Ambulance UK February 2023

Volume 38 No. 1 

February 2023 

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CONTENTS 

CONTENTS 

Ambulance UK 

4 EDITOR’S COMMENT 

6 FEATURES 

6 How long are we prepared to wait and see if the NHS 

improves? 

8 Predictive clinical utility of pre-hospital point of care 

lactate for transfusion of blood product in patients 

with suspected traumatic haemorrhage: derivation 

of a decision-support tool 

16 NEWSLINE 

27 IN PERSON 

31 COMPANY NEWS 

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This issue edited by: 

Sam English 

c/o Media Publishing Company 

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ADVERTISING: 

Terry Gardner, Samantha Marsh 

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3

EDITOR’S COMMENT 

EDITOR’S COMMENT 

Welcome to this issue of AUK 

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

predictions. This morning the Government have promised another 800 ambulances before next winter along 

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

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

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

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

high pressure environment. 


“We should 

know that 

something is 

wrong when 

highly qualified 

and caring 

staff leave 

a vocational 

career because 

they will afford 

more and 

experience 

less stress 

by working 

in a non 

professional 

role.” 

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

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

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

we have seen the numbers of staff leaving and shortages increase, we have watched unconcerned as the 

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

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

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

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

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

actually reach the end of their careers working in the NHS to enjoy it. 

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

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

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 

meet our needs when we have them. 

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

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

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

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

are achieved and best wishes for the year ahead. 

Sam English, Co-Editor Ambulance UK 

Publishers Statement 

For nearly 40 years, thanks to trade support, we have been able to provide Ambulance UK FREE OF 

CHARGE in the knowledge that those receiving our dedicated bi monthly publication enjoy having 

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

amongst Ambulance Service Suppliers these days, therefore if you enquire about a product advertised, 

please mention Ambulance UK as it will help us confirm to the trade that we are reaching the right 

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

to thank the following companies for their support as without their contribution towards our print and 

postal costs this issue would not have been published - Bluelight UK, CSS Europe, DS Medical, 

Eberspächer, Intersurgical, Ortus, Synergy business solutions, Vimpex, St Johns Western 

Australia. 

Terry Gardner 

Publisher 

4 

For more news visit: www.ambulanceukonline.com

FEATURE 

HOW LONG ARE WE PREPARED TO 

WAIT AND SEE IF THE NHS IMPROVES? 

By Ivor Campbell 

Waiting times, waiting times…oh how we’re all waiting for the time 

when waiting times improve and we can feel confident that the 

NHS is working again. 

The reality is, however, that without meaningful change, waiting times 

are likely only to become longer – at least in the short term. 

Besides, there are other metrics that may be more accurate in 

measuring quality of care, such as the time patients wait before being 

clinically assessed; how long critically ill patients wait before their 

treatment is completed; and the proportion of patients who return to 

A&E within seven days of their first attendance. Other measures, such 

as the time a patient waits to see a clinician, are also now recorded. 

Even if they improved, would that necessarily mean we had a properly 

functioning health service, or that patients were receiving a better 

standard of care? 

What is beyond question is that waiting times have become the standard 

against which the performance of the NHS and social care service are 

measured. With the publication of every new set of statistics, so the 

fulmination of the commentariat becomes louder and more hectoring. 

Once patients are inside the system, governments continue to rely on 

waiting times as a key measure of clinical performance. 

There’s a six-week target for the eight key diagnostic tests and 

investigations; a 12-week target wait for new outpatient appointments; a 

12-week treatment time guarantee; and a waiting target of 18 weeks for 

an outpatient appointment, diagnostic test (if required) and treatment (if 

appropriate). 

Most public angst is reserved for waiting times for A&E departments 

because they are the gateway through which most patients enter the 

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

service, primary care, community-based care, and social services. 

In October 2022, the NHS recorded its highest ever waiting times for 

A&E admission, with more than one in three patients having to wait 

longer than the four-hour target. 

Again, we obsess over whether these times are being met and handwring 

over the deluge of statistics highlighting missed targets and, 

axiomatically, over further evidence of a broken system. 

At the end of September 2022, we learned that 7.1million people in 

England were waiting to start routine hospital treatment – up by 100,000 

on the previous month and the highest number since records began in 

August 2007. 


In Scotland, the situation was worse, with 61.9% of patients attending 

casualty departments in the week up to November 27 admitted or 

discharged within four hours. 

As a result of those failures, we learned that, in the same month, four 

patients waited more than 20 hours in the back of ambulances outside 

Royal Shrewsbury Hospital, in England. 

The average wait for category two, 999 calls for an ambulance — 

including for chest pains and strokes — in England and Wales is now 60 

minutes, compared with a target of 18 minutes. 

When Matt Hancock was Health Secretary, he became so frustrated at 

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

he called for it to be scrapped because, he said, it was longer deemed 

to be ‘clinically appropriate.’ 

While Hancock might be a better guide to the flavour of marsupial 

genitalia than to the functioning of a health service, he may have a point 

that the practice has its limitations. 

The King’s Fund think tank has pointed out that even measuring the 

proportion of patients seen within four hours is problematic. Two 

separate departments could process the same proportion of patients 

within the timescale but have different average waiting times. 

Last November it was reported that two women from the North of 

Scotland, waited more than three years for an appointment with a 

psychiatrist. When Nessie Simpson was eventually seen by a mental 

health practitioner, she had to travel 65 miles away from her home in 

Fort William. 

Most people would agree that having to wait three years for an 

appointment, or to sit for more than 20 hours in an ambulance outside 

an emergency department, are failures of the system. 

But is it necessarily the case that the speed with which a physician gets 

through appointments with patients should be the sole criterion upon 

which the success or failure of the system should be decided? 

A doctor who spends more time with a patient and notices an underlying 

issue that has been overlooked by a colleague, who spends less time with 

each patient, is obviously doing his or her job more effectively, even if that 

means they are costing more in time and resources. 

Waiting time statistics don’t show how often someone turns-up with a 

minor complaint that is masking something more serious and which is 

subsequently detected by a diligent clinician. 

Diagnostics is increasingly focused on the personal side of healthcare. 

While newspaper headlines fixate about people sitting in ambulances 

6 

For further recruitment vacancies visit: www.ambulanceukonline.com

FEATURE 

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

hospitals do. 

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

service, but fewer people die from falling over when drunk or getting 

their head stuck in a saucepan than from heart disease, cancers, and 

strokes, which take more time to treat and rely on expensive and timeconsuming, 

long-term testing. 

Intranasal mucosal 

atomisation device 

At the heart of the dilemma over how to fix the health service is the question 

of where best to distribute scarce resources. We have too many patients 

with too few resources and our options are therefore to reduce the number 

of patients or to increase resources and the latter is not currently viable. 

Fewer patients would enter the system if more of them paid for their 

treatment privately or if those with less serious conditions avoided 

visiting their GP. 

In the republic of Ireland, a GP appointment costs around €60 – 

with exemptions for pensioners, children under six and people on 

low incomes. Patients are also charged if they visit an emergency 

department without a GP’s referral. 

The Irish system may be unpopular among some, but at least it stops 

people turning up because they need a packet of paracetamol. 

Its advocates point-out that it prevents misuse of GPs’ time, allowing 

them to focus on those who are genuinely ill and that the service 

remains free to those who cannot afford to pay. 

Critics say such charges, if introduced in the UK, would undermine the 

founding principle of NHS, of care being free at the point of delivery to 

everyone, regardless of their means. 

We need to have a grown-up discussion about what would be 

acceptable and it may come down to cost. Would those of us who 

could afford to, be prepared to pay £20 to see a doctor? Possibly. 

Would they be prepared to pay £200? Probably not. 

Around 12% of healthcare treatment is already delivered privately. That used 

to be called privatisation by stealth but now it is accepted as being part of 

the system. People recognise that having the money and spending it on 

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

There are already anomalies of private healthcare existing within the 

system. Only the poorest people now receive free dental and ophthalmic 

care and private companies routinely provide services for the NHS. 

Medication can be quickly 

and painlessly delivered with 

the DART intranasal mucosal 

atomisation device, helping the 

patient remain calm in a high 

stress situation. 

Scan the QR code to find out more: 

The system was devised in the late 1940s and, while it has been 

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

patients in the 1950s. 

How it will change in the next few years – if it changes at all – will 

depend upon public tolerance of a steadily worsening service. In the 

meantime, we will all have to wait and see. 

Ivor Campbell is Managing Director of Stirlingshire-based Snedden 

Campbell, a search company for the medical technology industry. 

Quality, innovation and choice 

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www.intersurgical.co.uk 

7

FEATURE 

PREDICTIVE CLINICAL UTILITY OF PRE-HOSPITAL POINT OF 

CARE LACTATE FOR TRANSFUSION OF BLOOD PRODUCT IN 

PATIENTS WITH SUSPECTED TRAUMATIC HAEMORRHAGE: 

DERIVATION OF A DECISION-SUPPORT TOOL 

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 

Ambulance Charity Kent Surrey Sussex 

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

Abstract 

Introduction 

Pre-hospital emergency medical teams can transfuse blood products 

to patients with suspected major traumatic haemorrhage. Common 

transfusion triggers based on physiological parameters have several 

disadvantages and are largely unvalidated in guiding pre-hospital 

transfusion. The addition of pre-hospital lactate (P-LACT) may overcome 

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

blood transfusion is unclear. 

Background 

Over the past decade pre-hospital critical care teams and helicopter 

emergency medical services (HEMS) have developed transfusion 

protocols and operational capability to transfuse blood products to 

patients with suspected traumatic haemorrhagic shock [1, 2]. Clinical 

gestalt in combination with clinical variables such as systolic blood 

pressure (SBP) and shock index (SI) are used to quantify the severity of 

haemorrhagic shock and guide transfusion with blood products, both in 

the pre-hospital- and the in-hospital phase of care [3]. 


Methods 

A retrospective analysis of patients with suspected major traumatic 

haemorrhage attended by Air Ambulance Charity Kent Surrey Sussex 

(KSS) between 8 July 2017 and 31 December 2019. The primary 

endpoint was the accuracy of P-LACT to predict the requirement for any 

in-hospital (continued) transfusion of blood product. 

Results 

During the study period, 306 patients with suspected major traumatic 

haemorrhage were attended by KSS. P-LACT was obtained in 194 

patients. In the cohort 103 (34%) patients were declared Code Red. A 

pre-hospital transfusion was commenced in 124 patients (41%) and inhospital 

transfusion was continued in 100 (81%) of these patients, in 24 

(19%) patients it was ceased. Predictive probabilities of various lactate 

cut-off points for requirement of in-hospital transfusion are documented. 

The highest overall proportion correctly classified patients were found for 

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

on the calculated predictive probabilities, optimal cut-off points were 

derived for both the exclusion- and inclusion of the need for in-hospital 

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

negative likelihood ratio [LR−] of 0.37 for the prediction of in-hospital 

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

specificity of 99.22%, [LR−] = 0.78. 

Conclusion 

Pre-hospital lactate measurements can be used to predict the need 

for (continued) in-hospital blood products in addition to current 

physiological parameters. A simple decision support tool derived in this 

study can help the clinician interpret pre-hospital lactate results and 

guide pre-hospital interventions in the major trauma patient. 

* Correspondence: Jogriggs@aakss.org.uk 

1 

Air Ambulance Charity Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill RH1 5YP, UK 

Full list of author information is available at the end of the article 

© The Author(s) 2022. 

Clinical variables, however, have several disadvantages in guiding 

pre-hospital transfusion. First, evidence-based cut-off values to guide 

transfusion are lacking. As a result, pre-hospital transfusion trigger 

thresholds vary [3, 4]. Second, physiological parameters cannot reliably 

determine the degree of occult and temporal haemorrhage as they are 

highly influenced by autoregulatory responses [3, 5, 6]. Third, changes 

in blood pressure are a late sign of a haemorrhagic shock and by using 

SBP or SI as transfusion triggers the transfusion decision point (TDP) 

may be delayed beyond the critical window for effective resuscitation 

[7]. Finally, other causes mimic the clinical signs of haemorrhagic shock 

and may confound decision-making, such as traumatic vasoactive head 

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

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

Pre-hospital point of care lactate measurement (P-LACT) has the 

potential to overcome some of these shortcomings. Lactate formation 

in major trauma patients is the result of tissue hypoperfusion, resulting in 

anaerobic glycolysis. Haemorrhage and inadequate ventilation following 

a traumatic injury can lead to hypovolemia, hypoxaemia and end-organ 

hypoperfusion, resulting in anaerobic glycolysis and lactate formation. 

