 patients (Fig.<br />

1). 14 of the patients receiving in-hospital transfusion fulfilled criteria<br />

for major transfusion, and 31 fulfilled criteria for massive transfusion.<br />

P-LACT was not measured in 56 (54%) of the patients with a suspicion<br />

of major traumatic haemorrhage.<br />

Baseline characteristics<br />

Patient demographics, mechanism of injury (MOI), presenting<br />

physiology, HEMS interventions and HEMS transfusion of patients<br />

attended with suspected major traumatic haemorrhage are presented<br />

in Table 1, stratified by the primary endpoint the need for (continued)<br />

in-hospital transfusion. Endpoint data were available for 268 (88%)<br />

of patients. Patients who needed in-hospital transfusion were more<br />

frequently injured in an RTC (72%); had a higher heart rate (106 bpm);<br />

a lower systolic blood pressure (88 mmHg); a higher shock index (1.3);<br />

a lower GCS (10/15); a higher overall injury severity score (ISS) and<br />

average P-LACT of 4.60 mmol/L. HEMS critical interventions were more<br />

prevalent in patients who required in-hospital transfusion.<br />

Diagnostic performance of lactate for the prediction of in-hospital<br />

transfusion<br />

The negative likelihood ratio [LR−] gives the change in odds of having<br />

a diagnosis in patients with a negative test. For example, a −LR of 0.1<br />

would indicate a tenfold decrease in the odds of having a condition in<br />

a patient with a negative test result. A -LR of 0.05 would be a 20-fold<br />

decrease in the odds of the condition studied.<br />

Predictive probabilities (95% CI) of cut-off points for every increase in<br />

lactate 1 mmol/L for the need for in-hospital transfusion is reported (Fig.<br />

2). The highest overall percentage of correctly classified patients for a<br />

single cut-off point was found at the inflection point of the curve, cutpoint<br />

5.4 mmol/L. (Table 2). For this cut-point 76.50% of the patients<br />

were correctly classified. However, sensitivity of a lactate < 5.4 mmol/L<br />

(38.03%) was too low to use as a single cut-off value to exclude the<br />

need for in-hospital transfusion.<br />

Sensitivity, specificity, and positive- and negative likelihood ratio’s as<br />

well as the percentage correctly classified subjects for various P-LACT<br />

values in the range between 1 and > 9.6 mmol/L are represented in<br />

Table 2.<br />

The cut-point currently used as an adjunct to exclude major<br />

haemorrhage (P-LACT < 2.5 mmol/L) had a sensitivity of 80.28%,<br />

[LR−] = 0.37 for the prediction of the need for in-hospital transfusion.<br />

However, a P-LACT > 2.5 mmol/L only had a specificity of 52.00%<br />

and was therefore not useful to identify those patients in whom a code<br />

red should be declared and communicated to the receiving hospital.<br />

Specificity increased gradually with increasing P-LACT values until a<br />

value of 6.0 mmol/L and plateaued thereafter. A P-LACT of 6.0 mmol/L<br />

had a specificity of 99.22%, [LR−] = 0.78.<br />

Based on the above findings a decision support tool was devised for the<br />

use of lactate in the pre-hospital phase of care (Fig. 3).<br />

Discussion<br />

In the present study we demonstrate that pre-hospital lactate<br />

measurements can be used to predict the need for (continued) inhospital<br />

blood product. A simple decision support tool can help the<br />

clinician to interpret pre-hospital lactate results and to guide transfusion.<br />

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FEATURE<br />

Table 1 Population characteristics stratified by need for (continued) transfusion of blood products in hospital<br />

All patients (n = 306)<br />

In‐hospital transfusion<br />

(n = 126)<br />

No In‐hospital transfusion<br />

(n = 142)<br />

p value<br />

Demographics<br />

Age, years (SD) 47.4 [21.6] 47.5 [21.7] 47.4 [21.6] .73<br />

Male, (n [%]) 197 [73.5] 90 [71.4] 107 [75.4] .57<br />

Female, (n [%]) 71 [23.2] 36 [28.6] 35 [24.6]<br />

Missing, (n [%]) 38 [3.3]<br />

Mechanism descriptors (n, %)<br />

RTC 162 [52.9] 91 [72.2] 71 [55.6] < 0.001<br />

Accidental Injury 20 [6.5] 16 [12.7] 4 [2.8]<br />

Intentional Self Harm 25 [8.1] 9 [7.14] 16 [11.3]<br />

Assault 19 [6.2] 8 [6.3] 18 [12.6]<br />

Fall 30 [9.8] 4 [3.2] 26 [18.4]<br />

Cyclist 5 [1.6] 0 [0] 5 [3.5]<br />

Motorcyclist 18 [5.9] 4 [3.2] 14 [9.9]<br />

Other 8 [2.6] 2 [1.6] 6 [4.2]<br />

Presenting physiology<br />

TCA (n [%]) 15 [8.5] 14 [10.4] 1 [9.2] < 0.001<br />

HR (mean [SD])<br />

missing<br />

SBP (mean [SD])<br />

missing<br />

Shock Index (mean [SD])<br />

missing<br />

GCS (median [IQR])<br />

missing<br />

P-LACT<br />

Presenting P-LACT (mmol/L) (mean [SD])<br />

missing<br />

Pre-hospital interventions<br />

91 [25.1]<br />

17<br />

106 [34.4]<br />

20<br />

1.0 [0.5]<br />

27<br />

13 [6–15]<br />

3<br />

2.9 [2.4]<br />

84<br />

Demographics, proxy injury and physiological parameters: HR heart rate, SBP systolic blood pressure, SI shock index, GCS Glasgow Coma Scale, PHEA pre-hospital<br />

emergency anaesthesia, PRBC packed red blood cells, FDP freeze-dried plasma, P‐LACT pre-hospital lactate, ICU Intensive Care Unit<br />

When patients are attended by pre-hospital care teams after major<br />

trauma, it can be a challenge to determine which patients suffer from<br />

major haemorrhage due to their injuries. Often this is obvious from the<br />

106 [32.6] 98 [29.6] < 0.001<br />

88 [31.8] 120 [29.5] < 0.001<br />

1.3 [0.6] 0.8 [0.3] < 0.001<br />

10 [3–14]<br />

0<br />

14 [10–15]<br />

3<br />

< 0.001<br />

4.60 [2.4] 3.5 [3.5] < 0.001<br />

PHEA (n [%]) 101 [36.9] 64 [50.4] 37 [25.5] < 0.001<br />

Pre-hospital Code Red 103 [39.9] 89 [70.4] 14 [9.2] < 0.001<br />

Pre-hospital Transfusion 124 [49.0] 100 [79.2] 24 [16.3] < 0.001<br />

PRBC (units, %) mode [range] 0 [4] 0 [3] < 0.001<br />

FDP (units, %) mode [range] 1 [4] 0 [4] < 0.001<br />

PRBC units (n, %)<br />

0 units 169 [60.8] 40 [31.2] 129 [91.5] .68<br />

1 units 44 [17.0] 37 [29.6] 7 [4.3]<br />

2 units 28 [10.1] 24 [19.2] 4 [2.8]<br />

3 units 18 [7.8] 16 [12.8] 2 [1.4]<br />

4 units 9 [4.2] 9 [7.2] 0 [0]<br />

Clinical outcome<br />

Hospital lactate (mmol/L)<br />

Missing (n [%])<br />

ISS (mean [SD])<br />

Missing (n [%])<br />

ICU Length of stay (mean [SD])<br />

Missing (n [%])<br />

Hospital Length of stay (mean [SD])<br />

Missing (n [%])<br />

Survival to discharge<br />

Missing (n [%])<br />

3.4 [2.6]<br />

204 [66.6]<br />

14 [17–41]<br />

82 [27.8]<br />

3 [.00–11.7]<br />

82 [27.8]<br />

16 [5.7 – 31.2]<br />

84 [27.45]<br />

144 (47.1)<br />

97[31.7]<br />

4.4 [3.0] 2.00 [1.0] < 0.001<br />

33 [23.5–43.0] 22 [13–33] < 0.001<br />

4.5 [1.00–16.75] 2 [.0–8.00] < 0.001<br />

18 [3–42] 14 [7–26.0] .50<br />

57 [44.8] 87 [61.0] < 0.001<br />

physical examination (i.e. when external bleeding is present, or when<br />

the patient presents in extremis/ peri-arrest). Sometimes, however, this<br />

is less clear, as patients may be seen early after their injury, with still<br />

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FEATURE<br />

Fig. 2 Predictive probabilities (95% CI) of various cut-off points for the need for in-hospital (continued) transfusion. Predicted probabilities and<br />

Fig. associated 2 Predictive 95% probabilities CIs of In-hospital (95% transfusion CI) of various as a cut-off function points of pre-hospital for the need lactate for in-hospital concentration (continued) transfusion. Predicted probabilities and<br />

associated 95% CIs of In-hospital transfusion as a function of pre-hospital lactate concentration<br />

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Table 2 Diagnostic performance of P-LACT for prediction of<br />

Table in-hospital 2 Diagnostic blood component performance therapy of P-LACT in patients for prediction with traumatic of<br />

in-hospital haemorrhage blood component therapy in patients with traumatic<br />

haemorrhage<br />

Cut‐point Sensitivity Specificity LR+‐ LR− Correctly<br />

Cut‐point (mmol/L) Sensitivity Specificity LR+‐ LR− Correctly classified<br />

(mmol/L)<br />

1 100.00 3.10 1.03 0.00<br />

classified<br />

37.50<br />

1 2 100.00 91.55 3.10 31.78 1.03 1.34 0.00 0.26 37.50 53.00<br />

2 2.5 91.55 80.28 31.78 51.94 1.34 1.67 0.26 0.37 53.00 62.00<br />

2.53 80.28 69.01 51.94 62.78 1.67 1.85 0.37 0.49 62.00 65.00<br />

3 4 69.01 50.34 62.78 82.95 1.85 3.30 0.49 0.52 65.00 73.50<br />

4 5 50.34 39.44 82.95 93.80 3.30 6.36 0.52 0.64 73.50 74.50<br />

5 6 39.44 22.54 93.80 99.22 6.36 29.07 0.64 0.78 74.50 72.00<br />

6 7 22.54 9.86 99.22 99.22 29.07 12.71 0.78 0.90 72.00 67.32<br />

7 8 9.86 7.04 99.22 100.00 12.71 – 0.90 0.91 67.32 67.50<br />

8 9 7.04 1.41 100.00 100.00 – – 0.91 0.98 67.50 65.00<br />

9 > 9 1.41 0.00 100.00 100.00 – – 0.98 1.00 65.00 64.50<br />

> 9 0.00 100.00 – 1.00 64.50<br />

LR+ is the ratio of the probability of a positive test among the truly positive<br />

LR+ subjects is the ratio to the of probability the probability of a positive of a positive test among test among the truly the truly negative positive subjects.<br />

subjects The LR– to is the the probability ratio of the of probability a positive of test a negative among the test truly among negative the truly subjects. positive<br />