Furthermore, lactate is formed as a result of adrenergic responses to 

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

balanced by counter-regulatory mechanisms and can be measured early 

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

can be used to predict both the need for resuscitative in-hospital care 

in trauma patients and the outcome of traumatically injured patients 

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

transfusion remains unclear [3, 16]. 

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

8 


FEATURE 

the need for (continued) in-hospital blood product transfusion in patients 

attended by HEMS with suspected major traumatic haemorrhage. 

Methods 

Study design 

We performed a retrospective analysis of all trauma patients with 

suspected major haemorrhage attended by Air Ambulance Kent Surrey 

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

(when lactate measurements became available to the service) and 31 

December 2019. We aimed to investigate the relationship between 

clinical variables and measured P-LACT values with the need for 

(continued) in-hospital blood product transfusion. 

Study setting 

KSS HEMS cover three counties in the southeast of England, a region 

of 7200km 2 with a resident population of 4.5 million, and a transient 

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

either a helicopter or rapid response vehicle from one operational base, 

attending approximately 2000 patients per year. Tertiary trauma care in the 

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

study KSS carried four units of O Rhesus negative packed red blood cells 

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

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

Blood products are administered as per KSS Standard Operating 

Procedure (SOP) to patients showing signs of severe haemorrhagic 

shock. The decision to transfuse blood products is based on clinical 

gestalt, considering clinical history, mechanism, physiology and 

response to resuscitative efforts. P-LACT is measured as per SOP as an 

adjunct to clinical findings to help exclude traumatic major haemorrhage 

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

and sign of haemodynamic compromise ‘Code Red’ is declared. Code 

Red activation enables a titrated transfusion of up to four units of O 

Rhesus negative PRBC and 4 units of FDP; administration of 10 mL 

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

(1 g) through a fluid warmer (Belmont Buddy Lite or Warrior Lite). 

In addition, a ‘pre-alert’ to the receiving hospital triggers a predefined 

in-hospital major haemorrhage protocol to ensure blood products are 

immediately available [17, 18]. Full traceability of blood transfusions 

and compliance with Blood Safety and Quality Regulations (2007) and 

Medicines and Healthcare Regulatory Agency (MHRA, 2016) is ensured. 

Point of care lactate sampling 

Lactate was measured from venous blood prior to sodium chloride 

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

or after insertion of an intravenous (IV) cannula using the NOVA 

StatStrip ® Biomedical Xpress point of care test (POCT) Lactate Meter 

system [12]. Samples were taken prior to the initiation of blood product 

transfusion. Measurement results were noted, time-stamped and 

retrospectively recorded in the KSS electronic patient record system 

(HEMSBase 2.0, Medic One Systems Ltd, UK). 

Outcome measures 

The primary endpoint of interest was the accuracy of P-LACT (both 

as a continuous variable and at various cut-off points) to predict the 

requirement for any (continued) transfusion of blood products inhospital. 

Data acquisition 

Patient demographics, mechanism of injury and nature of injuries, 

presenting physiology, POCT results (including lactate) and treatments 

provided by HEMS and other EMS (including blood product) were 

retrieved from the dedicated KSS electronic patient clinical record. Inhospital 

transfusion data were obtained from electronic health records of 

the respective MTC’s and shared with KSS in accordance with existing 

data-sharing agreements between KSS and the NHS Trusts. 

Ethical considerations 

This project was registered with the University of Surrey, and met 

National Institute for Healthcare Research (NIHR, UK) criteria as a service 

evaluation. All the data used for this study were routinely collected as 

part of standard pre-hospital and hospital patient data collection. The 

project was approved by the KSS Research & Development Committee 

and conducted in accordance with Strengthening the Reporting of 

Observational Studies in Epidemiology (STROBE) Guidelines [19]. 

Statistical analysis 

Descriptive statistics are given as mean [95% CI] or median [IQR]. 

Comparisons across groups were made using Fisher’s exact test and 

ANOVA Kruskal–Wallis test where appropriate. Sensitivity, specificity, 

and positive- and negative likelihood ratios as well as the percentage 

correctly classified were calculated for P-LACT values in the range 

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

the occurrence of the defined endpoint were calculated for each of 

these values using logistic regression analysis. 

Previously published work at KSS in the same patient cohort highlights 

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

evaluation highlights a 999 to hospital time of 1 h 50 min, putting the 

HEMS team patient side at between 30 and 45 min. 

Study population 

Patients were included in the analysis if they had presumed major 

haemorrhage as a result of traumatic injuries for which a P-LACT was 

measured on scene and for which the patient was transported (by air or 

land) to an MTC. Exclusions consisted of patients with traumatic cardiac 

arrest (TCA), patients pronounced life extinct (PLE) on scene, patients 

with potential haemorrhagic shock from a medical aetiology, patients 

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

of age. 

Missing values are reported in the results section of the manuscript 

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

as statistically significant. Statistical analyses were conducted using 

Stata 17.0 and SPSS 26.0. 

Results 

Study population 

During the study period KSS attended 306 trauma patients in whom 

major traumatic haemorrhage was suspected. 103 of these patients 

had signs of haemodynamic compromise for which a Code Red 

was declared. Overall, a P-LACT was obtained in a total of 194 

patients (47 in whom a Code Red was declared and 147 in whom not). 


Do you have anything you would like to add or include in Features? Please contact us and let us know. 

9

FEATURE 

Fig. 1 Derived study population and patient inclusion 


In-hospital transfusion was continued- or started in 126 patients (Fig. 

1). 14 of the patients receiving in-hospital transfusion fulfilled criteria 

for major transfusion, and 31 fulfilled criteria for massive transfusion. 

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

of major traumatic haemorrhage. 

Baseline characteristics 

Patient demographics, mechanism of injury (MOI), presenting 

physiology, HEMS interventions and HEMS transfusion of patients 

attended with suspected major traumatic haemorrhage are presented 

in Table 1, stratified by the primary endpoint the need for (continued) 

in-hospital transfusion. Endpoint data were available for 268 (88%) 

of patients. Patients who needed in-hospital transfusion were more 

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

a lower systolic blood pressure (88 mmHg); a higher shock index (1.3); 

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

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

prevalent in patients who required in-hospital transfusion. 

Diagnostic performance of lactate for the prediction of in-hospital 

transfusion 

The negative likelihood ratio [LR−] gives the change in odds of having 

a diagnosis in patients with a negative test. For example, a −LR of 0.1 

would indicate a tenfold decrease in the odds of having a condition in 

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

decrease in the odds of the condition studied. 

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

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

2). The highest overall percentage of correctly classified patients for a 

single cut-off point was found at the inflection point of the curve, cutpoint 

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

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

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

need for in-hospital transfusion. 

Sensitivity, specificity, and positive- and negative likelihood ratio’s as 

well as the percentage correctly classified subjects for various P-LACT 

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

Table 2. 

The cut-point currently used as an adjunct to exclude major 

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

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

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

and was therefore not useful to identify those patients in whom a code 

red should be declared and communicated to the receiving hospital. 

Specificity increased gradually with increasing P-LACT values until a 

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

had a specificity of 99.22%, [LR−] = 0.78. 

Based on the above findings a decision support tool was devised for the 

use of lactate in the pre-hospital phase of care (Fig. 3). 

Discussion 

In the present study we demonstrate that pre-hospital lactate 

measurements can be used to predict the need for (continued) inhospital 

blood product. A simple decision support tool can help the 

clinician to interpret pre-hospital lactate results and to guide transfusion. 

10 


FEATURE 

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

All patients (n = 306) 

In‐hospital transfusion 

(n = 126) 

No In‐hospital transfusion 

(n = 142) 

p value 

Demographics 

Age, years (SD) 47.4 [21.6] 47.5 [21.7] 47.4 [21.6] .73 

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

Female, (n [%]) 71 [23.2] 36 [28.6] 35 [24.6] 

Missing, (n [%]) 38 [3.3] 

Mechanism descriptors (n, %) 

RTC 162 [52.9] 91 [72.2] 71 [55.6] < 0.001 

Accidental Injury 20 [6.5] 16 [12.7] 4 [2.8] 

Intentional Self Harm 25 [8.1] 9 [7.14] 16 [11.3] 

Assault 19 [6.2] 8 [6.3] 18 [12.6] 

Fall 30 [9.8] 4 [3.2] 26 [18.4] 

Cyclist 5 [1.6] 0 [0] 5 [3.5] 

Motorcyclist 18 [5.9] 4 [3.2] 14 [9.9] 

Other 8 [2.6] 2 [1.6] 6 [4.2] 

Presenting physiology 

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

HR (mean [SD]) 

missing 

SBP (mean [SD]) 

missing 

Shock Index (mean [SD]) 

missing 

GCS (median [IQR]) 

missing 

P-LACT 

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

missing 

Pre-hospital interventions 

91 [25.1] 

17 

106 [34.4] 

20 

1.0 [0.5] 

27 

13 [6–15] 

3 

2.9 [2.4] 

84 

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

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

When patients are attended by pre-hospital care teams after major 

trauma, it can be a challenge to determine which patients suffer from 

major haemorrhage due to their injuries. Often this is obvious from the 

106 [32.6] 98 [29.6] < 0.001 

88 [31.8] 120 [29.5] < 0.001 

1.3 [0.6] 0.8 [0.3] < 0.001 

10 [3–14] 

0 

14 [10–15] 

3 

< 0.001 

4.60 [2.4] 3.5 [3.5] < 0.001 

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

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

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

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

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

PRBC units (n, %) 

0 units 169 [60.8] 40 [31.2] 129 [91.5] .68 

1 units 44 [17.0] 37 [29.6] 7 [4.3] 

2 units 28 [10.1] 24 [19.2] 4 [2.8] 

3 units 18 [7.8] 16 [12.8] 2 [1.4] 

4 units 9 [4.2] 9 [7.2] 0 [0] 

Clinical outcome 

Hospital lactate (mmol/L) 

Missing (n [%]) 

ISS (mean [SD]) 


ICU Length of stay (mean [SD]) 


Hospital Length of stay (mean [SD]) 


Survival to discharge 


3.4 [2.6] 

204 [66.6] 

14 [17–41] 

82 [27.8] 

3 [.00–11.7] 

82 [27.8] 

16 [5.7 – 31.2] 

84 [27.45] 

144 (47.1) 

97[31.7] 

4.4 [3.0] 2.00 [1.0] < 0.001 

33 [23.5–43.0] 22 [13–33] < 0.001 

4.5 [1.00–16.75] 2 [.0–8.00] < 0.001 

18 [3–42] 14 [7–26.0] .50 

57 [44.8] 87 [61.0] < 0.001 

physical examination (i.e. when external bleeding is present, or when 

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

is less clear, as patients may be seen early after their injury, with still 



11

FEATURE 

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

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 

associated 95% CIs of In-hospital transfusion as a function of pre-hospital lactate concentration 


Table 2 Diagnostic performance of P-LACT for prediction of 

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

in-hospital haemorrhage blood component therapy in patients with traumatic 

haemorrhage 

Cut‐point Sensitivity Specificity LR+‐ LR− Correctly 

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

(mmol/L) 

1 100.00 3.10 1.03 0.00 

classified 

37.50 

1 2 100.00 91.55 3.10 31.78 1.03 1.34 0.00 0.26 37.50 53.00 

2 2.5 91.55 80.28 31.78 51.94 1.34 1.67 0.26 0.37 53.00 62.00 

2.53 80.28 69.01 51.94 62.78 1.67 1.85 0.37 0.49 62.00 65.00 

3 4 69.01 50.34 62.78 82.95 1.85 3.30 0.49 0.52 65.00 73.50 

4 5 50.34 39.44 82.95 93.80 3.30 6.36 0.52 0.64 73.50 74.50 

5 6 39.44 22.54 93.80 99.22 6.36 29.07 0.64 0.78 74.50 72.00 

6 7 22.54 9.86 99.22 99.22 29.07 12.71 0.78 0.90 72.00 67.32 

7 8 9.86 7.04 99.22 100.00 12.71 – 0.90 0.91 67.32 67.50 

8 9 7.04 1.41 100.00 100.00 – – 0.91 0.98 67.50 65.00 

9 > 9 1.41 0.00 100.00 100.00 – – 0.98 1.00 65.00 64.50 

> 9 0.00 100.00 – 1.00 64.50 

LR+ is the ratio of the probability of a positive test among the truly positive 

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. 

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 

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 

subjects to the probability of a negative test among the truly negative subjects 

relatively preserved haemodynamics. In addition, the clinical picture of 

major haemorrhage and resultant shock can be mimicked by various 

conditions, such as vasoactive head injuries [8]. Clinical variables, 

such as blood pressure and heart rate cannot always discriminate 

in these instances [4, 10]. Delayed recognition of haemorrhage may 

delay appropriate treatment beyond the critical window for effective 

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

leaving clinicians with less time to prepare to receive the patient with 

the appropriate resources. However, over-transfusion of patients 

with a suspicion of major haemorrhage may occur based on clinical 

variables, where a blood transfusion is started in the absence of major 

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

with previous reports on the limited sensitivity and specificity of clinical 

variables for the prediction of ongoing major haemorrhage [5, 7], even 

when these variables are incorporated in sophisticated clinical scoring 

systems, such as the Trauma Associated Severe Haemorrhage Score 

and Assessment of Blood Consumption Score [3, 23]. 

In this study, we devise a decision support tool based on P-LACT 

measurements to aid clinicians at the transfusion decision point. Lactate 

is a well-known independent prognostic marker of in-hospital mortality 

in adult trauma patients [24] and previous studies have reported that 

P-LACT predicts the need for pre-hospital life-saving intervention beforeand 

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

of (continued) transfusion requirement in-hospital however has not been 

studied before. 

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

to exclude the need for in-hospital blood component therapy. This was 

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

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

hand, were highly predictive of the need for (continued) in-hospital 

transfusion and requirement of blood components. In combination with 

an appropriate trauma mechanism and/or clinical sign congruent with 

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

as a trigger to activate a ‘Code Red’ response to initiate pre-hospital 

transfusion, and to pre-alert the receiving hospital. P-LACT values 

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

in-line with previous studies, wherein it was shown that the aetiology of 

elevated P-LACT levels in trauma patients is multifactorial. Other factors 

than tissue hypoperfusion, such as increased lactate production due to 

catecholamine release as a result of pain, stress, or metabolic needs, or 

a decreased lactate clearance due to alcohol intoxication or liver injuries 

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

12 


FEATURE 

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

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

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

considered, especially when transport times to hospital are prolonged 

and whereby clinicians can aggressively resuscitate a lactate clearance 

to < 2.5 mmol/L. 

Currently, pre-hospital clinicians often transfuse one or more units of 

blood products to patients in whom major haemorrhage is suspected 

based on clinical variables. The clinical response is used to establish 

the need for further transfusion. However, this is not without risk, as 

transfusion related adverse events (although rare) may occur. Potential 

deleterious effects may be mitigated, to a certain degree by using 

serial P-LACT measurements [6]. The proposed algorithm in this study 

may help pre-hospital clinicians to achieve this. It may also attribute 

the correct identification of patients who have in-hospital transfusion 

requirements and may thereby contribute to the improvement of clinical 

pathways for these patients. 

Limitations 

Our study had several limitations. First, selection bias may have 

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

with suspected major haemorrhage. It is likely that a number of these 

patients presented in extremis and the completion of P-LACT would 

prolong the time to transfusion, mandating the crews on scene to 

prioritize resuscitative interventions above P-LACT measurements. In 

these patients however it is unlikely that P-LACT will add much in terms 

of decision-making regarding transfusion requirements. This highlights 

the challenges of ascertaining the temporality of bleeding in the prehospital 

phase of care. For example, identification and differentiation of 

the patient whom has active haemorrhage versus the patient who ‘has 

bled’. Tailoring of transfusion practice to each of these patients is the 

subject of further research. Further, qualitative research may be able 

to explore this further in combination with Bayesian theorem. Second, 

the P-LACT clinical decision tool developed in this study was derived 

from a relatively limited cohort of 221 trauma patients seen by a single 

centre. Validation in separate cohorts and other services is warranted 

to confirm diagnostic accuracy of the proposed P-LACT cut-off points. 

The decision tool should be tested to see if it results in more correctly 

classified patients resulting in earlier transfusion in those who need it and 

withhold transfusion in those who don’t. Third, in-hospital transfusion 

was used as a surrogate for ongoing haemorrhage. However, it is well 

known that heuristics and confirmation bias may have influenced the 

decision to start or continue in-hospital transfusion. Differences in local 

transfusion policies may have influenced this decision too, as patients 

were transported to three different MTC’s. 

Finally, P-LACT must be adopted within a heuristic approach, 

where clinical gestalt developed through pattern recognition, clinical 

observation and perception combine to estimate patient transfusion 

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

of a dynamic process. The clinical utility of P-LACT is likely found in a 

combination of physiological parameters. Future (Bayesian) prediction 

modelling to ascertain the value clinicians assign to clinical gestalt at the 

transfusion decision point may ascertain the adjunctive value of P-LACT 

in combination with physiological parameters [26] in the temporal 

management of the bleeding patient. 

Conclusion 

Pre-hospital lactate measurements can be used to predict the need for 

in-hospital blood component therapy. A simple decision support tool 

derived in this study can help the clinician interpret pre-hospital lactate 

results and guide the need for blood product transfusion. 

Abbreviations 

KSS: Air Ambulance Charity Kent Surrey Sussex; CCP: Critical Care 

Paramedic; CI: Confidence Interval; EOC: Emergency Operations 

Centre; FDP: Freeze-dried plasma; GCS: Glasgow Coma Score; HEMS: 

Helicopter Emergency Medical Service; HR: Heart rate; ICU: Intensive 

Care Unit; IQR: Interquartile range; MOI: Mechanism of injury; MTC: 

Major Trauma Centre; NIHR: National Institute for Healthcare Research; 

PHEA: Pre-hospital emergency anaesthesia; P-LACT : Prehospital 

lactate measurement; PRBC: Packed red blood cells; RTC : Road traffic 

collision; SBP: Systolic blood pressure; SI: Shock Index; STROBE: 

Strengthening the reporting of observational studies in epidemiology 



13

FEATURE 


guidelines; TARN: Trauma audit and research network; TDP: Transfusion 

decision point; USS: Ultrasound sonography. 

Acknowledgements 

We acknowledge the South-East Coast Ambulance Service NHS 

Foundation Trust and associated NHS Hospital Trusts for their ongoing 

support. 

Author contributions 

JG, ETA, RL conceived the study design. MS, JG and ETA performed 

statistical analysis. Data analysis and interpretation was performed 

by JG and ETA. JG and ETA drafted the manuscript. JB, GW and 

RL provided critical revision of the manuscript. All authors read and 

approved the final manuscript. 

Funding 

No funding was received for this study. 

Availability of data and materials 

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

available from the corresponding author on reasonable request. 

Declarations 

Ethics approval and consent to participate 

Internal service approval was sought from the Research, Audit and 

Development Department at KSS. All patient data were collected 

routinely as standard and therefore, ethics committee approval was not 

required. Patient identifiable data has been anonymised and stored on 

electronic devices with technical encryption (Data Protection Act, 1998). 

Consent for publication 

Not applicable. 

Competing interests 

JG, ETA, GW and RL are all employees of Air Ambulance Kent, Surrey 

and Sussex. JB is an employee of South East Coast Ambulance Service 

NHS Foundation Trust. There were no financial or non-financial conflicts 

of interest. 

Author details 

1 

Air Ambulance Charity Kent Surrey Sussex, Hanger 10 Redhill 

Aerodrome, Redhill RH1 5YP, UK. 2 University of Surrey, School of 

Health Sciences, Priestley Rd, Guildford GU2 7YH, UK. 3 Department of 

Emergency Medicine, University Medical Center Groningen, Groningen, 

The Netherlands. 4 University of Bristol, Child Dental Health, Bristol 

Dental School, Faculty of Health Sciences, Lower Maudlin Street, Bristol 

BS1 2LY, UK. 5 South East Coast Ambulance NHS Foundation Trust, 

Neptune House, Gatwick, Surrey RH10 9BG, UK. 

Received: 30 May 2022 Accepted: 1 December 2022 

Published online: 13 December 2022 

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14 


MOBILE WORKFORCE 

PURCHASING 

WORKSHOP 

MONITORING 

TASKS & 

SERVICING 

ASSET & INVENTORY 

MANAGEMENT 

RFID TECHNOLOGY 

STOCK 

MANAGEMENT 

MAKE READY 

FLEET 

MANAGEMENT 

BUSINESS INTELLIGENCE 

REPORTING

NEWSLINE 


‘Golden Hour’ Study 

Reaches Major 

Trauma Milestone 

More than 200 major trauma 

patients have been recruited 

for a pioneering £10 million 

research project looking at 

early detectors of probable 

susceptibility to in-hospital 

infection and / or multi-organ 

failure. 

The ‘Golden Hour’ study, which 

commenced in 2014, is being led 

by Research in Emergency and 

Acute Care Team at the Queen 

Elizabeth Hospital in Birmingham 

and is supported by the National 

Institute of Health Research 

(NIHR). The study aims to improve 

patient outcomes by developing 

tests to help clinicians treating 

those who have suffered a major 

trauma to spot the early signs of 

whether patients are more likely 

to develop a serious infection or 

multi-organ failure in hospital in 

the days and week following the 

initial injury. 

The research, which has now 

recruited more than half of 

the patients required, is being 

supported by the critical care 

paramedics and pre-hospital 

emergency medicine doctors 

at Midlands Air Ambulance 

Charity and West Midlands 

Ambulance Service University 

NHS Foundation Trust (WMAS), 

who collect blood samples from 

appropriate patients during the 

first hour of treatment. 

Dr Jon Hazeldine, research fellow 

at the University of Birmingham, 

who is leading the study, explains 

the research: “Although the 

major and immediate cause of 

death following severe trauma 

is haemorrhage, many trauma 

victims later die following 

complications such as multi-organ 

dysfunction or sepsis, with the 

individual’s immune response to 

injury significantly influencing the 

chances of developing these lifethreatening 

conditions. 

“To investigate the immune 

response to major trauma the 

Golden Hour study analyses blood 

samples acquired from trauma 

patients at a number of post-injury 

time-points. The acquisition of 

these samples commences in 

the pre-hospital setting, where 

patients are enrolled into the 

study within 60-minutes of their 

injury, a crucial time in which 

prompt medical treatment is key 

to survival. 

“Our collaboration with Midlands 

Air Ambulance Charity and WMAS 

provides us with unique access 

to trauma patient blood samples 

from the scene of injury, which 

enables us to study the immune 

system at the earliest possible 

opportunity following trauma. This 

has yielded new insights into the 

post-injury immune response and 

has demonstrated the importance 

of early blood sampling to truly 

understand how trauma alters the 

immune system. 

“To date, we have recruited more 

than 200 patients into the study 

and our experiments have shown 

that within minutes of injury, 

the immune system of trauma 

patients is suppressed. Based 

on these initial findings, our next 

aim is to establish whether, in the 

immediate aftermath of a major 

injury, there are differences in the 

immune responses of patients 

who experience poor clinical 

outcomes (e.g. the development 

of sepsis or multi-organ failure) 

compared to those who do not. 

If this proves to be the case, then 

we would be one step closer to 

uncovering potential markers that 

could be used to aid in the early 

identification and stratification of 

patients at risk of poor outcomes, 

which could have implications for 

their management and treatment.” 

Dr Mark Nash, medical director 

for Midlands Air Ambulance 

Charity, added: “The first hour 

of treatment post-incident is 

renowned for being the most 

beneficial, giving a patient the 

best possible chance of survival 

and good recovery. We were 

keen to support the Golden Hour 

study to assist with patients’ 

on-going advanced care within 

the hospital setting, again giving 

those in critical condition the best 

chance of a good outcome. The 

fact that more than 200 patients 

have now been recruited to the 

research will help the NIHR to 

positively influence in-hospital 

care, which will be of great benefit 

to patients.” 

To find out more about the 

Golden Hour study, visit srmrc. 

nihr.ac.uk/trials/golden-hour. 

Further information on Midlands 

Air Ambulance Charity is found 

at midlandsairambulance.com 

and West Midlands Ambulance 

Service is found at wmas.nhs.uk 

WAS 

Ambulance station 

welcomes Ukrainian 

refugees 

Welsh ambulance service 

staff have recently welcomed 

Ukrainian refugees to their station 

Rhyl Ambulance Station hosted 

Ukrainian refugees who have 

settled in the area to teach them 

about the Welsh Ambulance 

Service. 

As a result of Russia’s invasion 

on Ukraine, a large number of 

Ukrainian people have been 

displaced from their homes. 

To welcome them into Rhyl 

community, 10 Welsh Ambulance 

staff members gave those families 

living in the area a tour of the 

station and taught them lifesaving 

skills, all through an interpreter. 