The subjects LR– is the to the ratio probability of the probability of a negative of a negative test among test the among truly the negative truly positive subjects<br />

subjects to the probability of a negative test among the truly negative subjects<br />

relatively preserved haemodynamics. In addition, the clinical picture of<br />

major haemorrhage and resultant shock can be mimicked by various<br />

conditions, such as vasoactive head injuries [8]. Clinical variables,<br />

such as blood pressure and heart rate cannot always discriminate<br />

in these instances [4, 10]. Delayed recognition of haemorrhage may<br />

delay appropriate treatment beyond the critical window for effective<br />

resuscitation [7], and/or omitting a pre-alert to the receiving hospital,<br />

leaving clinicians with less time to prepare to receive the patient with<br />

the appropriate resources. However, over-transfusion of patients<br />

with a suspicion of major haemorrhage may occur based on clinical<br />

variables, where a blood transfusion is started in the absence of major<br />

haemorrhage, with resultant deleterious effects [6, 20–22]. This is in-line<br />

with previous reports on the limited sensitivity and specificity of clinical<br />

variables for the prediction of ongoing major haemorrhage [5, 7], even<br />

when these variables are incorporated in sophisticated clinical scoring<br />

systems, such as the Trauma Associated Severe Haemorrhage Score<br />

and Assessment of Blood Consumption Score [3, 23].<br />

In this study, we devise a decision support tool based on P-LACT<br />

measurements to aid clinicians at the transfusion decision point. Lactate<br />

is a well-known independent prognostic marker of in-hospital mortality<br />

in adult trauma patients [24] and previous studies have reported that<br />

P-LACT predicts the need for pre-hospital life-saving intervention beforeand<br />

after admission [15]. The predictive ability of P-LACT for the need<br />

of (continued) transfusion requirement in-hospital however has not been<br />

studied before.<br />

A P-LACT cut-off value of < 2.5 mmol/L had a sensitivity high enough<br />

to exclude the need for in-hospital blood component therapy. This was<br />

also a clinically useful cut-off, as 50% of the patients in our cohort had<br />

a lactate value < 2.5 mmol/L. P-LACT values > 6.0 mmol/L on the other<br />

hand, were highly predictive of the need for (continued) in-hospital<br />

transfusion and requirement of blood components. In combination with<br />

an appropriate trauma mechanism and/or clinical sign congruent with<br />

major haemorrhage, a value > 6.0 mmol/L can almost certainly be used<br />

as a trigger to activate a ‘Code Red’ response to initiate pre-hospital<br />

transfusion, and to pre-alert the receiving hospital. P-LACT values<br />

between 2.5 and 6 mmol/L are not unequivocally diagnostic, which is<br />

in-line with previous studies, wherein it was shown that the aetiology of<br />

elevated P-LACT levels in trauma patients is multifactorial. Other factors<br />

than tissue hypoperfusion, such as increased lactate production due to<br />

catecholamine release as a result of pain, stress, or metabolic needs, or<br />

a decreased lactate clearance due to alcohol intoxication or liver injuries<br />

may play a role. In these instances, serial P-LACT measurements can be<br />

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FEATURE<br />

Fig. 3 Division of a decision support tool using P-LACT in patients with suspected major haemorrhage. P-LACT, pre-hospital lactate; *Consider<br />

alternative causes increased lactate production due to catecholamine release as a result of pain, stress or increased metabolic demand, or due to<br />

isolated injuries such as TBI and amputations, or decreased lactate clearance: alcohol intoxication or liver trauma<br />

considered, especially when transport times to hospital are prolonged<br />

and whereby clinicians can aggressively resuscitate a lactate clearance<br />

to < 2.5 mmol/L.<br />

Currently, pre-hospital clinicians often transfuse one or more units of<br />

blood products to patients in whom major haemorrhage is suspected<br />

based on clinical variables. The clinical response is used to establish<br />

the need for further transfusion. However, this is not without risk, as<br />

transfusion related adverse events (although rare) may occur. Potential<br />

deleterious effects may be mitigated, to a certain degree by using<br />

serial P-LACT measurements [6]. The proposed algorithm in this study<br />

may help pre-hospital clinicians to achieve this. It may also attribute<br />

the correct identification of patients who have in-hospital transfusion<br />

requirements and may thereby contribute to the improvement of clinical<br />

pathways for these patients.<br />

Limitations<br />

Our study had several limitations. First, selection bias may have<br />

influenced our results as P-LACT was not measured in 85/306 patients<br />

with suspected major haemorrhage. It is likely that a number of these<br />

patients presented in extremis and the completion of P-LACT would<br />

prolong the time to transfusion, mandating the crews on scene to<br />

prioritize resuscitative interventions above P-LACT measurements. In<br />

these patients however it is unlikely that P-LACT will add much in terms<br />

of decision-making regarding transfusion requirements. This highlights<br />

the challenges of ascertaining the temporality of bleeding in the prehospital<br />

phase of care. For example, identification and differentiation of<br />

the patient whom has active haemorrhage versus the patient who ‘has<br />

bled’. Tailoring of transfusion practice to each of these patients is the<br />

subject of further research. Further, qualitative research may be able<br />

to explore this further in combination with Bayesian theorem. Second,<br />

the P-LACT clinical decision tool developed in this study was derived<br />

from a relatively limited cohort of 221 trauma patients seen by a single<br />

centre. Validation in separate cohorts and other services is warranted<br />

to confirm diagnostic accuracy of the proposed P-LACT cut-off points.<br />

The decision tool should be tested to see if it results in more correctly<br />

classified patients resulting in earlier transfusion in those who need it and<br />

withhold transfusion in those who don’t. Third, in-hospital transfusion<br />

was used as a surrogate for ongoing haemorrhage. However, it is well<br />

known that heuristics and confirmation bias may have influenced the<br />

decision to start or continue in-hospital transfusion. Differences in local<br />

transfusion policies may have influenced this decision too, as patients<br />

were transported to three different MTC’s.<br />

Finally, P-LACT must be adopted within a heuristic approach,<br />

where clinical gestalt developed through pattern recognition, clinical<br />

observation and perception combine to estimate patient transfusion<br />

requirement [25]. We are aware that a single P-LACT is a snapshot<br />

of a dynamic process. The clinical utility of P-LACT is likely found in a<br />

combination of physiological parameters. Future (Bayesian) prediction<br />

modelling to ascertain the value clinicians assign to clinical gestalt at the<br />

transfusion decision point may ascertain the adjunctive value of P-LACT<br />

in combination with physiological parameters [26] in the temporal<br />

management of the bleeding patient.<br />

Conclusion<br />

Pre-hospital lactate measurements can be used to predict the need for<br />

in-hospital blood component therapy. A simple decision support tool<br />

derived in this study can help the clinician interpret pre-hospital lactate<br />

results and guide the need for blood product transfusion.<br />

Abbreviations<br />

KSS: Air <strong>Ambulance</strong> Charity Kent Surrey Sussex; CCP: Critical Care<br />

Paramedic; CI: Confidence Interval; EOC: Emergency Operations<br />

Centre; FDP: Freeze-dried plasma; GCS: Glasgow Coma Score; HEMS:<br />

Helicopter Emergency Medical Service; HR: Heart rate; ICU: Intensive<br />

Care Unit; IQR: Interquartile range; MOI: Mechanism of injury; MTC:<br />

Major Trauma Centre; NIHR: National Institute for Healthcare Research;<br />

PHEA: Pre-hospital emergency anaesthesia; P-LACT : Prehospital<br />

lactate measurement; PRBC: Packed red blood cells; RTC : Road traffic<br />

collision; SBP: Systolic blood pressure; SI: Shock Index; STROBE:<br />

Strengthening the reporting of observational studies in epidemiology<br />

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FEATURE<br />

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guidelines; TARN: Trauma audit and research network; TDP: Transfusion<br />

decision point; USS: Ultrasound sonography.<br />

Acknowledgements<br />

We acknowledge the South-East Coast <strong>Ambulance</strong> Service NHS<br />

Foundation Trust and associated NHS Hospital Trusts for their ongoing<br />

support.<br />

Author contributions<br />

JG, ETA, RL conceived the study design. MS, JG and ETA performed<br />

statistical analysis. Data analysis and interpretation was performed<br />

by JG and ETA. JG and ETA drafted the manuscript. JB, GW and<br />

RL provided critical revision of the manuscript. All authors read and<br />

approved the final manuscript.<br />

Funding<br />

No funding was received for this study.<br />

Availability of data and materials<br />

The datasets used and/or analysed during the current study are<br />

available from the corresponding author on reasonable request.<br />

Declarations<br />

Ethics approval and consent to participate<br />

Internal service approval was sought from the Research, Audit and<br />

Development Department at KSS. All patient data were collected<br />

routinely as standard and therefore, ethics committee approval was not<br />

required. Patient identifiable data has been anonymised and stored on<br />

electronic devices with technical encryption (Data Protection Act, 1998).<br />

Consent for publication<br />

Not applicable.<br />

Competing interests<br />

JG, ETA, GW and RL are all employees of Air <strong>Ambulance</strong> Kent, Surrey<br />

and Sussex. JB is an employee of South East Coast <strong>Ambulance</strong> Service<br />

NHS Foundation Trust. There were no financial or non-financial conflicts<br />

of interest.<br />

Author details<br />

1<br />

Air <strong>Ambulance</strong> Charity Kent Surrey Sussex, Hanger 10 Redhill<br />

Aerodrome, Redhill RH1 5YP, <strong>UK</strong>. 2 University of Surrey, School of<br />

Health Sciences, Priestley Rd, Guildford GU2 7YH, <strong>UK</strong>. 3 Department of<br />

Emergency Medicine, University Medical Center Groningen, Groningen,<br />

The Netherlands. 4 University of Bristol, Child Dental Health, Bristol<br />

Dental School, Faculty of Health Sciences, Lower Maudlin Street, Bristol<br />

BS1 2LY, <strong>UK</strong>. 5 South East Coast <strong>Ambulance</strong> NHS Foundation Trust,<br />

Neptune House, Gatwick, Surrey RH10 9BG, <strong>UK</strong>.<br />

Received: 30 May 2022 Accepted: 1 December 2022<br />

Published online: 13 December 2022<br />

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of compensatory reserve and arterial lactate as markers of shock and resuscitation. J<br />

Trauma Acute Care Surg. 2017;83(4):603–8.<br />

8. Gavrilovski M, El-Zanfaly M, Lyon RM. Isolated traumatic brain injury results in significant<br />

pre-hospital derangement of cardiovascular physiology. Injury. 2018;49(9):1675–9.<br />

9. Brown JB, Cohen MJ, Minei JP, Maier RV, West MA, Billiar TR, et al. Pretrauma center red<br />

blood cell transfusion is associated with reduced mortality and coagulopathy in severely<br />

injured patients with blunt trauma. Ann Surg. 2015;261(5):997–1005.<br />

10. Odom SR, Howell MD, Silva GS, Nielsen VM, Gupta A, Shapiro NI, et al. Lactate<br />

clearance as a predictor of mortality in trauma patients. J Trauma Acute Care Surg.<br />

2013;74(4):999–1004.<br />

11. Oyetunji TA, Chang DC, Crompton JG, Greene WR, Efron DT, Haut ER, et al. Redefining<br />

hypotension in the elderly: normotension is not reassuring. Arch Surg Chic Ill 1960.<br />

2011;146(7):865–9.<br />

12. ter Avest E, Griggs J, Wijesuriya J, Russell MQ, Lyon RM. Determinants of prehospital<br />

lactate in trauma patients: a retrospective cohort study. BMC Emerg Med. 2020;20(1):18.<br />

13. Bloom BM, Grundlingh J, Bestwick JP, Harris T. The role of venous blood gas in the<br />

emergency department: a systematic review and meta-analysis. Eur J Emerg Med Off J<br />

Eur Soc Emerg Med. 2014;21(2):81–8.<br />

14. Baxter J, Cranfield KR, Clark G, Harris T, Bloom B, Gray AJ. Do lactate levels in the<br />

emergency department predict outcome in adult trauma patients? A systematic review. J<br />

Trauma Acute Care Surg. 2016;81(3):555–66.<br />

15. Vincent JL, Quintairos e Silva A, Couto L, Taccone FS. The value of blood lactate kinetics<br />

in critically ill patients: a systematic review. Crit Care. 2016;13(20):257.<br />

16. Guyette FX, Meier EN, Newgard C, McKnight B, Daya M, Bulger EM, et al. A comparison<br />

of prehospital lactate and systolic blood pressure for predicting the need for resuscitative<br />

care in trauma transported by ground. J Trauma Acute Care Surg. 2015;78(3):600–6.<br />

17. Rehn M, Weaver A, Eshelby S, Lockey D. London’s air ambulance: 3 year experience with<br />

pre-hospital transfusion. Resuscitation. 2015;1(96):156.<br />

18. Weaver A, Eshelby S, Norton J, Lockey D. The introduction of on-scene blood transfusion<br />

in a civilian physician-led pre-hospital trauma service. Scand J Trauma Resusc Emerg<br />

Med. 2013;21(Suppl 1):S27.<br />

19. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al.<br />

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)<br />

statement: guidelines for reporting observational studies. Epidemiol Camb Mass.<br />

2007;18(6):800–4.<br />

20. Bodnar D, Rashford S, Williams S, Enraght-Moony E, Parker L, Clarke B. The feasibility<br />

of civilian prehospital trauma teams carrying and administering packed red blood cells.<br />

Emerg Med J. 2014;31(2):93–5.<br />

21. Miller TE. New evidence in trauma resuscitation—is 1:1:1 the answer? Perioper Med.<br />

2013;3(2):13.<br />

22. Chaiwat O, Lang JD, Vavilala MS, Wang J, MacKenzie EJ, Jurkovich GJ, et al. Early<br />

packed red blood cell transfusion and acute respiratory distress syndrome after trauma.<br />

Anesthesiology. 2009;110(2):351–60.<br />

23. Tonglet ML. Early prediction of ongoing hemorrhage in severe trauma: presentation of the<br />

existing scoring systems. Arch Trauma Res. 2016;5(4):e33377.<br />

24. Salottolo KM, Mains CW, Offner PJ, Bourg PW, Bar-Or D. A retrospective analysis of<br />

geriatric trauma patients: venous lactate is a better predictor of mortality than traditional<br />

vital signs. Scand J Trauma Resusc Emerg Med. 2013;14(21):7.<br />

25. Cantle PM, Cotton BA. Prediction of massive transfusion in trauma. Crit Care Clin.<br />

2017;33(1):71–84.<br />

26. Early Identification of Trauma-induced Coagulopathy: Development and Validation of a<br />

Multivariable Risk Prediction Model—PubMed [Internet]. [cited 2022 Feb 15]. https://<br />

pubmed.ncbi.nlm.nih.gov/31972649/.<br />

Publisher’s Note<br />

Springer Nature remains neutral with regard to jurisdictional claims in<br />

published maps and institutional affiliations.<br />

14<br />

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NEWSLINE<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