Dermot O’Leary, Duty Operations 

Manager for Conwy and 

Denbighshire, who helped arrange 

the visit, said: “Humanitarianism 

crosses all language barriers. 

“It’s been a great experience, 

especially seeing the smiles on the 

children’s faces as they had a go 

at bandaging. 

“No words or interpreters are 

needed to see enjoyment firsthand.” 

The children were able to tour an 

emergency ambulance and rapid 

response vehicle and learnt how 

to perform CPR and how to use a 

defibrillator. 

Dermot continued: “It was great 

to see community engagement in 

action, especially from so many 

of our staff who willingly gave up 

their free time to support the visit. 

“Seeing these kids from a wartorn 

country being so positive and 

upbeat made me really value what 

16 


NEWSLINE 

I have and realise that despite all 

the pressures, we are lucky.” 

EEAST 

EEAST and Magpas 

Air Ambulance 

crews win 999 Hero 

category at The 

Sun’s Who Cares 

Wins awards 

Crews from the East of England 

Ambulance Service NHS 

Trust (EEAST) and Magpas 

Air Ambulance received a 

national award for their efforts 

in bringing a 13-year-old in 

cardiac arrest back to life. 

Prime Minister Rishi Sunak 

presented the team with the 

999 Hero award at the Sun’s 

Who Cares Win awards at a 

star-studded ceremony at the 

Roundhouse in London which 

was broadcast on Channel 4 on 

Sunday 27th November. 

The team won the award for their 

work in saving the life of Daisy 

Webb, who suffered a cardiac 

arrest when walking to school in 

Huntingdon in April. 

EEAST crew members Grace 

Lemin, Harrison Galgut and 

Charlie Harris arrived within 

minutes of the 999 call from 

Tommy Sadler, 15, and his mum 

Linda. They discovered Daisy had 

had a cardiac arrest, and began 

CPR and shocked Daisy’s heart 

until her pulse returned. 

The crews then handed over care 

to colleagues from Magpas Air 

Ambulance: Dr James Price and 

Critical Care Paramedics Steve 

Chambers and Thomas Giddings. 

The team performed a rapid 

general anaesthetic at the incident 

scene – a procedure usually only 

available in a hospital – to protect 

Daisy’s vital functions before 

she was transferred by land to 

Addenbrooke’s Hospital for further 

care. She has since made a full 

recovery. 

Lesley Hall, Leading Operations 

Manager with EEAST who was 

also on scene during the incident, 

said: “We are all so proud to receive 

the award which recognised the 

incredible teamwork that saved 

Daisy’s life on that day in April. 

“We often talk about the chain 

of survival in our work and the 

actions of everyone involved 

changed the course of what could 

have happened to Daisy – from 

Tommy and Linda calling 999, to 

Charlie, Grace and Harrison taking 

their swift action to get Daisy’s 

heart started and to the seamless 

transition of care to the Magpas 

Air Ambulance critical care team. 

“Thanks to everyone involved Daisy 

has the rest of life in front of her. 

“We all had an amazing evening 

meeting so many famous faces 

and it was great to receive 

recognition for the work that we 

do, as the past two years have 

been challenging for ambulance 

services and the NHS as a 

whole.” 

Tom Abell, Chief Executive of 

East of England Ambulance 

Service, said: “I am really 

pleased to hear that Daisy is 

recovering well. Everyone at 

EEAST is immensely proud of 

the team involved in saving 

Daisy’s life and receiving the 999 

Hero award at The Sun’s Who 

Cares Wins awards. 

“Our dedicated staff do lifesaving 

work like this every day, and 

this national recognition for this 

wonderful team will hopefully 

serve as a boost to their 

colleagues who are all working 

incredibly hard.” 


For the latest Ambulance Service News visit: www.ambulancenewsdesk.com 

17

NEWSLINE 

LAS 

Paramedic taught 

himself to swim for 

new role 

A paramedic who failed to get 

recruited for a specialist team 

at London Ambulance Service 

taught himself to swim so he 

could qualify for the role. 

After four years working on 

ambulances, Han Tugcu was 

keen to join the Hazardous Area 

Response Team (HART), a group 

of specially recruited and highly 

trained paramedics who provide 

life-saving medical care in highrisk 

and complex emergency 

situations, such as industrial 

accidents and natural disasters. 

To join HART, paramedics must 

complete a clinical exam and 

a fitness test, which includes 

swimming. 

However despite growing up in 

Sydney, Australia - close to some 

of the world’s most beautiful 

beaches - Han never learned to 

swim as a child. 

He said: “I don’t know how I 

avoided it but as you get older 

it gets harder to learn. It was 

embarrassing and I felt annoyed 

at myself that I couldn’t do it. 

“But I really wanted to join HART – 

I love working as a team in the big 

complex difficult jobs and I always 

like a challenge.” 

Han watched YouTube tutorial 

videos and visited his local pool 

a couple of times to try to teach 

himself to swim. 

However this challenge proved 

too much – Han failed the swim 

test and did not get the job, 

despite doing well in the rest of his 

fitness test and the clinical skills 

assessment. 

He admitted: “I was very stressed 

and very embarrassed not to 

complete the timed swim. I was 

devastated and disheartened 

about it.” 

Han was encouraged to improve 

his swimming and re-apply for 

the HART position. In between 

shifts, Han kept going back to 

the pool whenever he could, and 

when he re-applied a few months 

later, he managed to successfully 

complete the swimming test. 

He has since spent weeks 

completing tough water rescue 

training in Cardiff as well as 

learning all the other skills to 

prepare him to treat patients in 

perilous situations including fires, 

collapsed buildings, under trains 

or vehicles, or other in hard-toreach 

places. 

Training manager Chris Gill said: 

“Han has demonstrated incredible 

fortitude in overcoming his 

non-swimmer status and in less 

than a year, deftly participated 

in a number of water rescue 

scenarios. 

“He is a credit to himself and 

his team; and an inspiration to 

others.” 

Like all HART paramedics, Han 

is also trained to respond to 

chemical incidents, terror attacks 

and other high risk jobs. 

Care Quality Commission’s 

(CQC’s) inspection report of 13 

July 2022, which recognised 

the improved responsiveness of 

the Trust to incidents of alleged 

bullying, harassment, and 

discrimination. The EHRC was 

also encouraged by the Trust’s 

commitment to continuous 

improvement and the ongoing 

actions it plans to take. 

The action plan – including formal 

monitoring – had been agreed 

with the EHRC on 26th April 

2021 after a referral from the 

Care Quality Commission (CQC) 

following the inspection in August 

2020. That report found that 

the Trust had not done enough 

to address serious incidents 

of sexual abuse against both 

patients and staff. 

Since then, the Trust has delivered 

an action plan to address the 

concerns identified which has 

included enhanced training 

in appropriate behaviours, 

strengthening of the policies for 

handling cases of harassment and 

abuse, and training for managers 

which has led to stronger action 

when cases occur. 


He added: “The opportunities 

and variety you get working as a 

paramedic in London surprise me 

every day. 

“My advice if you’re thinking of 

joining? You only grow through 

challenging yourself.” 

EEAST 

EHRC concludes 

legal agreement with 

EEAST 

The East of England Ambulance 

Service (EEAST) NHS Trust has 

made significant progress in 

tackling sexual harassment and 

is no longer under the legally 

enforceable action plan which 

was agreed with the Equality 

and Human Rights Commission 

(EHRC) in April 2021. 

The EHRC acknowledged the 

progress made and noted the 

While formal monitoring ended at 

the conclusion of the agreement 

at the end of October, EEAST has 

committed to making continuous 

improvements to protect its 

workforce and ensure a safe and 

supportive workplace. 

Tom Abell, Chief Executive of 

EEAST, said: 

“The conclusion of this agreement 

with the EHRC shows the 

progress that we have made in 

tackling long-standing cultural 

issues at the Trust. 

“I would like to thank all our 

people for their hard work during 

a time when our service has been 

under severe pressure. 

“We still have a long way to 

go, and we are committed to 

continuing this improvement and 

building a culture which is a great 

place to work for everyone.” 

18 


NEWSLINE 

Over half of NHS 

Trusts providing or 

planning foodbanks 

for staff 

New research from NHS 

Charities Together suggests 

over half of NHS Trusts and 

Health Boards could be 

providing or planning to provide 

foodbanks for their staff, as the 

cost of living skyrockets. 

In a survey of NHS charities, who 

support every Trust and Health 

Board in the UK, 21% of the 34 

who responded said they had an 

active foodbank for NHS staff or 

are implementing one, and a further 

35% are exploring the possibility. 

Of the six active foodbanks who 

responded, three were newly 

opened between October- 

December 2022. Across these six 

alone, they estimate nearly 5000 

NHS staff are making use of them 

on a monthly basis, with around 

550 of these nurses. 

In addition to food banks, over 

half of the NHS charities surveyed 

(53%) are looking at other food 

support for staff – these include 

voucher programmes, free 

breakfasts, and subsidised meals 

in the canteen, where staff can 

also bring their families. 

Ellie Orton OBE, Chief Executive 

of NHS Charities Together, said: 

“As the cost of living escalates, like 

many employers NHS Trusts and 

the charities who support them are 

looking at ways to help staff through 

the crisis. But with pressures facing 

NHS workers already so extreme, 

it’s heart-breaking that some are 

having to resort to using food banks 

to get by. 

“Right now hardship funds 

and support are the main topic 

of interest for NHS charities. 

Queries from our members range 

from the setting up of Benevolent 

Funds and access to travel 

bursaries, to the possibility of 

providing hot meal vouchers and 

other basic support, including 

food banks. 

“As a sector we are proud to 

support the staff and patients of 

the NHS however we can, and 

sadly today that support is more 

important than ever.” 

Examples of the response to 

increased need amongst staff 

include in Liverpool, where 

Liverpool Women’s NHS 

Foundation Trust’s partnership 

with a food poverty charity is 

providing around three trollies of 

food a week, with other staff also 

donating items. 

Michelle Turner, Chief People 

Officer and Deputy Chief 

Executive at Liverpool Women’s 

NHS Foundation Trust, said: 

“We know with the pressures of 

the current financial climate, like 

many other people our staff may 

be finding things more difficult at 

the moment. We decided to set 

up a staff pantry to provide help 

to anyone who may need it - no 

questions asked. The pantry 

consists of sealed and dry foods 

as well as other essential items 

such as sanitary products which 

can be accessed by staff 24/7. 

The running costs of the pantry is 

managed through our staff health 

and wellbeing fund as well as 

relying on kind donations of items 

from staff who are in a position to 

donate and donations from other 

partners in the city. So far it has 

been very well received and we 

will continue offering it for as long 

as it is needed.” 

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In Lothian, Food Pantries have 

been set up by the local Unison 

branch with support from NHS 

Lothian Charity and Edinburgh 

and East Lothian Food Projects 

to help staff who are struggling 

financially because of the 

increased prices of gas, electricity, 

mortgages and more. 

Jane Ferguson, Director of NHS 

Lothian Charity, said: “As an NHS 

charity, we are committed to 

working together with partners 

to support our local NHS staff 

who are experiencing economic 

hardship as a result of this crisis 

in whichever way we are able to. 

Unison Lothian Health Branch 

had been made aware that some 

staff were struggling to buy food 

for their children or didn’t have 

enough for their bus fare to 

come into work and, together, 

we wanted to do something 

to help. With funding from the 

Charity for food parcels, Unison 

has co-ordinated setting up Food 

Pantries at various sites across 

Edinburgh, Midlothian, East 

Lothian and West Lothian for staff 

in need of additional support.” 

As the national charity caring for 

the NHS, NHS Charities Together 

works with a network of over 230 

NHS charities providing extra 

support in every hospital and 

health board in the UK. To find 

out more about NHS Charities 

Together and the work NHS 

charities do to support staff, 

please visit 

www.nhscharitiestogether.co.uk 

YAS 

Yorkshire Ambulance 

Service staff praised 

for long service 

Members of staff with a 

combined service of 3,280 

years have been recognised by 

Yorkshire Ambulance Service 

NHS Trust (YAS) at the Long 

Service and Retirement Awards 

2022, including one member 

of staff who has clocked up an 

incredible 50 years. 

They gathered for the special 

celebration at Pavilions of 

Harrogate and were joined by 

other guests including Reverend 

Brian Hunt, Deputy Lieutenant of 

North Yorkshire. 

This year’s recipients of awards 

for 20, 30, 40 and 50 years’ 

service include staff from A&E 

Operations, the Emergency 

Operations Centre, nonemergency 

Patient Transport 

Service, NHS 111, clinical 

education, project management, 

and quality improvement. 

The honours also included 

the Queen’s Long Service and 

Good Conduct Medal, which 

was awarded to 32 staff on the 

day for 20 years’ exemplary 

frontline emergency service and 

14 retirees were also recognised 

for their valuable service to the 

Trust and communities across 

Yorkshire. 

In total, 43 individuals were 

congratulated for achieving 

20 years’ NHS service and 10 

individuals for reaching the 30 

years’ service milestone. Seven 

staff were recognised for an 

incredible 40 years of service. 

The longest-serving member of 

staff in attendance was Service 

Development Project Manager 

(Integrated Urgent Care) Bob 

Sunley, who picked up an award 

for an outstanding 50 years’ 

service. 

Bob started his career with 

East Yorkshire County Council 

Ambulance Service (which later 

became Humberside Ambulance 

Service) on 1 March 1971 as an 

ambulance cadet, working initially 

as an ambulanceman in Beverley 

and Bridlington. He also worked 

in the control room where he 

was Control Superintendent. 

After 23 years in operations, he 

became Director of Business 

Development for Humberside 

Ambulance Service, before taking 

on the role of General Manager 

for NHS Direct when it was 

hosted by Tees, East and North 


(TENYAS). Latterly, he has been 

a huge part of the NHS 111 

management team, delivering 

many successful projects in the 

urgent care service. 

Rod Barnes, Chief Executive of 


NHS Trust, said: 

“The pressures the service and 

wider NHS have faced over the 

last three years have been the 

most significant of our lifetime 

and are likely to be with us for 

some time to come. This has 

tested our physical and emotional 

resilience as never before. 

“During these pressured 

moments we often don’t spend 

enough time simply letting people 

know how we feel, saying thankyou 

or well done, you’ve done a 

great job. 

“So, it’s even more important that 

we take time at these awards 

ceremonies to ensure colleagues 

are recognised for the fantastic 

work that they do and their 

tireless dedication to patient care. 

“The commitment, compassion 

and teamwork shown by people 

across the service in responding 

to the pandemic and wider 

challenges has been simply 

extraordinary and humbling 

to witness. Everyone has 

consistently gone above and 

beyond for our patients, and 

they all have so much to be really 

proud about.” 

The awards ceremony was also 

an opportunity for members 

of staff who recently retired to 

celebrate a lifetime of service to 

the NHS. Some of them enjoyed 

their jobs so much that they 

have come out of retirement and 

returned to work. 

SWASFT 

Ambulance service 

wins national award 

for new system that 

helps vulnerable 

patients 

A new IT system which has 

transformed how the South 

Western Ambulance Service 

NHS Foundation Trust 

(SWASFT) identifies and helps 

vulnerable patients, has won a 

national award. 

SWASFT teamed up with Exeterbased 

Iridium Consulting to create 

the Frequent Caller Management 

System (FCMS), which has won 

the Best Healthcare Management 

Solution category in the Health 

Tech Digital Awards 2022. 

The system was developed in Exeter 

and Bristol but serves patients from 

across the whole of the South West 

region from the Isles of Scilly to 

North Gloucestershire. 

FCMS is the first system of its 

kind in the UK that automatically 

identifies any individual who meets 

the criteria of being a frequent 

caller to 999 and who contacts 

the ambulance service from within 

its geographical area. 

Previously, SWASFT’s database 

could identify only addresses, not 

people – which caused problems 

if callers were away from home, or 

if they lived in a house of multiple 

occupancy. 

The bespoke system uses a 

unique algorithm to identify 

people who contact the service 

frequently and enables SWASFT 

to provide accurate, up-to-date 

information to Multi-Disciplinary 

Team meetings about them. Its 

data also helps shape specialised 

programmes for this group of 

20 


NEWSLINE 

patients. Together, this enables 

them to receive more personalised 

care. 

Frequent callers, defined as 

anyone who calls the ambulance 

service five times or more in one 

month, are vulnerable because 

they often have a complex 

mixture of medical, social and 

psychological needs. This 

means they need the help of a 

Multi-Disciplinary Team and can 

experience repeated difficulties 

when trying to access care and 

support. 

“Distilling and presenting such 

a large dataset into a concise, 

more manageable and meaningful 

version required new approaches 

and solutions, making FCMS a 

truly unique application in the 

space. It wouldn’t have been 

possible without such a close 

working relationship with the team 

at SWASFT and it is an honour to 

see the application being used as 

a central tool for managing such 

a complex part of the service 

SWASFT provides.” 

Other benefits of FCMS include: 

Jonathan Hammond-Williams, 

SWASFT’s Complex Care Lead, 

says: “This system helps us to 

identify and support some of our 

most vulnerable patients. They are 

often socially isolated and have 

not one but several health needs. 

Having multiple problems coming 

together forms what can feel like 

the perfect storm for them. 

“FCMS has revolutionised what 

we do. We have gone from 

manually counting houses to 

automatically providing data to 

help improve each individual 

patient’s quality of life. It allows 

us to track who has called and 

why, and to support the wider 

healthcare system in getting them 

the personalised help they need. 

“It was a real team effort to 

develop FCMS and I’m so 

pleased SWASFT and Iridium 

Consulting have earned this 

national acknowledgement. I’d 

like to thank everyone who has 

contributed, both within and 

outside the ambulance service”. 

Sam Rankin, Director of Iridium 

Consulting, says: “We were 

delighted when we learnt about 

winning the award. Overcoming 

the challenges to design and 

develop FCMS to support the 

ambulance service that serves 20 

per cent of England’s land-mass is 

something the team at Iridium are 

immensely proud of. 

• Reducing the number of distinct 

frequent callers to SWASFT 

from 1,500 a month in 2018 

to 925 in 2022, as callers are 

supported by more appropriate 

services than an emergency 

ambulance 

• Improving the availability of 

ambulances across the South 

West to attend life-threatening 

emergencies 

• Providing a one-stop shop for 

health professionals to see all 

previous episodes of care, the 

reasons for a call, and the actions 

completed by the clinicians 

involved in their 999 calls 

• Enabling improved links 

with other parts of the NHS, 

including acute hospitals trusts 

and mental health trusts. 

Jess Taylor, Senior Frequent Caller 

Administrator, helped develop the 

system. She adds: “FCMS allows 

us to put the patient at the centre of 

everything we do. A lot of work has 

gone into the system, so it’s very 

humbling and very exciting to get 

that recognition on a national level”. 

The system, which became 

operational in November 2020, 

has also supplied data that has 

helped shape services for this 

very vulnerable group of patients 

across the whole of the South 

West, with at least five new 

services being developed within 

parts of the region as a result. 


Do you have anything you would like to add or include in Newsline? Please contact us and let us know. 

21

NEWSLINE 

LAS 

“Don’t ‘man up’, 

get help!” – 999 

call handler opens 

up about mental 

health struggle as he 

appeals for men to 

seek support 

A London Ambulance Service 

(LAS) emergency call handler 

is urging men to seek mental 

health support as soon as they 

realise something is wrong, 

and not shy away from having 

that conversation with their 

loved ones. 

Scott Robertson, 33, who has 

worked as an LAS emergency 

call coordinator since 2019, 

made the appeal to mark 

Men’s Mental Health Month in 

November 2022. 

Scott was diagnosed with 

bipolar disorder four years 

ago but has suffered from 

poor mental health since his 

adolescence. 

Living with bipolar disorder 

means his life can be affected 

by extreme mood swings, and 

without the appropriate medical 

and psychological approach, 

he can face periods of severe 

emotional highs and lows. 

He said: “Living with bipolar 

almost feels like my mood is 

under a magnifying glass. I take 

medications to keep my mood 

stable, but there are periods 

in which my mental health can 

deteriorate. 

“Just a couple of months ago, 

I had a depressive episode 

and had to take some time off 

work and throw myself into my 

support network, which includes 

my husband, brother, and 

manager.” 

With calls to 999 often being 

the first point of care for those 

in a mental health crisis, Scott 

is witness to the mental health 

struggles of many Londoners. 

From September 2021 to 

August 2022, nearly 186,000 

calls with a potential mental 

health element were made to 

London Ambulance Service, 

86,758 of which were from male 

patients.* Over the past year, our 

staff and volunteers attended 

18,735 call-outs to patients with 

suicidal symptoms or having 

attempted suicide, and 9,028 of 

these incidents involved a male 

patient.** 

Scott fears that the number of 

men in London suffering from 

mental health conditions is 

higher than LAS figures may 

depict. 

“Societal pressures can put men 

off from calling for help, he said. 

“I felt a sense of shame when 

confessing my mental health 

condition, because I felt the 

pressure to ‘man up’ and meet 

the standard of what a man 

should be. 

“When I was diagnosed with 

bipolar I became very secretive 

about it. I was ashamed of the 

diagnosis and I didn’t want 

“If someone calls 999, they want 

to reach out and talk about 

the problem. When they don’t, 

they’re quick enough to tell you 

and you change the subject as 

necessary.” 

Having battled with low mood 

for a large part of his life, Scott 

wants to normalise the debate 

around mental health, especially 

amongst men, who can face 

stigma when opening up. 

Scott’s advice is straightforward: 

“Don’t ‘man up’, get help! If 

you have a support network 

– a group of trusted friends or 

family, then give them a chance. 

Sometimes you write people off 

thinking that they’re not going to 

understand. But I’ve found that 

the minute you open up, people 

do want to understand and want 

to support you. 

“The more we open up, the more 

we discuss mental health, the 

more we empower those around 

us to do the same and support 

each other.” 

anyone to know about it. I 

If you are having suicidal 

swore the people around me to 

thoughts, thoughts of harming 

secrecy, Scott continued. 

yourself or others, or if you do 

not feel you can keep yourself 

“As a gay man, I felt a bit 

and someone else safe call 999 

excluded from typical ideas 

or go to A&E now. 

of masculinity. Being then 

diagnosed with a mental health 

If you need help urgently for your 

condition made me fear that I 

mental health, but it’s not an 

wouldn’t be taken as seriously 

emergency call 111 or use NHS 

as a straight, healthy man.” 

111 online service. 


But Scott’s battle with mental 

health, which has marked over 

half of his life, now acts as an 

inspiration to better empathise 

with patients who are at crisis 

point. 

He said: “I experience those 

crises myself and I know the 

desperation that you can feel 

in those situations, so I’m 

not frightened to have those 

conversations with patients. 

If you are experiencing 

symptoms such as low mood, 

anxiety, and depression call 111 

or speak to your GP. 

To access more mental health 

services, visit www.nhs.uk/ 

nhs-services/mental-healthservices/. 

Your mental health is as important 

as your physical health. You will 

not be wasting anyone’s time. 

22 


NEWSLINE 

New mental health 

ambulances scheme 

to take pressure off 

other emergency 

services - Hexagon 

comments 

The UK Government 

announced* that a £150 

million investment will be 

made to support those 

experiencing mental health 

issues through specialised 

mental health ambulances 

and other crisis services. The 

investment will enable the 

procurement of approximately 

100 new mental health 

ambulances, which will 

take specially trained staff 

directly to patients in order 

to deliver support on the 

scene or transfer them to an 

appropriate place of care. 

With patients facing mental health 

problems being twice as likely 

to spend 12 hours or more in 

emergency departments than 

other patients, this funding will 

allow 150 new projects centered 

on supporting the provision of 

mental health crisis response 

to enable more convenient and 

efficient care for mental health 

patients whilst reducing critical 

hospital admissions. 

Nick Chorley, director of public 

safety and security for EMEA at 

Hexagon’s Safety, Infrastructure 

& Geospatial division, welcomes 

these new programmes and 

comments on what else needs to 

be considered. 

“Given the rise in patients 

presenting with mental health 

issues, it is great to see 

programmes being rolled out to 

provide better patient care, by 

delivering specialist staff who are 

more adept in dealing with mental 

health emergencies. Equally, it 

is essential that specialist and 

expensive resources like sworn 

police officers or ambulances 

that are uniquely able to perform 

certain tasks are kept available for 

those tasks when they happen and 

not tied up on tasks that others 

can perform. Nonetheless, whilst 

this is a step in the right direction 

for improving care of mental 

health patients, if the triaging 

of appropriate care remains 

ineffective, patients will not receive 

the help they need, and this 

investment will be wasted. 

“Indeed, the UK Government 

must streamline the way 

emergency services respond 

to patients experiencing mental 

health issues by ensuring that 

modern technology is available 

to accommodate these new 

programmes. One of the best 

ways that technology can help 

this new way of dispatching 

personnel to mental health 

emergencies is via data analysis. 