‘Golden Hour’ Study<br />

Reaches Major<br />

Trauma Milestone<br />

More than 200 major trauma<br />

patients have been recruited<br />

for a pioneering £10 million<br />

research project looking at<br />

early detectors of probable<br />

susceptibility to in-hospital<br />

infection and / or multi-organ<br />

failure.<br />

The ‘Golden Hour’ study, which<br />

commenced in 2014, is being led<br />

by Research in Emergency and<br />

Acute Care Team at the Queen<br />

Elizabeth Hospital in Birmingham<br />

and is supported by the National<br />

Institute of Health Research<br />

(NIHR). The study aims to improve<br />

patient outcomes by developing<br />

tests to help clinicians treating<br />

those who have suffered a major<br />

trauma to spot the early signs of<br />

whether patients are more likely<br />

to develop a serious infection or<br />

multi-organ failure in hospital in<br />

the days and week following the<br />

initial injury.<br />

The research, which has now<br />

recruited more than half of<br />

the patients required, is being<br />

supported by the critical care<br />

paramedics and pre-hospital<br />

emergency medicine doctors<br />

at Midlands Air <strong>Ambulance</strong><br />

Charity and West Midlands<br />

<strong>Ambulance</strong> Service University<br />

NHS Foundation Trust (WMAS),<br />

who collect blood samples from<br />

appropriate patients during the<br />

first hour of treatment.<br />

Dr Jon Hazeldine, research fellow<br />

at the University of Birmingham,<br />

who is leading the study, explains<br />

the research: “Although the<br />

major and immediate cause of<br />

death following severe trauma<br />

is haemorrhage, many trauma<br />

victims later die following<br />

complications such as multi-organ<br />

dysfunction or sepsis, with the<br />

individual’s immune response to<br />

injury significantly influencing the<br />

chances of developing these lifethreatening<br />

conditions.<br />

“To investigate the immune<br />

response to major trauma the<br />

Golden Hour study analyses blood<br />

samples acquired from trauma<br />

patients at a number of post-injury<br />

time-points. The acquisition of<br />

these samples commences in<br />

the pre-hospital setting, where<br />

patients are enrolled into the<br />

study within 60-minutes of their<br />

injury, a crucial time in which<br />

prompt medical treatment is key<br />

to survival.<br />

“Our collaboration with Midlands<br />

Air <strong>Ambulance</strong> Charity and WMAS<br />

provides us with unique access<br />

to trauma patient blood samples<br />

from the scene of injury, which<br />

enables us to study the immune<br />

system at the earliest possible<br />

opportunity following trauma. This<br />

has yielded new insights into the<br />

post-injury immune response and<br />

has demonstrated the importance<br />

of early blood sampling to truly<br />

understand how trauma alters the<br />

immune system.<br />

“To date, we have recruited more<br />

than 200 patients into the study<br />

and our experiments have shown<br />

that within minutes of injury,<br />

the immune system of trauma<br />

patients is suppressed. Based<br />

on these initial findings, our next<br />

aim is to establish whether, in the<br />

immediate aftermath of a major<br />

injury, there are differences in the<br />

immune responses of patients<br />

who experience poor clinical<br />

outcomes (e.g. the development<br />

of sepsis or multi-organ failure)<br />

compared to those who do not.<br />

If this proves to be the case, then<br />

we would be one step closer to<br />

uncovering potential markers that<br />

could be used to aid in the early<br />

identification and stratification of<br />

patients at risk of poor outcomes,<br />

which could have implications for<br />

their management and treatment.”<br />

Dr Mark Nash, medical director<br />

for Midlands Air <strong>Ambulance</strong><br />

Charity, added: “The first hour<br />

of treatment post-incident is<br />

renowned for being the most<br />

beneficial, giving a patient the<br />

best possible chance of survival<br />

and good recovery. We were<br />

keen to support the Golden Hour<br />

study to assist with patients’<br />

on-going advanced care within<br />

the hospital setting, again giving<br />

those in critical condition the best<br />

chance of a good outcome. The<br />

fact that more than 200 patients<br />

have now been recruited to the<br />

research will help the NIHR to<br />

positively influence in-hospital<br />

care, which will be of great benefit<br />

to patients.”<br />

To find out more about the<br />

Golden Hour study, visit srmrc.<br />

nihr.ac.uk/trials/golden-hour.<br />

Further information on Midlands<br />

Air <strong>Ambulance</strong> Charity is found<br />

at midlandsairambulance.com<br />

and West Midlands <strong>Ambulance</strong><br />

Service is found at wmas.nhs.uk<br />

WAS<br />

<strong>Ambulance</strong> station<br />

welcomes Ukrainian<br />

refugees<br />

Welsh ambulance service<br />

staff have recently welcomed<br />

Ukrainian refugees to their station<br />

Rhyl <strong>Ambulance</strong> Station hosted<br />

Ukrainian refugees who have<br />

settled in the area to teach them<br />

about the Welsh <strong>Ambulance</strong><br />

Service.<br />

As a result of Russia’s invasion<br />

on Ukraine, a large number of<br />

Ukrainian people have been<br />

displaced from their homes.<br />

To welcome them into Rhyl<br />

community, 10 Welsh <strong>Ambulance</strong><br />

staff members gave those families<br />

living in the area a tour of the<br />

station and taught them lifesaving<br />

skills, all through an interpreter.<br />

Dermot O’Leary, Duty Operations<br />

Manager for Conwy and<br />

Denbighshire, who helped arrange<br />

the visit, said: “Humanitarianism<br />

crosses all language barriers.<br />

“It’s been a great experience,<br />

especially seeing the smiles on the<br />

children’s faces as they had a go<br />

at bandaging.<br />

“No words or interpreters are<br />

needed to see enjoyment firsthand.”<br />

The children were able to tour an<br />

emergency ambulance and rapid<br />

response vehicle and learnt how<br />

to perform CPR and how to use a<br />

defibrillator.<br />

Dermot continued: “It was great<br />

to see community engagement in<br />

action, especially from so many<br />

of our staff who willingly gave up<br />

their free time to support the visit.<br />

“Seeing these kids from a wartorn<br />

country being so positive and<br />

upbeat made me really value what<br />

16<br />

For more news visit: www.ambulanceukonline.com


NEWSLINE<br />

I have and realise that despite all<br />

the pressures, we are lucky.”<br />

EEAST<br />

EEAST and Magpas<br />

Air <strong>Ambulance</strong><br />

crews win 999 Hero<br />

category at The<br />

Sun’s Who Cares<br />

Wins awards<br />

Crews from the East of England<br />

<strong>Ambulance</strong> Service NHS<br />

Trust (EEAST) and Magpas<br />

Air <strong>Ambulance</strong> received a<br />

national award for their efforts<br />

in bringing a 13-year-old in<br />

cardiac arrest back to life.<br />

Prime Minister Rishi Sunak<br />

presented the team with the<br />

999 Hero award at the Sun’s<br />

Who Cares Win awards at a<br />

star-studded ceremony at the<br />

Roundhouse in London which<br />

was broadcast on Channel 4 on<br />

Sunday 27th November.<br />

The team won the award for their<br />

work in saving the life of Daisy<br />

Webb, who suffered a cardiac<br />

arrest when walking to school in<br />

Huntingdon in April.<br />

EEAST crew members Grace<br />

Lemin, Harrison Galgut and<br />

Charlie Harris arrived within<br />

minutes of the 999 call from<br />

Tommy Sadler, 15, and his mum<br />

Linda. They discovered Daisy had<br />

had a cardiac arrest, and began<br />

CPR and shocked Daisy’s heart<br />

until her pulse returned.<br />

The crews then handed over care<br />

to colleagues from Magpas Air<br />

<strong>Ambulance</strong>: Dr James Price and<br />

Critical Care Paramedics Steve<br />

Chambers and Thomas Giddings.<br />

The team performed a rapid<br />

general anaesthetic at the incident<br />

scene – a procedure usually only<br />

available in a hospital – to protect<br />

Daisy’s vital functions before<br />

she was transferred by land to<br />

Addenbrooke’s Hospital for further<br />

care. She has since made a full<br />

recovery.<br />

Lesley Hall, Leading Operations<br />

Manager with EEAST who was<br />

also on scene during the incident,<br />

said: “We are all so proud to receive<br />

the award which recognised the<br />

incredible teamwork that saved<br />

Daisy’s life on that day in April.<br />

“We often talk about the chain<br />

of survival in our work and the<br />

actions of everyone involved<br />

changed the course of what could<br />

have happened to Daisy – from<br />

Tommy and Linda calling 999, to<br />

Charlie, Grace and Harrison taking<br />

their swift action to get Daisy’s<br />

heart started and to the seamless<br />

transition of care to the Magpas<br />

Air <strong>Ambulance</strong> critical care team.<br />

“Thanks to everyone involved Daisy<br />

has the rest of life in front of her.<br />

“We all had an amazing evening<br />

meeting so many famous faces<br />

and it was great to receive<br />

recognition for the work that we<br />

do, as the past two years have<br />

been challenging for ambulance<br />

services and the NHS as a<br />

whole.”<br />

Tom Abell, Chief Executive of<br />

East of England <strong>Ambulance</strong><br />

Service, said: “I am really<br />

pleased to hear that Daisy is<br />

recovering well. Everyone at<br />

EEAST is immensely proud of<br />

the team involved in saving<br />

Daisy’s life and receiving the 999<br />

Hero award at The Sun’s Who<br />

Cares Wins awards.<br />

“Our dedicated staff do lifesaving<br />

work like this every day, and<br />

this national recognition for this<br />

wonderful team will hopefully<br />

serve as a boost to their<br />

colleagues who are all working<br />

incredibly hard.”<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

For the latest <strong>Ambulance</strong> Service News visit: www.ambulancenewsdesk.com<br />

17


NEWSLINE<br />

LAS<br />

Paramedic taught<br />

himself to swim for<br />

new role<br />

A paramedic who failed to get<br />

recruited for a specialist team<br />

at London <strong>Ambulance</strong> Service<br />

taught himself to swim so he<br />

could qualify for the role.<br />

After four years working on<br />

ambulances, Han Tugcu was<br />

keen to join the Hazardous Area<br />

Response Team (HART), a group<br />

of specially recruited and highly<br />

trained paramedics who provide<br />

life-saving medical care in highrisk<br />

and complex emergency<br />

situations, such as industrial<br />

accidents and natural disasters.<br />

To join HART, paramedics must<br />

complete a clinical exam and<br />

a fitness test, which includes<br />

swimming.<br />

However despite growing up in<br />

Sydney, Australia - close to some<br />

of the world’s most beautiful<br />

beaches - Han never learned to<br />

swim as a child.<br />

He said: “I don’t know how I<br />

avoided it but as you get older<br />

it gets harder to learn. It was<br />

embarrassing and I felt annoyed<br />

at myself that I couldn’t do it.<br />

“But I really wanted to join HART –<br />

I love working as a team in the big<br />

complex difficult jobs and I always<br />

like a challenge.”<br />

Han watched YouTube tutorial<br />

videos and visited his local pool<br />

a couple of times to try to teach<br />

himself to swim.<br />

However this challenge proved<br />

too much – Han failed the swim<br />

test and did not get the job,<br />

despite doing well in the rest of his<br />

fitness test and the clinical skills<br />

assessment.<br />

He admitted: “I was very stressed<br />

and very embarrassed not to<br />

complete the timed swim. I was<br />

devastated and disheartened<br />

about it.”<br />

Han was encouraged to improve<br />

his swimming and re-apply for<br />

the HART position. In between<br />

shifts, Han kept going back to<br />

the pool whenever he could, and<br />

when he re-applied a few months<br />

later, he managed to successfully<br />

complete the swimming test.<br />

He has since spent weeks<br />

completing tough water rescue<br />

training in Cardiff as well as<br />

learning all the other skills to<br />

prepare him to treat patients in<br />

perilous situations including fires,<br />

collapsed buildings, under trains<br />

or vehicles, or other in hard-toreach<br />

places.<br />

Training manager Chris Gill said:<br />

“Han has demonstrated incredible<br />

fortitude in overcoming his<br />

non-swimmer status and in less<br />

than a year, deftly participated<br />

in a number of water rescue<br />

scenarios.<br />

“He is a credit to himself and<br />

his team; and an inspiration to<br />

others.”<br />

Like all HART paramedics, Han<br />

is also trained to respond to<br />

chemical incidents, terror attacks<br />

and other high risk jobs.<br />

Care Quality Commission’s<br />

(CQC’s) inspection report of 13<br />

July 2022, which recognised<br />

the improved responsiveness of<br />

the Trust to incidents of alleged<br />

bullying, harassment, and<br />

discrimination. The EHRC was<br />

also encouraged by the Trust’s<br />

commitment to continuous<br />

improvement and the ongoing<br />

actions it plans to take.<br />

The action plan – including formal<br />

monitoring – had been agreed<br />

with the EHRC on 26th April<br />

2021 after a referral from the<br />

Care Quality Commission (CQC)<br />

following the inspection in August<br />

2020. That report found that<br />

the Trust had not done enough<br />

to address serious incidents<br />

of sexual abuse against both<br />

patients and staff.<br />

Since then, the Trust has delivered<br />

an action plan to address the<br />

concerns identified which has<br />

included enhanced training<br />

in appropriate behaviours,<br />

strengthening of the policies for<br />

handling cases of harassment and<br />

abuse, and training for managers<br />

which has led to stronger action<br />

when cases occur.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

He added: “The opportunities<br />

and variety you get working as a<br />

paramedic in London surprise me<br />

every day.<br />

“My advice if you’re thinking of<br />

joining? You only grow through<br />

challenging yourself.”<br />

EEAST<br />

EHRC concludes<br />

legal agreement with<br />

EEAST<br />

The East of England <strong>Ambulance</strong><br />

Service (EEAST) NHS Trust has<br />

made significant progress in<br />

tackling sexual harassment and<br />

is no longer under the legally<br />

enforceable action plan which<br />

was agreed with the Equality<br />

and Human Rights Commission<br />

(EHRC) in April 2021.<br />

The EHRC acknowledged the<br />

progress made and noted the<br />

While formal monitoring ended at<br />

the conclusion of the agreement<br />

at the end of October, EEAST has<br />

committed to making continuous<br />

improvements to protect its<br />

workforce and ensure a safe and<br />

supportive workplace.<br />

Tom Abell, Chief Executive of<br />

EEAST, said:<br />

“The conclusion of this agreement<br />

with the EHRC shows the<br />

progress that we have made in<br />

tackling long-standing cultural<br />

issues at the Trust.<br />

“I would like to thank all our<br />

people for their hard work during<br />

a time when our service has been<br />

under severe pressure.<br />

“We still have a long way to<br />

go, and we are committed to<br />

continuing this improvement and<br />

building a culture which is a great<br />

place to work for everyone.”<br />

18<br />

For further recruitment vacancies visit: www.ambulanceukonline.com


NEWSLINE<br />

Over half of NHS<br />

Trusts providing or<br />

planning foodbanks<br />

for staff<br />

New research from NHS<br />

Charities Together suggests<br />

over half of NHS Trusts and<br />

Health Boards could be<br />

providing or planning to provide<br />

foodbanks for their staff, as the<br />

cost of living skyrockets.<br />

In a survey of NHS charities, who<br />

support every Trust and Health<br />

Board in the <strong>UK</strong>, 21% of the 34<br />

who responded said they had an<br />

active foodbank for NHS staff or<br />

are implementing one, and a further<br />

35% are exploring the possibility.<br />

Of the six active foodbanks who<br />

responded, three were newly<br />

opened between October-<br />

December 2022. Across these six<br />

alone, they estimate nearly 5000<br />

NHS staff are making use of them<br />

on a monthly basis, with around<br />

550 of these nurses.<br />

In addition to food banks, over<br />

half of the NHS charities surveyed<br />

(53%) are looking at other food<br />

support for staff – these include<br />

voucher programmes, free<br />

breakfasts, and subsidised meals<br />

in the canteen, where staff can<br />

also bring their families.<br />

Ellie Orton OBE, Chief Executive<br />

of NHS Charities Together, said:<br />

“As the cost of living escalates, like<br />

many employers NHS Trusts and<br />

the charities who support them are<br />

looking at ways to help staff through<br />

the crisis. But with pressures facing<br />

NHS workers already so extreme,<br />

it’s heart-breaking that some are<br />

having to resort to using food banks<br />

to get by.<br />

“Right now hardship funds<br />

and support are the main topic<br />

of interest for NHS charities.<br />

Queries from our members range<br />

from the setting up of Benevolent<br />

Funds and access to travel<br />

bursaries, to the possibility of<br />

providing hot meal vouchers and<br />

other basic support, including<br />

food banks.<br />

“As a sector we are proud to<br />

support the staff and patients of<br />

the NHS however we can, and<br />

sadly today that support is more<br />

important than ever.”<br />

Examples of the response to<br />

increased need amongst staff<br />

include in Liverpool, where<br />

Liverpool Women’s NHS<br />

Foundation Trust’s partnership<br />

with a food poverty charity is<br />

providing around three trollies of<br />

food a week, with other staff also<br />

donating items.<br />

Michelle Turner, Chief People<br />

Officer and Deputy Chief<br />

Executive at Liverpool Women’s<br />

NHS Foundation Trust, said:<br />

“We know with the pressures of<br />

the current financial climate, like<br />

many other people our staff may<br />

be finding things more difficult at<br />

the moment. We decided to set<br />

up a staff pantry to provide help<br />

to anyone who may need it - no<br />

questions asked. The pantry<br />

consists of sealed and dry foods<br />

as well as other essential items<br />

such as sanitary products which<br />

can be accessed by staff 24/7.<br />

The running costs of the pantry is<br />

managed through our staff health<br />

and wellbeing fund as well as<br />

relying on kind donations of items<br />

from staff who are in a position to<br />

donate and donations from other<br />

partners in the city. So far it has<br />

been very well received and we<br />

will continue offering it for as long<br />

as it is needed.”<br />

>>><br />

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NEWSLINE<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