Utilising analytics from routine 

operational data, such as call data 

from computer-aided dispatch 

systems, emergency centre 

managers can gain insights to 

help ensure that the right member 

of staff is assigned to the job that 

they are best placed to deal with. 

Operational data and analytics can 

also be integrated with artificial 

intelligence to offer new levels of 

assistive insights to dispatchers, 

enabling the best possible level of 

care to be provided to the patient at 

hand. Not only do these solutions 

have the potential to treat mental 

health emergencies quicker and 

more efficiently, but they can also 

save emergency service resources.” 

*https://www.gov.uk/ 

government/news/mental- 

health-services-boosted-by- 

150-million-government-funding 



23

NEWSLINE 


LAS 

Paramedic speaks 

out after patient 

jailed for sexual 

assault 

A paramedic at London 

Ambulance Service who 

was sexually assaulted by a 

patient has spoken out in the 

hope it will encourage others 

to seek justice – after her 

attacker was jailed. 

Naveed Ahmed, aged 35, of 

Hickling Road, Ilford, was jailed 

in November for nine months 

after he groped paramedic 

Charlotte Miller and exposed 

himself. 

Charlotte has waived her 

right to anonymity, which is 

automatically granted to victims 

of sexual offences, in the hope it 

will encourage others to report 

similar crimes. 

She said: “My crewmate and I 

were encouraging the patient to 

get into the ambulance so we 

could assess him but he grabbed 

my crotch and tried to grab me 

again. Then he pulled his pants 

down. 

“I couldn’t believe it, I was asking 

myself if it really happened. I was 

frightened and scared. I think the 

reason I was so shocked was 

because it was so unexpected – 

I was there to help him.” 

Newly released footage from an 

ambulance video camera, shows 

Charlotte on her radio calling the 

police moments after the assault. 

Police officers arrived in less than 

a minute and arrested Ahmed 

after the incident in Edgware 

Road last October. 

Charlotte added: “The whole 

thing was sickening and 

disgusting and really made us 

feel quite vulnerable. 

“But I would urge everyone to 

report these things because I was 

well supported by my management 

team and by the police. 

“It’s only by reporting this sort of 

behaviour and helping police to 

prosecute that the message will 

get through that there are serious 

consequences.” 

In 2022 there were a total of 

49 sexual assaults on London 

Ambulance Service (LAS) staff or 

volunteers. There were a further 

516 physical assaults – including 

kicking, punching, head-butting 

and attacks with a weapon - and 

601 reports of verbal abuse or 

threats of violence. 

The Service has invested more 

than £3 million in kitting out its 

ambulances with video cameras 

aimed at protecting crews. So far, 

video captured by the ambulance 

cameras has been used in several 

successful prosecutions, with 92 

submissions of video evidence 

since April 2022. 

London Ambulance Service’s 

Chief Paramedic Dr John Martin 

said: “Our ambulance crews and 

call handlers should be able to 

work without fear of violence, 

sexual violence or threats. 

“They come to work each day 

to help others so we will do 

everything we can to keep them 

safe and ensure they are treated 

with the respect they deserve.” 

LAS joined ambulance services 

across the country to launch a 

“Work Without Fear” campaign 

to promote a no-violence culture 

and help create a safer work 

environment for front-line staff and 

volunteers. 

The Service has dedicated 

Violence Reduction Officers who 

encourage colleagues to report 

all incidents of abuse while also 

supporting them through the court 

process. 

Detective Constable Jorge Sobral, 

of the Metropolitan Police, was 

part of the team who pursued the 

case again Ahmed. 

He said: “Our colleagues in the 

ambulance service dedicate their 

lives to helping people, and it is 

not acceptable for them to be 

treated like this. 

“We will always investigate 

crimes like this and I would urge 

people to always report this sort 

of appalling behaviour to the 

police. This was a good result 

and will hopefully change people’s 

behaviour.” 

‘Unusual norovirus 

activity’ sees cases 

soar 37% higher 

than pre-pandemic 

average 

The UKHSA is reporting a 37% 

surge in cases of norovirus – 

often called winter vomiting 

sickness – compared to pre- 

Covid levels for the first weeks 

of January. As it warns ‘unusual 

norovirus activity’ will continue, 

a leading testing expert fears 

further strains on the NHS. 

Cases of norovirus, commonly 

known as winter vomiting 

sickness, have soared by 37% 

compared to the same period 

pre-Covid. A report from the UK 

Health Safety Agency (UKHSA) 

says cases for the first two weeks 

in January jumped by 37% over 

the five season average prepandemic, 

with over 65s reporting 

the steepest rise. 

A leading testing expert is 

concerned that the changing 

pattern may indicate a further 

surge to come. He cautions that 

the virus has not returned to its 

overall pre-pandemic seasonal 

trend this winter and warns health 

professionals to take note of 

the UKHSA’s observation that 

24 


NEWSLINE 

‘unusual norovirus activity will 

continue throughout the 2022/23 

season’. 

Dr Quinton Fivelman PhD, Chief 

Scientific Officer at London Medical 

Laboratory, says: ‘Norovirus is 

a very unpleasant virus. As its 

common name, winter vomiting 

bug, implies, it often causes 

sickness and diarrhoea. Other 

symptoms can include a fever, 

headache and aching arms and 

legs. Typically, it doesn’t last very 

long and usually goes away in 

two to three days, but it can lead 

to complications. In particular, 

children and the elderly can be 

badly affected by this virus and 

may require hospital treatment. 

‘The obvious concern is that the 

NHS has no spare capacity to 

deal with a further epidemic this 

winter, on top of Covid, flu and 

Strep A outbreaks. With industrial 

action in the health service set 

to escalate, increasing cases 

of norovirus couldn’t come at a 

worse time. 

‘Commonly, the most serious 

complication from norovirus is 

dehydration, particularly if you 

or your child cannot keep fluids 

down. In the case of babies and 

young children, seek medical 

advice if they stop breast or bottle 

feeding, or if they show other 

signs of dehydration such as 

fewer wet nappies. 

‘You should call 111 if you (or 

your child) have bloody diarrhoea 

or bleeding from the bottom, 

diarrhoea for more than 7 days or 

vomiting for more than 2-3 days. 

‘Concerning though this sudden 

jump in cases is, the good news 

is that it is unlikely that we are 

seeing a new mutation, despite 

the warning of “unusual” activity. 

This winter, the main strain 

continues to be genogroup 2 (GII) 

that makes up 74% of cases, 

with the main genotype being 

GII.4, causing 32% of cases. Last 

winter, GII caused 90% of cases 

and GII.4 specifically 48%. 

‘Rather than any new variant, 

the main reason for this month’s 

spike in cases is likely to be that 

immunity against norovirus is 

fairly short-lived and during the 

pandemic fewer people were 

exposed to the virus than normal. 

Now everyone is mixing again, 

cases are increasing. This virus 

spreads very easily and quickly, 

more so than the other viruses 

causing illness this winter. 

‘With our immunity down, it’s 

sensible to take precautions to 

avoid this unpleasant virus, if 

possible. You can catch norovirus 

from: 

• close contact with someone 

with the virus 

• touching surfaces or objects 

that have the virus on them, 

then touching your mouth 

• eating food that’s been 

prepared or handled by 

someone with norovirus 

‘As with Covid, washing your 

hands frequently with soap and 

water is the best way to stop it 

spreading. However, it’s important 

to note that alcohol hand gels 

don’t kill this bug. 

‘A general health test might be a 

useful course of action for anyone 

concerned, to ensure they are 

in good health to fight infections 

and reduce the likelihood of 

needing access to health services 

this winter. London Medical 

Laboratory’s General Health 

Profile Test provides people with a 

comprehensive check-up of their 

general health, including diabetes 

(HbA1c), gout, liver & kidney 

function, bone health, iron levels 

and a full cholesterol profile. Other 

more comprehensive tests check 

your vitamin D levels, which are 

often low at this time of year, and 

any potential thyroid or hormonal 

imbalances. 

‘They can be taken at home 

through the post, or at one of the 

many drop-in clinics that offer 

these tests across London and 

nationwide in over 90 selected 

pharmacies and health stores. 

If done in-store, a full blood test 

can be added that can indicate 

a wide range of issues such as 

infection, anaemia and leukaemia. 

For full details, see: https://www. 

londonmedicallaboratory.com/ 

product/general-health 

AAKSS 

Tracey Crouch MP 

presents the Queen’s 

Platinum Jubilee 

medals to front 

line staff from Air 

Ambulance Charity 

Kent Surrey Sussex 

(KSS) 

On Friday 25 November Tracey 

Crouch, MP for Chatham 

and Aylesford, attended the 

Rochester headquarters of 

Air Ambulance Charity Kent 

Surrey Sussex (KSS) to present 

the Queen’s Platinum Jubilee 

Medals to front line staff from 

the life-saving charity. 

KSS invited Tracey Crouch to 

present the medals in recognition 

of the exceptional role she played, 

in partnership with Air Ambulances 

UK (AAUK), in persuading the 

Government to enable eligible staff 

from Air Ambulance charities to be 

included in the medal allocation. 

Prior to this campaign, no one 

directly employed from the Air 

Ambulance sector was included in 

the awards. 

As part of the activity to extend 

the award eligibility to Air 

Ambulance staff, Tracey Crouch 

rallied support from 25 MPs 

across Kent, Surrey and Sussex. 

Together they signed a joint letter 

to the Rt Hon Sajid Javid MP, who 

was then the Secretary of State 

for Health and Social Care. 

David Welch, CEO, KSS said: 

“KSS wrote to Tracey Crouch 

earlier this year to highlight the 

exclusion of air ambulance staff 

from these awards and she 

immediately offered her support. 

Her actions resulted in the 

Department of Health and Social 

Care including eligible Helicopter 

Emergency Medical Services staff. 

“I couldn’t be prouder of the fact 

that 41 paramedics, doctors and 

pilots from Team KSS received 

their prestigious Platinum Jubilee 

Medals today. Without Tracey 

Crouch’s support, and the support 

from all our local MPs across 

Kent, Surrey and Sussex as well 

as Air Ambulances UK, it would 

not have been possible for them 

to have received this honour.” 

Tracey Crouch MP said: “The 

air ambulance is a vital part of 

our emergency services ecosystem 

and it seemed incredibly 

unfair that they were due to be 

exempt from recognition. With 

their base situated on the border 

of my constituency I often see 

the helicopter heading off to 

or returning from an incident, 

knowing that they are called to the 

most difficult and challenging of 

situations taking the equivalent of 

an emergency department right 

to the scene. It was my absolute 

privilege to co-ordinate a call 

for their inclusion in the Queen’s 

Platinum Jubilee Medals and I am 

humbled to present them to some 

absolute heroes.” 

KSS provides world-leading 

pre-hospital emergency care 

whenever and wherever required 

to save lives and ensure the 

best possible patient outcomes. 

Its crews of pilots, doctors and 

paramedics responded to 3,051 

incidents in 2021, the charity’s 

busiest year in its 32-year history 

– and so far this year, the service 

has been in demand more than 

ever before. 

>>> 


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25

NEWSLINE 

Each year, KSS must raise 

£15.2M to operate its life-saving 

service. 86% of its total income 

is raised through the generosity 

of KSS’s supporters. For further 

information, please visit www. 

aakss.org.uk 

Galen and College of 

Paramedics call for 

entries for the Dr John 

Hinds Scholarship 

Award 2023 

Galen, the privately-owned 

pharmaceutical sales and 

marketing company is 

pleased to announce that 

applications for the Dr John 

Hinds Scholarship Award 2023 

are now open across Northern 

Ireland and the Republic of 

Ireland. 

The scholarship, which runs in 

association with The College 

of Paramedics, is presented 

in memory of the late Dr John 

Hinds, who was regarded 

as an inspirational leader by 

paramedics and emergency 

medical technicians and those in 

pre-hospital care within Ireland. 

A world-renowned critical care 

physician, Dr Hinds gave a 

huge amount of his own time 

to educating and supporting 

paramedics and ambulance staff 

throughout the Island of Ireland. 

He died in 2015 following a 

motorcycle accident. 

The recipient of the scholarship 

will win a fully funded place on 

the highly coveted Anaesthesia 

Trauma and Critical Care (ATACC) 

course and have their case 

study published in the College 

of Paramedics’ magazine, 

‘Paramedic INSIGHT’. 

Dr Dennise Broderick, Managing 

Director & President, Galen, said: 

“We are delighted to support this 

award for a fourth year, through 

our partnership with The College 

of Paramedics and pay tribute to 

Dr John Hinds’ legacy. 

“At Galen, we appreciate now 

more than ever the importance 

of the work undertaken 

by emergency medicine 

professionals right across the 

island of Ireland. We hope that 

through this scholarship we 

can support the emergency 

medicine sector in a small way, 

by providing a unique opportunity 

for healthcare professionals to 

advance their expertise and gain 

access to a globally recognised 

training programme.” 

Imogen Carter, Executive Officer 

for Policy Development at the 

College of Paramedics said: 

“The College of Paramedics 

is proud to host this award in 

the name of Dr John Hinds, in 

partnership with Galen. We look 

forward to receiving many highquality 

clinical case studies from 

responders across NI and ROI by 

the 27th of February.” 

To apply for the scholarship 

award, entrants must submit 

a Clinical Case Study that 

was experienced in person. 

Submissions should be 

750–1,000 words, excluding 

references and appendices and 

be written to protect patient 

confidentiality. As a condition of 

the award, the case study will 

be submitted for publication in 

Paramedic INSIGHT magazine 

which has over 20,000 

subscribers, along with a followup 

article that describes their 

experience on the ATACC course. 

Submissions must be made using 

the Dr John Hinds Scholarship 

Award Entry Form, available at 

the following link: https://galenpharma.com/news-events/news/ 

john-hinds-scholarship-2023 and 

submitted via email to awards@ 

collegeofparamedics.co.uk by 

4pm on Monday 27th February 

2023. 

The College Honours and Awards 

Committee will then select the 

winning piece. The awards 

ceremony will take place at the 

College of Paramedics National 

Conference on 23rd May 2023. 

WAS 

Cheryl’s wing walk 

for charity 

A Welsh Ambulance Service 

worker is walking along a 

biplane wing for charity. 

Cheryl Hunter, a Volunteer Car 

Service Administrator for the 

Trust, will be walking the wing of 

a biplane to raise money for St 

Kentigern Hospice in memory of 

her father, James Miller Irvine. 

“But after seeing a picture of 

someone wing-walking a couple 

of years ago I just thought that I 

would love to do it, and why not 

fundraise while doing it.” 

The 60-year-old, who has 

worked for the Trust for 22 

years, will be taking on the 

aerial adventure for the mayor’s 

charity, which last year saw 

her husband, councillor Alan 

Hunter, the Mayor of Abergele, 

swim with sharks all in aid of St 

Kentigern Hospice. 

Cheryl said: “St Kentigern 

Hospice is a North Wales 

charity providing specialist 

palliative and end of life care, 

who do such a brilliant job. 

“It has a special place in my 

heart as the hospice cared for 

my father until the very end. 

“They have so much care to 

give to their patients but also 

provide so much support and 

comfort for families. 

“They are just fabulous.” 

Cheryl’s journey will start from 

Leeds East Airport, where the 

biplane will reach heights of up 

to 700ft and speeds of up to 

110mph. 

Pennie Walker, Volunteer 

Manager for the Trust’s Non- 

Emergency Patient Transport 

Service, said: “Cheryl is a brave 

and courageous woman, and I 

am proud that she is part of my 

team. 


Cheryl, who is also Mayoress of 

Abergele, will take to the skies on 

22 April 2023. 

She said: “I’m actually looking 

forward to it. 

“It’s strange because I would 

never do a bungee jump, I would 

not put an elastic band around my 

ankles and jump off something. 

“It takes a lot of willpower to do 

something like this. 

“I wish her all the best and hope 

that she raises a good amount 

for St Kentigern Hospice, which 

I know is very close to her 

heart.” 

You can sponsor Cheryl via her 

JustGiving page. 

26 


IN PERSON 

NWAS News 

Ambulance Service Deputy 

Chief Executive on 2022 New 

Year Honours list 

of towns in Cumbria including Cockermouth, 

Appleby, Keswick, and Kendal which 

devastated the area resulting in a mass 

evacuation and support systems to be put 

in place to look after many hundreds of 

members of the public displaced at the time. 

EHAAT News 

Operations Director for Essex 

& Herts Air Ambulance retires 

after 16 years’ service 

Deputy Chief Executive and Director of 

Strategy, Partnerships and Transformation 

Salman Desai has featured in the 2022 

King’s New Year Honours list. Salman will 

receive a King’s Ambulance Medal in the 

New Year. 

The King’s Ambulance Medal is awarded to 

ambulance staff who have shown distinguished 

service, exemplary dedication to their role, and 

demonstrated outstanding ability, merit and 

conduct to their vocation. On being awarded 

this honour, Salman said: “I am immensely 

proud and truly humbled to receive such an 

award after over 25 years’ service. It is an 

honour on a personal level but also for North 

West Ambulance Service (NWAS). 

“Helping people and shaping the organisation 

to meet and serve the needs of all of our 

communities is what motivates me. I have 

enjoyed every step of my career so far and 

receiving this honour is a true accolade.” 

Salman joined the ambulance service in 1997 

as a paramedic and has kept his paramedic 

registration to date. From 2007-2015 he was 

head of service development, undertaking 

a number of roles transforming services for 

patients. This included working with vulnerable 

and disadvantaged groups across Greater 

Manchester to prevent deaths from drug use. 

In addition to this, he provided commander 

support in response to two separate major 

incidents in Cumbria. 

The first incident was the shootings that 

occurred in and around Whitehaven in 2010. 

The second incident was the major flooding 

Salman joined our board of directors in 

2016 as director of strategy and planning 

and earlier this year, he was appointed as 

deputy chief executive of our trust which is 

the second-largest ambulance service in the 

country. 

Salman has worked hard to redress the 

balance of representation from ethnic minority 

communities within the ambulance sector, 

acting as a trailblazer for equity, equality, 

and a better understanding of the personal 

challenges that can bring. He recently shared 

his experiences with over 300 other leaders at 

an Ambulance Leadership Forum. 

Some of the steps he has taken to make 

change include being instrumental in supporting 

our Race Equality Network, moving it to a more 

formal footing, and ensuring its work is focused 

and impactful. Salman chairs our Equality, 

Diversity, and Inclusion Committee, driving 

improvements in the experience of patients 

using our services and staff. 

Salman’s portfolio includes patient 

experience, and he has established our 

diverse Patient and Public Panel ensuring 

we listen to and learns from the voice of 

our communities, from all ages and all 

backgrounds. This work enables service 

improvement and helps us address the health 

inequalities which have increased during the 

pandemic. 

Chief Executive Daren Mochrie QAM, said: 

“Salman is an exceptional and compassionate 

leader who always gives freely of his time to 

support and mentor individuals, teams, and 

peers across all service lines. He has been 

instrumental in developing our newly launched 

strategy and supporting myself and the 

Board to lead the transformation of the trust 

especially so during the past few years of a 

COVID pandemic. 

“He is both a well-respected leader and an 

asset to NWAS and the ambulance service 

nationally and I am proud of his achievement.” 

Congratulations Salman! 

After 16 years with Essex & Herts Air 

Ambulance (EHAAT) Cliff Gale has retired as 

Operations Director. 

Cliff joined the charity back in 2007, having spent 

30 years with Sussex Police where he gained 

hands-on experience managing the police air 

operation. Since joining EHAAT he has helped 

the charity achieve numerous milestones whilst 

setting the foundation for its massive growth. 

Cliff has been commended by his colleagues 

as helping to create clinical governance in prehospital 

care in the early days of air ambulance 

services. His achievements have been many, 

but probably the most notable are, playing an 

instrumental role in expanding the charity’s 

operations into Hertfordshire, cementing EHAAT’s 

future with its airbases at Earls Colne and North 

Weald, and purchasing its first owned helicopter. 

Cliff won’t be saying ‘goodbye’ completely though, 

as he will continue to work with the charity on a 

part-time basis to oversee the implementation 

of its carbon reduction strategy alongside other 

projects. However, he is handing over the 

‘operational reins’ to Paul Curtis who becomes 

EHAAT’s new Aviation & Operations Director. 

Paul has over 25 years in the aviation 

industry piloting helicopters for the military, air 

ambulances, the police and for the offshore oil 

and gas industries. He has also flown for Jet2. 

com, flying Boeing 737’s. 

Building on the excellent work already achieved, 

Paul, as part of the Executive Team, will be 

working alongside the whole EHAAT team, 

to help achieve its future strategic goals and 

ambitious plans to provide the highest possible 

standards of pre-hospital care for its patients. 

Jane Gurney, CEO of EHAAT said: “We are 

thankful for Cliff’s instrumental impact to the 

growth of the charity. His passion, energy, 

relentless drive and dedication has been clear, 

and his impact has been felt throughout the 

whole sector. However, I am hugely excited 

that someone as experienced as Paul has 

joined our team and I know he will do a 

fantastic job at guiding the charity through our 

next exciting chapter.” 



27

IN PERSON 

EEAST News 

Chair of EEAST to step down 

after three years 

The Chair of the East of England Ambulance 

Service NHS Trust (EEAST) is to step down 

after leading the Trust for three years. 

Nicola Scrivings joined EEAST in November 

2019 after previous roles with a Community 

Services NHS Trust, a Cambridge-based 

housing association and national roles with the 

Audit Commission and the Health and Care 

Professions Council (HCPC). 

As Chair, Ms Scrivings has overseen a period 

of improvement for the Trust, which has been 

recognised by the CQC and NHS England. 

She has now decided to step down from 

the role but will continue in post until her 

replacement is recruited. 

Ms Scrivings said: 

“It has been a great privilege and experience 

to travel alongside such dedicated ambulance 

crews and volunteers across the region. I know 

how hard everybody works to make sure that 

our patients receive the best possible care. 

“We set ourselves a vision of ‘outstanding 

care, excellent people every hour every day’ 

and I truly believe we are heading in the right 

direction under the guidance of our Chief 

Executive and the Board. I wish the new Chair 

a successful future with EEAST. 

“In the meantime, our Board is very focussed 

on working with our partners to address 

current performance issues.” 

This progress has been recognised by the 

CQC and NHSE with acknowledgement that 

the first phase of EEAST’s progress towards 

‘Good’ is drawing to a close. EEAST now has 

a stable Board with professional, committed 

members, with a range of combined talents to 

lead the Trust to the next level. 

Tom Abell, Chief Executive of East of England 

Ambulance Service NHS Trust said: 

“Nicola has made an incredible contribution 

to our improvement as an organisation, I 

would like to thank her for her dedication, 

and commitment to making our organisation 

a better place to work for our people and her 

passion to improve care for the communities 

we serve across the east of England. 

”Finding the right successor will take a little 

time, and there is a plan for a staged transition 

to a new Chair, aiming for appointment of 

a Chair Designate in May 2023. Until that 

time Nicola will continue to lead the Board 

with pride and support the hard work of 

ambulance crews on the frontline, including 

our volunteers.” 

SCAS News 

SCAS has announced two 

Non-Executive Appointments 

to its Board 

South Central Ambulance Service NHS 

Foundation Trust (SCAS) has announced 

two new non-executive appointments to its 

board of directors. 

Mike McEnaney, who comes with 25 years of 

finance director level experience, most recently as 

finance director for Oxford Health NHS Foundation 

Trust where he had additional responsibility for 

procurement, IT, HR and estates, began his initial 

three-year term on 1 January 2023. 

than a decade of experience in international 

healthcare management. He will begin his initial 

three-year term on 20 February 2023. 

He has been the global medical director of 

Marie Stopes International (MSI) Reproductive 

Choices UK for the last nine years, one of the 

largest providers of contraceptive and safe 

abortion care services in the world. 

He is part of the MSI executive team and 

provides professional clinical oversight globally 

for the organisation, which has 10,000 staff 

with 4,000 clinicians across 37 countries, as 

well as operating as a non-executive director 

for three countries. 

Prior to joining the SCAS Board, Dr Perera was 

an associate non-executive director with the 

Dorset County Hospital NHS Foundation Trust 

and is a member of working groups including 

with the World Health Organisation and 

International Federation of Obstetricians and 

Gynaecologists (FIGO). 

Mr McEnaney replaces Mike Hawker who 

has retired from SCAS after three terms 

of dedicated service as chair of the audit 

committee, while Dr Perera replaces Dr 

Henrietta Hughes OBE who left SCAS in 

September to take on the national role of the 

first Patient Safety Commissioner for England. 

Professor Sir Keith Willett, SCAS chair, said: 

“I am delighted to welcome both Mike and 

Dhammika to the SCAS board. 