In Lothian, Food Pantries have<br />

been set up by the local Unison<br />

branch with support from NHS<br />

Lothian Charity and Edinburgh<br />

and East Lothian Food Projects<br />

to help staff who are struggling<br />

financially because of the<br />

increased prices of gas, electricity,<br />

mortgages and more.<br />

Jane Ferguson, Director of NHS<br />

Lothian Charity, said: “As an NHS<br />

charity, we are committed to<br />

working together with partners<br />

to support our local NHS staff<br />

who are experiencing economic<br />

hardship as a result of this crisis<br />

in whichever way we are able to.<br />

Unison Lothian Health Branch<br />

had been made aware that some<br />

staff were struggling to buy food<br />

for their children or didn’t have<br />

enough for their bus fare to<br />

come into work and, together,<br />

we wanted to do something<br />

to help. With funding from the<br />

Charity for food parcels, Unison<br />

has co-ordinated setting up Food<br />

Pantries at various sites across<br />

Edinburgh, Midlothian, East<br />

Lothian and West Lothian for staff<br />

in need of additional support.”<br />

As the national charity caring for<br />

the NHS, NHS Charities Together<br />

works with a network of over 230<br />

NHS charities providing extra<br />

support in every hospital and<br />

health board in the <strong>UK</strong>. To find<br />

out more about NHS Charities<br />

Together and the work NHS<br />

charities do to support staff,<br />

please visit<br />

www.nhscharitiestogether.co.uk<br />

YAS<br />

Yorkshire <strong>Ambulance</strong><br />

Service staff praised<br />

for long service<br />

Members of staff with a<br />

combined service of 3,280<br />

years have been recognised by<br />

Yorkshire <strong>Ambulance</strong> Service<br />

NHS Trust (YAS) at the Long<br />

Service and Retirement Awards<br />

2022, including one member<br />

of staff who has clocked up an<br />

incredible 50 years.<br />

They gathered for the special<br />

celebration at Pavilions of<br />

Harrogate and were joined by<br />

other guests including Reverend<br />

Brian Hunt, Deputy Lieutenant of<br />

North Yorkshire.<br />

This year’s recipients of awards<br />

for 20, 30, 40 and 50 years’<br />

service include staff from A&E<br />

Operations, the Emergency<br />

Operations Centre, nonemergency<br />

Patient Transport<br />

Service, NHS 111, clinical<br />

education, project management,<br />

and quality improvement.<br />

The honours also included<br />

the Queen’s Long Service and<br />

Good Conduct Medal, which<br />

was awarded to 32 staff on the<br />

day for 20 years’ exemplary<br />

frontline emergency service and<br />

14 retirees were also recognised<br />

for their valuable service to the<br />

Trust and communities across<br />

Yorkshire.<br />

In total, 43 individuals were<br />

congratulated for achieving<br />

20 years’ NHS service and 10<br />

individuals for reaching the 30<br />

years’ service milestone. Seven<br />

staff were recognised for an<br />

incredible 40 years of service.<br />

The longest-serving member of<br />

staff in attendance was Service<br />

Development Project Manager<br />

(Integrated Urgent Care) Bob<br />

Sunley, who picked up an award<br />

for an outstanding 50 years’<br />

service.<br />

Bob started his career with<br />

East Yorkshire County Council<br />

<strong>Ambulance</strong> Service (which later<br />

became Humberside <strong>Ambulance</strong><br />

Service) on 1 March 1971 as an<br />

ambulance cadet, working initially<br />

as an ambulanceman in Beverley<br />

and Bridlington. He also worked<br />

in the control room where he<br />

was Control Superintendent.<br />

After 23 years in operations, he<br />

became Director of Business<br />

Development for Humberside<br />

<strong>Ambulance</strong> Service, before taking<br />

on the role of General Manager<br />

for NHS Direct when it was<br />

hosted by Tees, East and North<br />

Yorkshire <strong>Ambulance</strong> Service<br />

(TENYAS). Latterly, he has been<br />

a huge part of the NHS 111<br />

management team, delivering<br />

many successful projects in the<br />

urgent care service.<br />

Rod Barnes, Chief Executive of<br />

Yorkshire <strong>Ambulance</strong> Service<br />

NHS Trust, said:<br />

“The pressures the service and<br />

wider NHS have faced over the<br />

last three years have been the<br />

most significant of our lifetime<br />

and are likely to be with us for<br />

some time to come. This has<br />

tested our physical and emotional<br />

resilience as never before.<br />

“During these pressured<br />

moments we often don’t spend<br />

enough time simply letting people<br />

know how we feel, saying thankyou<br />

or well done, you’ve done a<br />

great job.<br />

“So, it’s even more important that<br />

we take time at these awards<br />

ceremonies to ensure colleagues<br />

are recognised for the fantastic<br />

work that they do and their<br />

tireless dedication to patient care.<br />

“The commitment, compassion<br />

and teamwork shown by people<br />

across the service in responding<br />

to the pandemic and wider<br />

challenges has been simply<br />

extraordinary and humbling<br />

to witness. Everyone has<br />

consistently gone above and<br />

beyond for our patients, and<br />

they all have so much to be really<br />

proud about.”<br />

The awards ceremony was also<br />

an opportunity for members<br />

of staff who recently retired to<br />

celebrate a lifetime of service to<br />

the NHS. Some of them enjoyed<br />

their jobs so much that they<br />

have come out of retirement and<br />

returned to work.<br />

SWASFT<br />

<strong>Ambulance</strong> service<br />

wins national award<br />

for new system that<br />

helps vulnerable<br />

patients<br />

A new IT system which has<br />

transformed how the South<br />

Western <strong>Ambulance</strong> Service<br />

NHS Foundation Trust<br />

(SWASFT) identifies and helps<br />

vulnerable patients, has won a<br />

national award.<br />

SWASFT teamed up with Exeterbased<br />

Iridium Consulting to create<br />

the Frequent Caller Management<br />

System (FCMS), which has won<br />

the Best Healthcare Management<br />

Solution category in the Health<br />

Tech Digital Awards 2022.<br />

The system was developed in Exeter<br />

and Bristol but serves patients from<br />

across the whole of the South West<br />

region from the Isles of Scilly to<br />

North Gloucestershire.<br />

FCMS is the first system of its<br />

kind in the <strong>UK</strong> that automatically<br />

identifies any individual who meets<br />

the criteria of being a frequent<br />

caller to 999 and who contacts<br />

the ambulance service from within<br />

its geographical area.<br />

Previously, SWASFT’s database<br />

could identify only addresses, not<br />

people – which caused problems<br />

if callers were away from home, or<br />

if they lived in a house of multiple<br />

occupancy.<br />

The bespoke system uses a<br />

unique algorithm to identify<br />

people who contact the service<br />

frequently and enables SWASFT<br />

to provide accurate, up-to-date<br />

information to Multi-Disciplinary<br />

Team meetings about them. Its<br />

data also helps shape specialised<br />

programmes for this group of<br />

20<br />

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NEWSLINE<br />

patients. Together, this enables<br />

them to receive more personalised<br />

care.<br />

Frequent callers, defined as<br />

anyone who calls the ambulance<br />

service five times or more in one<br />

month, are vulnerable because<br />

they often have a complex<br />

mixture of medical, social and<br />

psychological needs. This<br />

means they need the help of a<br />

Multi-Disciplinary Team and can<br />

experience repeated difficulties<br />

when trying to access care and<br />

support.<br />

“Distilling and presenting such<br />

a large dataset into a concise,<br />

more manageable and meaningful<br />

version required new approaches<br />

and solutions, making FCMS a<br />

truly unique application in the<br />

space. It wouldn’t have been<br />

possible without such a close<br />

working relationship with the team<br />

at SWASFT and it is an honour to<br />

see the application being used as<br />

a central tool for managing such<br />

a complex part of the service<br />

SWASFT provides.”<br />

Other benefits of FCMS include:<br />

Jonathan Hammond-Williams,<br />

SWASFT’s Complex Care Lead,<br />

says: “This system helps us to<br />

identify and support some of our<br />

most vulnerable patients. They are<br />

often socially isolated and have<br />

not one but several health needs.<br />

Having multiple problems coming<br />

together forms what can feel like<br />

the perfect storm for them.<br />

“FCMS has revolutionised what<br />

we do. We have gone from<br />

manually counting houses to<br />

automatically providing data to<br />

help improve each individual<br />

patient’s quality of life. It allows<br />

us to track who has called and<br />

why, and to support the wider<br />

healthcare system in getting them<br />

the personalised help they need.<br />

“It was a real team effort to<br />

develop FCMS and I’m so<br />

pleased SWASFT and Iridium<br />

Consulting have earned this<br />

national acknowledgement. I’d<br />

like to thank everyone who has<br />

contributed, both within and<br />

outside the ambulance service”.<br />

Sam Rankin, Director of Iridium<br />

Consulting, says: “We were<br />

delighted when we learnt about<br />

winning the award. Overcoming<br />

the challenges to design and<br />

develop FCMS to support the<br />

ambulance service that serves 20<br />

per cent of England’s land-mass is<br />

something the team at Iridium are<br />

immensely proud of.<br />

• Reducing the number of distinct<br />

frequent callers to SWASFT<br />

from 1,500 a month in 2018<br />

to 925 in 2022, as callers are<br />

supported by more appropriate<br />

services than an emergency<br />

ambulance<br />

• Improving the availability of<br />

ambulances across the South<br />

West to attend life-threatening<br />

emergencies<br />

• Providing a one-stop shop for<br />

health professionals to see all<br />

previous episodes of care, the<br />

reasons for a call, and the actions<br />

completed by the clinicians<br />

involved in their 999 calls<br />

• Enabling improved links<br />

with other parts of the NHS,<br />

including acute hospitals trusts<br />

and mental health trusts.<br />

Jess Taylor, Senior Frequent Caller<br />

Administrator, helped develop the<br />

system. She adds: “FCMS allows<br />

us to put the patient at the centre of<br />

everything we do. A lot of work has<br />

gone into the system, so it’s very<br />

humbling and very exciting to get<br />

that recognition on a national level”.<br />

The system, which became<br />

operational in November 2020,<br />

has also supplied data that has<br />

helped shape services for this<br />

very vulnerable group of patients<br />

across the whole of the South<br />

West, with at least five new<br />

services being developed within<br />

parts of the region as a result.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

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21


NEWSLINE<br />

LAS<br />

“Don’t ‘man up’,<br />

get help!” – 999<br />

call handler opens<br />

up about mental<br />

health struggle as he<br />

appeals for men to<br />

seek support<br />

A London <strong>Ambulance</strong> Service<br />

(LAS) emergency call handler<br />

is urging men to seek mental<br />

health support as soon as they<br />

realise something is wrong,<br />

and not shy away from having<br />

that conversation with their<br />

loved ones.<br />

Scott Robertson, 33, who has<br />

worked as an LAS emergency<br />

call coordinator since 2019,<br />

made the appeal to mark<br />

Men’s Mental Health Month in<br />

November 2022.<br />

Scott was diagnosed with<br />

bipolar disorder four years<br />

ago but has suffered from<br />

poor mental health since his<br />

adolescence.<br />

Living with bipolar disorder<br />

means his life can be affected<br />

by extreme mood swings, and<br />

without the appropriate medical<br />

and psychological approach,<br />

he can face periods of severe<br />

emotional highs and lows.<br />

He said: “Living with bipolar<br />

almost feels like my mood is<br />

under a magnifying glass. I take<br />

medications to keep my mood<br />

stable, but there are periods<br />

in which my mental health can<br />

deteriorate.<br />

“Just a couple of months ago,<br />

I had a depressive episode<br />

and had to take some time off<br />

work and throw myself into my<br />

support network, which includes<br />

my husband, brother, and<br />

manager.”<br />

With calls to 999 often being<br />

the first point of care for those<br />

in a mental health crisis, Scott<br />

is witness to the mental health<br />

struggles of many Londoners.<br />

From September 2021 to<br />

August 2022, nearly 186,000<br />

calls with a potential mental<br />

health element were made to<br />

London <strong>Ambulance</strong> Service,<br />

86,758 of which were from male<br />

patients.* Over the past year, our<br />

staff and volunteers attended<br />

18,735 call-outs to patients with<br />

suicidal symptoms or having<br />

attempted suicide, and 9,028 of<br />

these incidents involved a male<br />

patient.**<br />

Scott fears that the number of<br />

men in London suffering from<br />

mental health conditions is<br />

higher than LAS figures may<br />

depict.<br />

“Societal pressures can put men<br />

off from calling for help, he said.<br />

“I felt a sense of shame when<br />

confessing my mental health<br />

condition, because I felt the<br />

pressure to ‘man up’ and meet<br />

the standard of what a man<br />

should be.<br />

“When I was diagnosed with<br />

bipolar I became very secretive<br />

about it. I was ashamed of the<br />

diagnosis and I didn’t want<br />

“If someone calls 999, they want<br />

to reach out and talk about<br />

the problem. When they don’t,<br />

they’re quick enough to tell you<br />

and you change the subject as<br />

necessary.”<br />

Having battled with low mood<br />

for a large part of his life, Scott<br />

wants to normalise the debate<br />

around mental health, especially<br />

amongst men, who can face<br />

stigma when opening up.<br />

Scott’s advice is straightforward:<br />

“Don’t ‘man up’, get help! If<br />

you have a support network<br />

– a group of trusted friends or<br />

family, then give them a chance.<br />

Sometimes you write people off<br />

thinking that they’re not going to<br />

understand. But I’ve found that<br />

the minute you open up, people<br />

do want to understand and want<br />

to support you.<br />

“The more we open up, the more<br />

we discuss mental health, the<br />

more we empower those around<br />

us to do the same and support<br />

each other.”<br />

anyone to know about it. I<br />

If you are having suicidal<br />

swore the people around me to<br />

thoughts, thoughts of harming<br />

secrecy, Scott continued.<br />

yourself or others, or if you do<br />

not feel you can keep yourself<br />

“As a gay man, I felt a bit<br />

and someone else safe call 999<br />

excluded from typical ideas<br />

or go to A&E now.<br />

of masculinity. Being then<br />

diagnosed with a mental health<br />

If you need help urgently for your<br />

condition made me fear that I<br />

mental health, but it’s not an<br />

wouldn’t be taken as seriously<br />

emergency call 111 or use NHS<br />

as a straight, healthy man.”<br />

111 online service.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

But Scott’s battle with mental<br />

health, which has marked over<br />

half of his life, now acts as an<br />

inspiration to better empathise<br />

with patients who are at crisis<br />

point.<br />

He said: “I experience those<br />

crises myself and I know the<br />

desperation that you can feel<br />

in those situations, so I’m<br />

not frightened to have those<br />

conversations with patients.<br />

If you are experiencing<br />

symptoms such as low mood,<br />

anxiety, and depression call 111<br />

or speak to your GP.<br />

To access more mental health<br />

services, visit www.nhs.uk/<br />

nhs-services/mental-healthservices/.<br />

Your mental health is as important<br />

as your physical health. You will<br />

not be wasting anyone’s time.<br />

22<br />

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NEWSLINE<br />

New mental health<br />

ambulances scheme<br />

to take pressure off<br />

other emergency<br />

services - Hexagon<br />

comments<br />

The <strong>UK</strong> Government<br />

announced* that a £150<br />

million investment will be<br />

made to support those<br />

experiencing mental health<br />

issues through specialised<br />

mental health ambulances<br />

and other crisis services. The<br />

investment will enable the<br />

procurement of approximately<br />

100 new mental health<br />

ambulances, which will<br />

take specially trained staff<br />

directly to patients in order<br />

to deliver support on the<br />

scene or transfer them to an<br />

appropriate place of care.<br />

With patients facing mental health<br />

problems being twice as likely<br />

to spend 12 hours or more in<br />

emergency departments than<br />

other patients, this funding will<br />

allow 150 new projects centered<br />

on supporting the provision of<br />

mental health crisis response<br />

to enable more convenient and<br />

efficient care for mental health<br />

patients whilst reducing critical<br />

hospital admissions.<br />

Nick Chorley, director of public<br />

safety and security for EMEA at<br />

Hexagon’s Safety, Infrastructure<br />

& Geospatial division, welcomes<br />

these new programmes and<br />

comments on what else needs to<br />

be considered.<br />

“Given the rise in patients<br />

presenting with mental health<br />

issues, it is great to see<br />

programmes being rolled out to<br />

provide better patient care, by<br />

delivering specialist staff who are<br />

more adept in dealing with mental<br />

health emergencies. Equally, it<br />

is essential that specialist and<br />

expensive resources like sworn<br />

police officers or ambulances<br />

that are uniquely able to perform<br />

certain tasks are kept available for<br />

those tasks when they happen and<br />

not tied up on tasks that others<br />

can perform. Nonetheless, whilst<br />

this is a step in the right direction<br />

for improving care of mental<br />

health patients, if the triaging<br />

of appropriate care remains<br />

ineffective, patients will not receive<br />

the help they need, and this<br />

investment will be wasted.<br />

“Indeed, the <strong>UK</strong> Government<br />

must streamline the way<br />

emergency services respond<br />

to patients experiencing mental<br />

health issues by ensuring that<br />

modern technology is available<br />

to accommodate these new<br />

programmes. One of the best<br />

ways that technology can help<br />

this new way of dispatching<br />

personnel to mental health<br />

emergencies is via data analysis.<br />

Utilising analytics from routine<br />

operational data, such as call data<br />

from computer-aided dispatch<br />

systems, emergency centre<br />

managers can gain insights to<br />

help ensure that the right member<br />

of staff is assigned to the job that<br />

they are best placed to deal with.<br />

Operational data and analytics can<br />

also be integrated with artificial<br />

intelligence to offer new levels of<br />

assistive insights to dispatchers,<br />

enabling the best possible level of<br />

care to be provided to the patient at<br />

hand. Not only do these solutions<br />

have the potential to treat mental<br />

health emergencies quicker and<br />

more efficiently, but they can also<br />

save emergency service resources.”<br />

*https://www.gov.uk/<br />

government/news/mental-<br />

health-services-boosted-by-<br />

150-million-government-funding<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

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23


NEWSLINE<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

LAS<br />

Paramedic speaks<br />

out after patient<br />

jailed for sexual<br />

assault<br />

A paramedic at London<br />

<strong>Ambulance</strong> Service who<br />

was sexually assaulted by a<br />

patient has spoken out in the<br />

hope it will encourage others<br />

to seek justice – after her<br />

attacker was jailed.<br />

Naveed Ahmed, aged 35, of<br />

Hickling Road, Ilford, was jailed<br />

in November for nine months<br />

after he groped paramedic<br />

Charlotte Miller and exposed<br />

himself.<br />

Charlotte has waived her<br />

right to anonymity, which is<br />

automatically granted to victims<br />

of sexual offences, in the hope it<br />

will encourage others to report<br />

similar crimes.<br />

She said: “My crewmate and I<br />

were encouraging the patient to<br />

get into the ambulance so we<br />

could assess him but he grabbed<br />

my crotch and tried to grab me<br />

again. Then he pulled his pants<br />

down.<br />

“I couldn’t believe it, I was asking<br />

myself if it really happened. I was<br />

frightened and scared. I think the<br />

reason I was so shocked was<br />

because it was so unexpected –<br />

I was there to help him.”<br />

Newly released footage from an<br />

ambulance video camera, shows<br />

Charlotte on her radio calling the<br />

police moments after the assault.<br />

Police officers arrived in less than<br />

a minute and arrested Ahmed<br />

after the incident in Edgware<br />

Road last October.<br />

Charlotte added: “The whole<br />

thing was sickening and<br />

disgusting and really made us<br />

feel quite vulnerable.<br />

“But I would urge everyone to<br />

report these things because I was<br />

well supported by my management<br />

team and by the police.<br />

“It’s only by reporting this sort of<br />

behaviour and helping police to<br />

prosecute that the message will<br />

get through that there are serious<br />

consequences.”<br />

In 2022 there were a total of<br />

49 sexual assaults on London<br />

<strong>Ambulance</strong> Service (LAS) staff or<br />

volunteers. There were a further<br />

516 physical assaults – including<br />

kicking, punching, head-butting<br />

and attacks with a weapon - and<br />

601 reports of verbal abuse or<br />

threats of violence.<br />

The Service has invested more<br />

than £3 million in kitting out its<br />

ambulances with video cameras<br />

aimed at protecting crews. So far,<br />

video captured by the ambulance<br />

cameras has been used in several<br />

successful prosecutions, with 92<br />

submissions of video evidence<br />

since April 2022.<br />

London <strong>Ambulance</strong> Service’s<br />

Chief Paramedic Dr John Martin<br />

said: “Our ambulance crews and<br />

call handlers should be able to<br />

work without fear of violence,<br />

sexual violence or threats.<br />

“They come to work each day<br />

to help others so we will do<br />

everything we can to keep them<br />

safe and ensure they are treated<br />

with the respect they deserve.”<br />

LAS joined ambulance services<br />

across the country to launch a<br />

“Work Without Fear” campaign<br />

to promote a no-violence culture<br />

and help create a safer work<br />

environment for front-line staff and<br />

volunteers.<br />

The Service has dedicated<br />

Violence Reduction Officers who<br />

encourage colleagues to report<br />

all incidents of abuse while also<br />

supporting them through the court<br />

process.<br />

Detective Constable Jorge Sobral,<br />

of the Metropolitan Police, was<br />

part of the team who pursued the<br />

case again Ahmed.<br />

He said: “Our colleagues in the<br />

ambulance service dedicate their<br />

lives to helping people, and it is<br />

not acceptable for them to be<br />

treated like this.<br />

“We will always investigate<br />

crimes like this and I would urge<br />

people to always report this sort<br />

of appalling behaviour to the<br />

police. This was a good result<br />

and will hopefully change people’s<br />

behaviour.”<br />

‘Unusual norovirus<br />

activity’ sees cases<br />

soar 37% higher<br />

than pre-pandemic<br />

average<br />

The <strong>UK</strong>HSA is reporting a 37%<br />

surge in cases of norovirus –<br />

often called winter vomiting<br />

sickness – compared to pre-<br />

Covid levels for the first weeks<br />

of January. As it warns ‘unusual<br />

norovirus activity’ will continue,<br />

a leading testing expert fears<br />

further strains on the NHS.<br />

Cases of norovirus, commonly<br />

known as winter vomiting<br />

sickness, have soared by 37%<br />

compared to the same period<br />

pre-Covid. A report from the <strong>UK</strong><br />

Health Safety Agency (<strong>UK</strong>HSA)<br />

says cases for the first two weeks<br />

in January jumped by 37% over<br />

the five season average prepandemic,<br />

with over 65s reporting<br />

the steepest rise.<br />

A leading testing expert is<br />

concerned that the changing<br />

pattern may indicate a further<br />

surge to come. He cautions that<br />

the virus has not returned to its<br />

overall pre-pandemic seasonal<br />

trend this winter and warns health<br />

professionals to take note of<br />

the <strong>UK</strong>HSA’s observation that<br />

24<br />

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NEWSLINE<br />

‘unusual norovirus activity will<br />

continue throughout the 2022/23<br />

season’.<br />

Dr Quinton Fivelman PhD, Chief<br />

Scientific Officer at London Medical<br />

Laboratory, says: ‘Norovirus is<br />

a very unpleasant virus. As its<br />

common name, winter vomiting<br />

bug, implies, it often causes<br />

sickness and diarrhoea. Other<br />

symptoms can include a fever,<br />

headache and aching arms and<br />

legs. Typically, it doesn’t last very<br />

long and usually goes away in<br />

two to three days, but it can lead<br />

to complications. In particular,<br />

children and the elderly can be<br />

badly affected by this virus and<br />

may require hospital treatment.<br />

‘The obvious concern is that the<br />

NHS has no spare capacity to<br />

deal with a further epidemic this<br />

winter, on top of Covid, flu and<br />

Strep A outbreaks. With industrial<br />

action in the health service set<br />

to escalate, increasing cases<br />

of norovirus couldn’t come at a<br />

worse time.<br />

‘Commonly, the most serious<br />

complication from norovirus is<br />

dehydration, particularly if you<br />

or your child cannot keep fluids<br />

down. In the case of babies and<br />

young children, seek medical<br />

advice if they stop breast or bottle<br />

feeding, or if they show other<br />

signs of dehydration such as<br />

fewer wet nappies.<br />

‘You should call 111 if you (or<br />

your child) have bloody diarrhoea<br />

or bleeding from the bottom,<br />

diarrhoea for more than 7 days or<br />

vomiting for more than 2-3 days.<br />

‘Concerning though this sudden<br />

jump in cases is, the good news<br />

is that it is unlikely that we are<br />

seeing a new mutation, despite<br />

the warning of “unusual” activity.<br />

This winter, the main strain<br />

continues to be genogroup 2 (GII)<br />

that makes up 74% of cases,<br />

with the main genotype being<br />

GII.4, causing 32% of cases. Last<br />

winter, GII caused 90% of cases<br />

and GII.4 specifically 48%.<br />

‘Rather than any new variant,<br />

the main reason for this month’s<br />

spike in cases is likely to be that<br />

immunity against norovirus is<br />

fairly short-lived and during the<br />

pandemic fewer people were<br />

exposed to the virus than normal.<br />

Now everyone is mixing again,<br />

cases are increasing. This virus<br />

spreads very easily and quickly,<br />

more so than the other viruses<br />

causing illness this winter.<br />

‘With our immunity down, it’s<br />

sensible to take precautions to<br />

avoid this unpleasant virus, if<br />

possible. You can catch norovirus<br />

from:<br />

• close contact with someone<br />

with the virus<br />

• touching surfaces or objects<br />

that have the virus on them,<br />

then touching your mouth<br />

• eating food that’s been<br />

prepared or handled by<br />

someone with norovirus<br />

‘As with Covid, washing your<br />

hands frequently with soap and<br />

water is the best way to stop it<br />

spreading. However, it’s important<br />

to note that alcohol hand gels<br />

don’t kill this bug.<br />

‘A general health test might be a<br />

useful course of action for anyone<br />

concerned, to ensure they are<br />

in good health to fight infections<br />

and reduce the likelihood of<br />

needing access to health services<br />

this winter. London Medical<br />

Laboratory’s General Health<br />

Profile Test provides people with a<br />

comprehensive check-up of their<br />

general health, including diabetes<br />

(HbA1c), gout, liver & kidney<br />

function, bone health, iron levels<br />

and a full cholesterol profile. Other<br />

more comprehensive tests check<br />

your vitamin D levels, which are<br />

often low at this time of year, and<br />

any potential thyroid or hormonal<br />

imbalances.<br />

‘They can be taken at home<br />

through the post, or at one of the<br />

many drop-in clinics that offer<br />

these tests across London and<br />

nationwide in over 90 selected<br />

pharmacies and health stores.<br />

If done in-store, a full blood test<br />

can be added that can indicate<br />

a wide range of issues such as<br />

infection, anaemia and leukaemia.<br />

For full details, see: https://www.<br />

londonmedicallaboratory.com/<br />

product/general-health<br />

AAKSS<br />

Tracey Crouch MP<br />

presents the Queen’s<br />

Platinum Jubilee<br />

medals to front<br />

line staff from Air<br />

<strong>Ambulance</strong> Charity<br />

Kent Surrey Sussex<br />

(KSS)<br />

On Friday 25 November Tracey<br />

Crouch, MP for Chatham<br />

and Aylesford, attended the<br />

Rochester headquarters of<br />

Air <strong>Ambulance</strong> Charity Kent<br />

Surrey Sussex (KSS) to present<br />

the Queen’s Platinum Jubilee<br />

Medals to front line staff from<br />

the life-saving charity.<br />

KSS invited Tracey Crouch to<br />

present the medals in recognition<br />

of the exceptional role she played,<br />

in partnership with Air <strong>Ambulance</strong>s<br />

<strong>UK</strong> (AA<strong>UK</strong>), in persuading the<br />

Government to enable eligible staff<br />

from Air <strong>Ambulance</strong> charities to be<br />

included in the medal allocation.<br />

Prior to this campaign, no one<br />

directly employed from the Air<br />

<strong>Ambulance</strong> sector was included in<br />

the awards.<br />

As part of the activity to extend<br />

the award eligibility to Air<br />

<strong>Ambulance</strong> staff, Tracey Crouch<br />

rallied support from 25 MPs<br />

across Kent, Surrey and Sussex.<br />

Together they signed a joint letter<br />

to the Rt Hon Sajid Javid MP, who<br />

was then the Secretary of State<br />

for Health and Social Care.<br />

David Welch, CEO, KSS said:<br />

“KSS wrote to Tracey Crouch<br />

earlier this year to highlight the<br />

exclusion of air ambulance staff<br />

from these awards and she<br />

immediately offered her support.<br />

Her actions resulted in the<br />

Department of Health and Social<br />

Care including eligible Helicopter<br />

Emergency Medical Services staff.<br />

“I couldn’t be prouder of the fact<br />

that 41 paramedics, doctors and<br />

pilots from Team KSS received<br />

their prestigious Platinum Jubilee<br />

Medals today. Without Tracey<br />

Crouch’s support, and the support<br />

from all our local MPs across<br />

Kent, Surrey and Sussex as well<br />

as Air <strong>Ambulance</strong>s <strong>UK</strong>, it would<br />

not have been possible for them<br />

to have received this honour.”<br />

Tracey Crouch MP said: “The<br />

air ambulance is a vital part of<br />

our emergency services ecosystem<br />

and it seemed incredibly<br />

unfair that they were due to be<br />

exempt from recognition. With<br />

their base situated on the border<br />

of my constituency I often see<br />

the helicopter heading off to<br />

or returning from an incident,<br />

knowing that they are called to the<br />

most difficult and challenging of<br />

situations taking the equivalent of<br />

an emergency department right<br />

to the scene. It was my absolute<br />

privilege to co-ordinate a call<br />

for their inclusion in the Queen’s<br />

Platinum Jubilee Medals and I am<br />

humbled to present them to some<br />

absolute heroes.”<br />

KSS provides world-leading<br />

pre-hospital emergency care<br />

whenever and wherever required<br />

to save lives and ensure the<br />

best possible patient outcomes.<br />

Its crews of pilots, doctors and<br />

paramedics responded to 3,051<br />

incidents in 2021, the charity’s<br />

busiest year in its 32-year history<br />

– and so far this year, the service<br />

has been in demand more than<br />

ever before.<br />

>>><br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

Do you have anything you would like to add or include in Newsline? Please contact us and let us know.<br />

25


NEWSLINE<br />

Each year, KSS must raise<br />

£15.2M to operate its life-saving<br />

service. 86% of its total income<br />

is raised through the generosity<br />

of KSS’s supporters. For further<br />

information, please visit www.<br />

aakss.org.uk<br />

Galen and College of<br />

Paramedics call for<br />

entries for the Dr John<br />

Hinds Scholarship<br />

Award <strong>2023</strong><br />

Galen, the privately-owned<br />

pharmaceutical sales and<br />

marketing company is<br />

pleased to announce that<br />

applications for the Dr John<br />

Hinds Scholarship Award <strong>2023</strong><br />

are now open across Northern<br />

Ireland and the Republic of<br />

Ireland.<br />

The scholarship, which runs in<br />

association with The College<br />

of Paramedics, is presented<br />

in memory of the late Dr John<br />

Hinds, who was regarded<br />

as an inspirational leader by<br />

paramedics and emergency<br />

medical technicians and those in<br />

pre-hospital care within Ireland.<br />

A world-renowned critical care<br />

physician, Dr Hinds gave a<br />

huge amount of his own time<br />

to educating and supporting<br />

paramedics and ambulance staff<br />

throughout the Island of Ireland.<br />

He died in 2015 following a<br />

motorcycle accident.<br />

The recipient of the scholarship<br />

will win a fully funded place on<br />

the highly coveted Anaesthesia<br />

Trauma and Critical Care (ATACC)<br />

course and have their case<br />

study published in the College<br />

of Paramedics’ magazine,<br />

‘Paramedic INSIGHT’.<br />

Dr Dennise Broderick, Managing<br />

Director & President, Galen, said:<br />

“We are delighted to support this<br />

award for a fourth year, through<br />

our partnership with The College<br />

of Paramedics and pay tribute to<br />

Dr John Hinds’ legacy.<br />

“At Galen, we appreciate now<br />

more than ever the importance<br />

of the work undertaken<br />

by emergency medicine<br />

professionals right across the<br />

island of Ireland. We hope that<br />

through this scholarship we<br />

can support the emergency<br />

medicine sector in a small way,<br />

by providing a unique opportunity<br />

for healthcare professionals to<br />

advance their expertise and gain<br />

access to a globally recognised<br />

training programme.”<br />

Imogen Carter, Executive Officer<br />

for Policy Development at the<br />

College of Paramedics said:<br />

“The College of Paramedics<br />

is proud to host this award in<br />

the name of Dr John Hinds, in<br />

partnership with Galen. We look<br />

forward to receiving many highquality<br />

clinical case studies from<br />

responders across NI and ROI by<br />

the 27th of <strong>February</strong>.”<br />

To apply for the scholarship<br />

award, entrants must submit<br />

a Clinical Case Study that<br />

was experienced in person.<br />

Submissions should be<br />

750–1,000 words, excluding<br />

references and appendices and<br />

be written to protect patient<br />

confidentiality. As a condition of<br />

the award, the case study will<br />

be submitted for publication in<br />

Paramedic INSIGHT magazine<br />

which has over 20,000<br />

subscribers, along with a followup<br />

article that describes their<br />

experience on the ATACC course.<br />

Submissions must be made using<br />

the Dr John Hinds Scholarship<br />

Award Entry Form, available at<br />

the following link: https://galenpharma.com/news-events/news/<br />

john-hinds-scholarship-<strong>2023</strong> and<br />

submitted via email to awards@<br />

collegeofparamedics.co.uk by<br />

4pm on Monday 27th <strong>February</strong><br />

<strong>2023</strong>.<br />

The College Honours and Awards<br />

Committee will then select the<br />

winning piece. The awards<br />

ceremony will take place at the<br />

College of Paramedics National<br />

Conference on 23rd May <strong>2023</strong>.<br />

WAS<br />

Cheryl’s wing walk<br />

for charity<br />

A Welsh <strong>Ambulance</strong> Service<br />

worker is walking along a<br />

biplane wing for charity.<br />

Cheryl Hunter, a Volunteer Car<br />

Service Administrator for the<br />

Trust, will be walking the wing of<br />

a biplane to raise money for St<br />

Kentigern Hospice in memory of<br />

her father, James Miller Irvine.<br />

“But after seeing a picture of<br />

someone wing-walking a couple<br />

of years ago I just thought that I<br />

would love to do it, and why not<br />

fundraise while doing it.”<br />

The 60-year-old, who has<br />

worked for the Trust for 22<br />

years, will be taking on the<br />

aerial adventure for the mayor’s<br />

charity, which last year saw<br />

her husband, councillor Alan<br />

Hunter, the Mayor of Abergele,<br />

swim with sharks all in aid of St<br />

Kentigern Hospice.<br />

Cheryl said: “St Kentigern<br />

Hospice is a North Wales<br />

charity providing specialist<br />

palliative and end of life care,<br />

who do such a brilliant job.<br />

“It has a special place in my<br />

heart as the hospice cared for<br />

my father until the very end.<br />

“They have so much care to<br />

give to their patients but also<br />

provide so much support and<br />

comfort for families.<br />

“They are just fabulous.”<br />

Cheryl’s journey will start from<br />

Leeds East Airport, where the<br />

biplane will reach heights of up<br />

to 700ft and speeds of up to<br />

110mph.<br />

Pennie Walker, Volunteer<br />

Manager for the Trust’s Non-<br />

Emergency Patient Transport<br />

Service, said: “Cheryl is a brave<br />

and courageous woman, and I<br />

am proud that she is part of my<br />

team.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

Cheryl, who is also Mayoress of<br />

Abergele, will take to the skies on<br />

22 April <strong>2023</strong>.<br />

She said: “I’m actually looking<br />

forward to it.<br />

“It’s strange because I would<br />

never do a bungee jump, I would<br />

not put an elastic band around my<br />

ankles and jump off something.<br />

“It takes a lot of willpower to do<br />

something like this.<br />

“I wish her all the best and hope<br />

that she raises a good amount<br />

for St Kentigern Hospice, which<br />

I know is very close to her<br />

heart.”<br />

You can sponsor Cheryl via her<br />

JustGiving page.<br />

26<br />

For further recruitment vacancies visit: www.ambulanceukonline.com


IN PERSON<br />

NWAS News<br />

<strong>Ambulance</strong> Service Deputy<br />

Chief Executive on 2022 New<br />

Year Honours list<br />

of towns in Cumbria including Cockermouth,<br />

Appleby, Keswick, and Kendal which<br />

devastated the area resulting in a mass<br />

evacuation and support systems to be put<br />

in place to look after many hundreds of<br />

members of the public displaced at the time.<br />

EHAAT News<br />

Operations Director for Essex<br />

& Herts Air <strong>Ambulance</strong> retires<br />

after 16 years’ service<br />

Deputy Chief Executive and Director of<br />

Strategy, Partnerships and Transformation<br />

Salman Desai has featured in the 2022<br />

King’s New Year Honours list. Salman will<br />

receive a King’s <strong>Ambulance</strong> Medal in the<br />

New Year.<br />

The King’s <strong>Ambulance</strong> Medal is awarded to<br />

ambulance staff who have shown distinguished<br />

service, exemplary dedication to their role, and<br />

demonstrated outstanding ability, merit and<br />

conduct to their vocation. On being awarded<br />

this honour, Salman said: “I am immensely<br />

proud and truly humbled to receive such an<br />

award after over 25 years’ service. It is an<br />

honour on a personal level but also for North<br />

West <strong>Ambulance</strong> Service (NWAS).<br />

“Helping people and shaping the organisation<br />

to meet and serve the needs of all of our<br />

communities is what motivates me. I have<br />

enjoyed every step of my career so far and<br />

receiving this honour is a true accolade.”<br />

Salman joined the ambulance service in 1997<br />

as a paramedic and has kept his paramedic<br />

registration to date. From 2007-2015 he was<br />

head of service development, undertaking<br />

a number of roles transforming services for<br />

patients. This included working with vulnerable<br />

and disadvantaged groups across Greater<br />

Manchester to prevent deaths from drug use.<br />

In addition to this, he provided commander<br />

support in response to two separate major<br />

incidents in Cumbria.<br />

The first incident was the shootings that<br />

occurred in and around Whitehaven in 2010.<br />

The second incident was the major flooding<br />

Salman joined our board of directors in<br />

2016 as director of strategy and planning<br />

and earlier this year, he was appointed as<br />

deputy chief executive of our trust which is<br />

the second-largest ambulance service in the<br />

country.<br />

Salman has worked hard to redress the<br />

balance of representation from ethnic minority<br />

communities within the ambulance sector,<br />

acting as a trailblazer for equity, equality,<br />

and a better understanding of the personal<br />

challenges that can bring. He recently shared<br />

his experiences with over 300 other leaders at<br />

an <strong>Ambulance</strong> Leadership Forum.<br />

Some of the steps he has taken to make<br />

change include being instrumental in supporting<br />

our Race Equality Network, moving it to a more<br />

formal footing, and ensuring its work is focused<br />

and impactful. Salman chairs our Equality,<br />

Diversity, and Inclusion Committee, driving<br />

improvements in the experience of patients<br />

using our services and staff.<br />

Salman’s portfolio includes patient<br />

experience, and he has established our<br />

diverse Patient and Public Panel ensuring<br />

we listen to and learns from the voice of<br />

our communities, from all ages and all<br />

backgrounds. This work enables service<br />

improvement and helps us address the health<br />

inequalities which have increased during the<br />

pandemic.<br />

Chief Executive Daren Mochrie QAM, said:<br />

“Salman is an exceptional and compassionate<br />

leader who always gives freely of his time to<br />

support and mentor individuals, teams, and<br />

peers across all service lines. He has been<br />

instrumental in developing our newly launched<br />

strategy and supporting myself and the<br />

Board to lead the transformation of the trust<br />

especially so during the past few years of a<br />

COVID pandemic.<br />

“He is both a well-respected leader and an<br />

asset to NWAS and the ambulance service<br />

nationally and I am proud of his achievement.”<br />

Congratulations Salman!<br />

After 16 years with Essex & Herts Air<br />

<strong>Ambulance</strong> (EHAAT) Cliff Gale has retired as<br />

Operations Director.<br />

Cliff joined the charity back in 2007, having spent<br />

30 years with Sussex Police where he gained<br />

hands-on experience managing the police air<br />

operation. Since joining EHAAT he has helped<br />

the charity achieve numerous milestones whilst<br />

setting the foundation for its massive growth.<br />

Cliff has been commended by his colleagues<br />

as helping to create clinical governance in prehospital<br />

care in the early days of air ambulance<br />

services. His achievements have been many,<br />

but probably the most notable are, playing an<br />

instrumental role in expanding the charity’s<br />

operations into Hertfordshire, cementing EHAAT’s<br />

future with its airbases at Earls Colne and North<br />

Weald, and purchasing its first owned helicopter.<br />

Cliff won’t be saying ‘goodbye’ completely though,<br />

as he will continue to work with the charity on a<br />

part-time basis to oversee the implementation<br />

of its carbon reduction strategy alongside other<br />

projects. However, he is handing over the<br />

‘operational reins’ to Paul Curtis who becomes<br />

EHAAT’s new Aviation & Operations Director.<br />

Paul has over 25 years in the aviation<br />

industry piloting helicopters for the military, air<br />

ambulances, the police and for the offshore oil<br />

and gas industries. He has also flown for Jet2.<br />

com, flying Boeing 737’s.<br />

Building on the excellent work already achieved,<br />

Paul, as part of the Executive Team, will be<br />

working alongside the whole EHAAT team,<br />

to help achieve its future strategic goals and<br />

ambitious plans to provide the highest possible<br />

standards of pre-hospital care for its patients.<br />

Jane Gurney, CEO of EHAAT said: “We are<br />

thankful for Cliff’s instrumental impact to the<br />

growth of the charity. His passion, energy,<br />

relentless drive and dedication has been clear,<br />

and his impact has been felt throughout the<br />

whole sector. However, I am hugely excited<br />

that someone as experienced as Paul has<br />

joined our team and I know he will do a<br />

fantastic job at guiding the charity through our<br />

next exciting chapter.”<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

For the latest <strong>Ambulance</strong> Service News visit: www.ambulancenewsdesk.com<br />

27


IN PERSON<br />

EEAST News<br />

Chair of EEAST to step down<br />

after three years<br />

The Chair of the East of England <strong>Ambulance</strong><br />

Service NHS Trust (EEAST) is to step down<br />

after leading the Trust for three years.<br />

Nicola Scrivings joined EEAST in November<br />

2019 after previous roles with a Community<br />

Services NHS Trust, a Cambridge-based<br />

housing association and national roles with the<br />

Audit Commission and the Health and Care<br />

Professions Council (HCPC).<br />

As Chair, Ms Scrivings has overseen a period<br />

of improvement for the Trust, which has been<br />

recognised by the CQC and NHS England.<br />

She has now decided to step down from<br />

the role but will continue in post until her<br />

replacement is recruited.<br />

Ms Scrivings said:<br />

“It has been a great privilege and experience<br />

to travel alongside such dedicated ambulance<br />

crews and volunteers across the region. I know<br />

how hard everybody works to make sure that<br />

our patients receive the best possible care.<br />

“We set ourselves a vision of ‘outstanding<br />

care, excellent people every hour every day’<br />

and I truly believe we are heading in the right<br />

direction under the guidance of our Chief<br />

Executive and the Board. I wish the new Chair<br />

a successful future with EEAST.<br />

“In the meantime, our Board is very focussed<br />

on working with our partners to address<br />

current performance issues.”<br />

This progress has been recognised by the<br />

CQC and NHSE with acknowledgement that<br />

the first phase of EEAST’s progress towards<br />

‘Good’ is drawing to a close. EEAST now has<br />

a stable Board with professional, committed<br />

members, with a range of combined talents to<br />

lead the Trust to the next level.<br />

Tom Abell, Chief Executive of East of England<br />

<strong>Ambulance</strong> Service NHS Trust said:<br />

“Nicola has made an incredible contribution<br />

to our improvement as an organisation, I<br />

would like to thank her for her dedication,<br />

and commitment to making our organisation<br />

a better place to work for our people and her<br />

passion to improve care for the communities<br />

we serve across the east of England.<br />

”Finding the right successor will take a little<br />

time, and there is a plan for a staged transition<br />

to a new Chair, aiming for appointment of<br />

a Chair Designate in May <strong>2023</strong>. Until that<br />

time Nicola will continue to lead the Board<br />

with pride and support the hard work of<br />

ambulance crews on the frontline, including<br />

our volunteers.”<br />

SCAS News<br />

SCAS has announced two<br />

Non-Executive Appointments<br />

to its Board<br />

South Central <strong>Ambulance</strong> Service NHS<br />

Foundation Trust (SCAS) has announced<br />

two new non-executive appointments to its<br />

board of directors.<br />

Mike McEnaney, who comes with 25 years of<br />

finance director level experience, most recently as<br />

finance director for Oxford Health NHS Foundation<br />

Trust where he had additional responsibility for<br />

procurement, IT, HR and estates, began his initial<br />

three-year term on 1 January <strong>2023</strong>.<br />

than a decade of experience in international<br />

healthcare management. He will begin his initial<br />

three-year term on 20 <strong>February</strong> <strong>2023</strong>.<br />

He has been the global medical director of<br />

Marie Stopes International (MSI) Reproductive<br />

Choices <strong>UK</strong> for the last nine years, one of the<br />

largest providers of contraceptive and safe<br />

abortion care services in the world.<br />

He is part of the MSI executive team and<br />

provides professional clinical oversight globally<br />

for the organisation, which has 10,000 staff<br />

with 4,000 clinicians across 37 countries, as<br />

well as operating as a non-executive director<br />

for three countries.<br />

Prior to joining the SCAS Board, Dr Perera was<br />

an associate non-executive director with the<br />

Dorset County Hospital NHS Foundation Trust<br />

and is a member of working groups including<br />

with the World Health Organisation and<br />

International Federation of Obstetricians and<br />

Gynaecologists (FIGO).<br />

Mr McEnaney replaces Mike Hawker who<br />

has retired from SCAS after three terms<br />

of dedicated service as chair of the audit<br />

committee, while Dr Perera replaces Dr<br />

Henrietta Hughes OBE who left SCAS in<br />

September to take on the national role of the<br />

first Patient Safety Commissioner for England.<br />

Professor Sir Keith Willett, SCAS chair, said:<br />

“I am delighted to welcome both Mike and<br />

Dhammika to the SCAS board.<br />

“Mike brings a breadth of experience and<br />

skills which I know will be incredibly useful in<br />

helping SCAS to achieve its ambitions despite<br />

the economic challenges that we are all<br />

facing, while Dhammika has a very interesting<br />

clinical background which brings very valuable<br />

experience to help us as we continue our<br />

improvement journey.”<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

He has also worked in senior manufacturing<br />

and logistics roles for Honda Motor Company<br />

and Avis Plc and has non-executive director<br />

experience as part of the audit committee at<br />

Oxford Brookes University. He also sits on the<br />

finance committee of NHS Providers and the<br />

board of Akrivia Health (a venture with Oxford<br />

University and the NHS).<br />

He is joined by Dr Dhammika Perera, a<br />

public health professional with over 20 years’<br />

experience as a medical doctor and more<br />

Mike McEnaney and Dr Dhammika Perera<br />

28<br />

For more news visit: www.ambulanceukonline.com


IN PERSON<br />

SECAMB News<br />

Trust announces two new<br />

board appointments<br />

South East Coast <strong>Ambulance</strong> Service<br />

NHS Foundation Trust, (SECAmb), has<br />

announced the appointment of two new<br />

Board members.<br />

Joining the executive team as Chief Medical<br />

Officer is Dr Rachel Oaten, while Max Puller<br />

joins the Board as an Independent Non-<br />

Executive Director for an initial term of three<br />

years. Rachel will join the Trust on 1 <strong>February</strong><br />

with Max taking up his role from 6 <strong>February</strong>.<br />

Dr Oaten replaces Dr Fionna Moore on the<br />

SECAmb’s executive team with Dr Moore<br />

stepping down from her role as Medical<br />

Director for the Trust as announced last year<br />

- SECAmb Medical Director to stand down<br />

after 50 years’ NHS service - NHS South East<br />

Coast <strong>Ambulance</strong> Service. While Fionna is<br />

stepping down from our executive role, she will<br />

remain with the Trust in a part-time clinicallyfocused<br />

advisory role.<br />

Dr Oaten, who qualified as Consultant in<br />

Emergency Medicine in 2017, took up a<br />

post at Salisbury Hospital and in 2018 was<br />

appointed the Clinical Lead role for the<br />

Emergency Department. She also held a parttime<br />

post at East Midlands <strong>Ambulance</strong> Service<br />

in March 2020 where she served as Deputy<br />

Medical Director.<br />

In October 2021 she was appointed Deputy<br />

Clinical Director of Medicine at Salisbury<br />

Hospital. She maintains a clinical hands-on<br />

presence as an Emergency Consultant and<br />

also undertakes shifts working as a Trauma<br />

Team Leader.<br />

Dr Oaten said: “It’s important to me that<br />

everybody delivering care at SECAmb<br />

feels supported and knows that they are<br />

working alongside a chief medical officer<br />

who understands the current pressures and<br />

issues faced by staff and who delivers care in<br />

similar circumstances. I am keen to combine<br />

my acute care and pre-hospital experience to<br />

develop collaborative and effective systembased<br />

ways of working for our patients and<br />

staff.”<br />

Max Puller is currently Director at BCW<br />

Change, the organisational change and<br />

employee experience specialists at global<br />

communications agency, BCW. His role<br />

sees him work with global clients to<br />

deliver successful, sustainable business<br />

transformation and culture change.<br />

His previous roles include Head of Colleague<br />

Communications and Engagement at Tesco<br />

Bank, Employee and Change Communications<br />

Director at Sodexo, and Chief Communications<br />

Officer at the <strong>UK</strong> Ministry of Defence. Prior to<br />

his SECAmb appointment, Max was on the<br />

Board of the Salvation Army where he advised<br />

on reputation, marketing and fundraising<br />

issues.<br />

He said: “I am delighted to join the Board of<br />

SECAmb and excited to work with colleagues<br />

across the Trust as we continue on our<br />

improvement journey. I look forward to adding<br />

to the wealth of expertise and experience<br />

already on the Board, as we work together to<br />

drive positive outcomes for staff and patients<br />

across the region.”<br />

SECAmb Interim Chief Executive Siobhan<br />

Melia said: “I’m pleased we have been able to<br />

make these important appointments. Rachel<br />

and Max both bring a wealth of knowledge and<br />

experience from within and from outside the<br />

NHS. They will be made to feel very welcome<br />

at SECAmb and I look forward to working with<br />

them. I would also like to pay tribute to Fionna<br />

as she steps back from her executive role and<br />

thank her for her immense contribution to the<br />

ambulance sector over so many years.”<br />

SECAmb Chairman David Astley said: “I<br />

welcome both Rachel and Max to SECAmb.<br />

They are both strong appointments. I am<br />

pleased that Fionna is retaining a part-time<br />

role. I have always valued her advice to the<br />

Board and I am also grateful for her leadership<br />

as Interim CEO on two occasions in my time<br />

as Chair.”<br />

WAS News<br />

Coveted award for Welsh<br />

<strong>Ambulance</strong> Service<br />

The Welsh <strong>Ambulance</strong> Service won not<br />

one, but two prestigious awards.<br />

The Trust’s Emergency Communication Nurse<br />

System (ECNS) project team were named the<br />

winner of the Digital and Technology Innovation<br />

Award at last week’s Advancing Healthcare<br />

Awards Wales ceremony, while Advanced<br />

Paramedic Practitioner Ed Harry was highly<br />

commended in the Allied Health Professional of<br />

the Year category.<br />

ECNS is a new telephone consultation tool to<br />

help control room clinicians arrange the most<br />

appropriate care for 999 callers.<br />

Ellen Edwards, Senior Practice Educator and<br />

project team member, said: “It was an absolute<br />

honour to win the Advancing Healthcare Award<br />

for Digital and Technology Innovation.<br />

“The implementation of ECNS onto the Clinical<br />

Support Desk has been a challenge, with<br />

winter pressures, mass recruitment and a<br />

condensed timeline.<br />

“But despite all of this, the team have worked<br />

extremely hard, and this is a testament to<br />

that.”<br />

>>><br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

Do you have anything you would like to add or include? Please contact us and let us know.<br />

29


IN PERSON<br />

For the last four and a half years David has<br />

been working as Managing Director at George<br />

Eliot Hospital NHS Trust, Nuneaton, one of<br />

three District General Hospitals that make up<br />

the Foundation Group. Prior to this, David<br />

was Chief Operating Officer at University<br />

Hospitals Coventry and Warwickshire NHS<br />

Trust, during which time he also supported<br />

NHS Improvement Midlands & East, as Senior<br />

Winter Adviser.<br />

David has a particularly strong patient focus,<br />

underpinned by his clinical background and<br />

active nurse registration. His considerable<br />

expertise in system wide urgent and<br />

emergency care will be extremely valuable in<br />

leading SCAS as it seeks to further integrate<br />

health and social care through its key role as<br />

care navigator.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

On the award, which was sponsored by<br />

the Welsh Government, the judging panel<br />

felt the ECNS project showed “workforce<br />

sustainability, an extremely high impact to<br />

patients and would be of worldwide interest.”<br />

Penny Durrant, Service Manager for the Clinical<br />

Support Desk said: “I am incredibly proud of<br />

all the staff that have made a contribution to us<br />

winning this award.<br />

“There have been significant changes to the<br />

CSD in the last 12 months with the expansion<br />

in clinician numbers, the introduction of the<br />

Mental Health Practitioners and a new way of<br />

working with the implementation of LowCode,<br />

which operates ECNS.<br />

“This award is evidence of the dedication<br />

and hard work of CSD and its continued<br />

commitment to service improvement and<br />

ultimately patient care.”<br />

Advanced Paramedic Practitioner Ed Harry<br />

was also awarded ‘Highly Commended’ in the<br />

Allied Health Professional of the Year category.<br />

He said: “The only other individual who has<br />

been previously shortlisted from WAST for this<br />

award was Andy Swinburn, our Director of<br />

Paramedicine, so I’m just so grateful to even<br />

be nominated, let alone a runner-up.”<br />

Ed started his career as a paramedic in 2009<br />

and is now an APP who supports various<br />

projects and teams including the clinical<br />

support desk, APP training and ECNS, all while<br />

undertaking a PHD.<br />

Kerry Robertshaw, Professional Development<br />

Lead for Advanced Practice, said: “I nominated<br />

Ed, as his enthusiasm is infectious, and he is one<br />

of those people who just goes above and beyond.<br />

“He does so much incredible work in his own<br />

time – down to transformational projects<br />

that he is working on with the college of<br />

paramedics, to his PHD that is looking at<br />

the impact of Covid-19 on the health and<br />

wellbeing of our ambulance staff.<br />

“He’s really keen that our voice is remembered<br />

during this difficult time.”<br />

The Advancing Health Care Awards are held<br />

every year and is an opportunity to recognise<br />

and celebrate the important and innovative<br />

work of healthcare scientists and allied health<br />

professionals across Wales.<br />

SCAS News<br />

South Central <strong>Ambulance</strong><br />

Service appoints new Chief<br />

Executive Officer<br />

Following a robust recruitment process,<br />

South Central <strong>Ambulance</strong> Service NHS<br />

Foundation Trust (SCAS) has appointed<br />

David Eltringham to the role of Chief<br />

Executive Officer, starting in March <strong>2023</strong>.<br />

David said: “I’m delighted to be joining South<br />

Central <strong>Ambulance</strong> Service as its new Chief<br />

Executive. Every part of the NHS is under<br />

significant pressure at the moment and SCAS<br />

is no exception. When I join the Trust in March,<br />

I’ll be focusing on making sure that we look<br />

after our patients and our staff to the highest<br />

standards. I am committed to developing<br />

those around me to be the very best that they<br />

can be. I think that my expertise in this area<br />

will be of great value to SCAS. I met some<br />

fantastic, skilled and committed people during<br />

the recruitment process and I can’t wait to<br />

become part of the team.”<br />

Professor Sir Keith Willett CBE, Chair at<br />

SCAS, added: “I am excited to welcome<br />

David to the SCAS Board. He brings a wealth<br />

of experience, a passion for working with<br />

ambulance services and a strong track record<br />

in service improvement. This will certainly<br />

support SCAS in the delivery of its ambitious<br />

strategy and ultimately in the delivery of the<br />

best possible care for our patients and their<br />

families.”<br />

30<br />

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AMBULANCE <strong>UK</strong> - FEBRUARY<br />

For the latest <strong>Ambulance</strong> Service News visit: www.ambulancenewsdesk.com<br />

31


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