“Mike brings a breadth of experience and 

skills which I know will be incredibly useful in 

helping SCAS to achieve its ambitions despite 

the economic challenges that we are all 

facing, while Dhammika has a very interesting 

clinical background which brings very valuable 

experience to help us as we continue our 

improvement journey.” 


He has also worked in senior manufacturing 

and logistics roles for Honda Motor Company 

and Avis Plc and has non-executive director 

experience as part of the audit committee at 

Oxford Brookes University. He also sits on the 

finance committee of NHS Providers and the 

board of Akrivia Health (a venture with Oxford 

University and the NHS). 

He is joined by Dr Dhammika Perera, a 

public health professional with over 20 years’ 

experience as a medical doctor and more 

Mike McEnaney and Dr Dhammika Perera 

28 


IN PERSON 

SECAMB News 

Trust announces two new 

board appointments 

South East Coast Ambulance Service 

NHS Foundation Trust, (SECAmb), has 

announced the appointment of two new 

Board members. 

Joining the executive team as Chief Medical 

Officer is Dr Rachel Oaten, while Max Puller 

joins the Board as an Independent Non- 

Executive Director for an initial term of three 

years. Rachel will join the Trust on 1 February 

with Max taking up his role from 6 February. 

Dr Oaten replaces Dr Fionna Moore on the 

SECAmb’s executive team with Dr Moore 

stepping down from her role as Medical 

Director for the Trust as announced last year 

- SECAmb Medical Director to stand down 

after 50 years’ NHS service - NHS South East 

Coast Ambulance Service. While Fionna is 

stepping down from our executive role, she will 

remain with the Trust in a part-time clinicallyfocused 

advisory role. 

Dr Oaten, who qualified as Consultant in 

Emergency Medicine in 2017, took up a 

post at Salisbury Hospital and in 2018 was 

appointed the Clinical Lead role for the 

Emergency Department. She also held a parttime 

post at East Midlands Ambulance Service 

in March 2020 where she served as Deputy 

Medical Director. 

In October 2021 she was appointed Deputy 

Clinical Director of Medicine at Salisbury 

Hospital. She maintains a clinical hands-on 

presence as an Emergency Consultant and 

also undertakes shifts working as a Trauma 

Team Leader. 

Dr Oaten said: “It’s important to me that 

everybody delivering care at SECAmb 

feels supported and knows that they are 

working alongside a chief medical officer 

who understands the current pressures and 

issues faced by staff and who delivers care in 

similar circumstances. I am keen to combine 

my acute care and pre-hospital experience to 

develop collaborative and effective systembased 

ways of working for our patients and 

staff.” 

Max Puller is currently Director at BCW 

Change, the organisational change and 

employee experience specialists at global 

communications agency, BCW. His role 

sees him work with global clients to 

deliver successful, sustainable business 

transformation and culture change. 

His previous roles include Head of Colleague 

Communications and Engagement at Tesco 

Bank, Employee and Change Communications 

Director at Sodexo, and Chief Communications 

Officer at the UK Ministry of Defence. Prior to 

his SECAmb appointment, Max was on the 

Board of the Salvation Army where he advised 

on reputation, marketing and fundraising 

issues. 

He said: “I am delighted to join the Board of 

SECAmb and excited to work with colleagues 

across the Trust as we continue on our 

improvement journey. I look forward to adding 

to the wealth of expertise and experience 

already on the Board, as we work together to 

drive positive outcomes for staff and patients 

across the region.” 

SECAmb Interim Chief Executive Siobhan 

Melia said: “I’m pleased we have been able to 

make these important appointments. Rachel 

and Max both bring a wealth of knowledge and 

experience from within and from outside the 

NHS. They will be made to feel very welcome 

at SECAmb and I look forward to working with 

them. I would also like to pay tribute to Fionna 

as she steps back from her executive role and 

thank her for her immense contribution to the 

ambulance sector over so many years.” 

SECAmb Chairman David Astley said: “I 

welcome both Rachel and Max to SECAmb. 

They are both strong appointments. I am 

pleased that Fionna is retaining a part-time 

role. I have always valued her advice to the 

Board and I am also grateful for her leadership 

as Interim CEO on two occasions in my time 

as Chair.” 

WAS News 

Coveted award for Welsh 

Ambulance Service 

The Welsh Ambulance Service won not 

one, but two prestigious awards. 

The Trust’s Emergency Communication Nurse 

System (ECNS) project team were named the 

winner of the Digital and Technology Innovation 

Award at last week’s Advancing Healthcare 

Awards Wales ceremony, while Advanced 

Paramedic Practitioner Ed Harry was highly 

commended in the Allied Health Professional of 

the Year category. 

ECNS is a new telephone consultation tool to 

help control room clinicians arrange the most 

appropriate care for 999 callers. 

Ellen Edwards, Senior Practice Educator and 

project team member, said: “It was an absolute 

honour to win the Advancing Healthcare Award 

for Digital and Technology Innovation. 

“The implementation of ECNS onto the Clinical 

Support Desk has been a challenge, with 

winter pressures, mass recruitment and a 

condensed timeline. 

“But despite all of this, the team have worked 

extremely hard, and this is a testament to 

that.” 

>>> 


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29

IN PERSON 

For the last four and a half years David has 

been working as Managing Director at George 

Eliot Hospital NHS Trust, Nuneaton, one of 

three District General Hospitals that make up 

the Foundation Group. Prior to this, David 

was Chief Operating Officer at University 

Hospitals Coventry and Warwickshire NHS 

Trust, during which time he also supported 

NHS Improvement Midlands & East, as Senior 

Winter Adviser. 

David has a particularly strong patient focus, 

underpinned by his clinical background and 

active nurse registration. His considerable 

expertise in system wide urgent and 

emergency care will be extremely valuable in 

leading SCAS as it seeks to further integrate 

health and social care through its key role as 

care navigator. 


On the award, which was sponsored by 

the Welsh Government, the judging panel 

felt the ECNS project showed “workforce 

sustainability, an extremely high impact to 

patients and would be of worldwide interest.” 

Penny Durrant, Service Manager for the Clinical 

Support Desk said: “I am incredibly proud of 

all the staff that have made a contribution to us 

winning this award. 

“There have been significant changes to the 

CSD in the last 12 months with the expansion 

in clinician numbers, the introduction of the 

Mental Health Practitioners and a new way of 

working with the implementation of LowCode, 

which operates ECNS. 

“This award is evidence of the dedication 

and hard work of CSD and its continued 

commitment to service improvement and 

ultimately patient care.” 

Advanced Paramedic Practitioner Ed Harry 

was also awarded ‘Highly Commended’ in the 

Allied Health Professional of the Year category. 

He said: “The only other individual who has 

been previously shortlisted from WAST for this 

award was Andy Swinburn, our Director of 

Paramedicine, so I’m just so grateful to even 

be nominated, let alone a runner-up.” 

Ed started his career as a paramedic in 2009 

and is now an APP who supports various 

projects and teams including the clinical 

support desk, APP training and ECNS, all while 

undertaking a PHD. 

Kerry Robertshaw, Professional Development 

Lead for Advanced Practice, said: “I nominated 

Ed, as his enthusiasm is infectious, and he is one 

of those people who just goes above and beyond. 

“He does so much incredible work in his own 

time – down to transformational projects 

that he is working on with the college of 

paramedics, to his PHD that is looking at 

the impact of Covid-19 on the health and 

wellbeing of our ambulance staff. 

“He’s really keen that our voice is remembered 

during this difficult time.” 

The Advancing Health Care Awards are held 

every year and is an opportunity to recognise 

and celebrate the important and innovative 

work of healthcare scientists and allied health 

professionals across Wales. 

SCAS News 

South Central Ambulance 

Service appoints new Chief 

Executive Officer 

Following a robust recruitment process, 

South Central Ambulance Service NHS 

Foundation Trust (SCAS) has appointed 

David Eltringham to the role of Chief 

Executive Officer, starting in March 2023. 

David said: “I’m delighted to be joining South 

Central Ambulance Service as its new Chief 

Executive. Every part of the NHS is under 

significant pressure at the moment and SCAS 

is no exception. When I join the Trust in March, 

I’ll be focusing on making sure that we look 

after our patients and our staff to the highest 

standards. I am committed to developing 

those around me to be the very best that they 

can be. I think that my expertise in this area 

will be of great value to SCAS. I met some 

fantastic, skilled and committed people during 

the recruitment process and I can’t wait to 

become part of the team.” 

Professor Sir Keith Willett CBE, Chair at 

SCAS, added: “I am excited to welcome 

David to the SCAS Board. He brings a wealth 

of experience, a passion for working with 

ambulance services and a strong track record 

in service improvement. This will certainly 

support SCAS in the delivery of its ambitious 

strategy and ultimately in the delivery of the 

best possible care for our patients and their 

families.” 

30 


COMPANY NEWS 

LogRx Offers a 

Better Alternative for 

Tracking Controlled 

Medications 

Ambulance companies 

contracted with NHS 

are subject to reporting 

controlled medications. We 

all know that it’s an arduous 

process: pull out the register 

after shift and log the 

administration of controlled 

drugs and other prescriptiononly 

medications. 

Most of the time, the reporting 

process goes smoothly-- 

emergency responders are 

notoriously meticulous. But we’re 

also notoriously busy, working 

in high-stress environments. So 

even when the coolest heads 

prevail, the process of pen-andpaper 

logging takes valuable time 

and leaves room for human error 

(and misuse). LogRx offers a 

simplified way to easily track with 

accuracy. 

Paper Tracking Can Result in 

Errors 

With access to controlled 

medicines come regulations 

and tracking requirements. 

Unfortunately, many organisations 

still rely on paper records to 

track, carrying a register in the 

medicine bag. 

In the stress and pressure of 

emergency response, people 

can, unfortunately, make 

intentional and unintentional 

mistakes. 

Because the Home Office and 

Care Quality Commission (CQC) 

regulates the specific medications 

emergency responders can 

carry and administer, especially 

controlled medications, they 

must be carefully recorded. 

Organisations are subject to 

periodic inspections to ensure 

that their company is in line with 

requirements. 

Proper recording of drug 

inventories helps organisations 

ensure there’s enough on hand 

and that it’s not expired or 

damaged. 

Implementing the right systems 

will help your team perform at the 

highest level. It protects those 

in management from breaching 

regulations and responders from 

questions about misuse. The 

right tools also protect patients— 

ensuring that paramedics can 

access what they need when 

they need it. 

A Better Solution for Digitally 

Tracking Medications 

LogRx is an innovative solution to 

ensure accuracy in drug tracking. 

The software allows responders 

to easily log and manage the 

medication inventory with their 

handheld devices, like phones or 

tablets. 

With a quick scan using the 

device’s camera, LogRx allows 

users to record medication 

in a digital log. It provides a 

groundbreaking solution for NHS 

ambulance teams and other 

emergency responders. LogRx 

doesn’t require special hardware, 

and it’s an extremely affordable 

option that saves money on 

costly errors and time-consuming 

reporting. 

LogRx is a tamper-evident 

system. Labels with purposebuilt 

QR codes ensure accurate 

tracking. The system is easy 

to use, without a high learning 

curve for busy teams. If your 

team ventures out of a service 

area during their work, they can 

still use LogRx and upload the 

tracking when they return in 

range. 

LogRx meets the needs of 

ambulance services with 

accountability, tracking history, 

and organisation. It allows 

you to access a full view as a 

manager, knowing what is being 

administered, where, times, GPS 

location, and trends—quickly 

identify any areas of concern. 

LogRx provides a fail-safe report 

for expiring drugs, helping 

users know when to replenish 

stock and manage inventory. 

With a glance, you can monitor 

the integrity of your medicine 

supply. From the administrative 

dashboard, many helpful reports 

make the jobs of the appointed 

medicine leads easier, especially 

when it’s time to report to 

the Home Office and CQC 

inspections. The cloud-based 

administrative dashboard makes 

it seamless and simple. 

The program was developed 

by those working in emergency 

response. Initially developed 

for use in the U.S., the LogRx 

team worked with U.K. field 

representatives to ensure 

compatibility across devices 

and platforms. For the last 

several years, many ambulance 

services that contract with NHS 

have successfully used LogRx 

to improve accountability and 

efficiency, as well as to reduce 

staff hours. 

LogRx works internationally with 

public and private emergency 

response organisations, 

ambulance services, fire, police, 

veterinary medicine, and wildlife 

professionals. To learn more 

about LogRx medication tracking 

for your organisation, visit 

LogRx.com. 

As with any paper system, there’s 

plenty of margin for error. Logs 

can get damaged and misplaced. 

In the busyness of emergency 

response, it’s easy for people to 

forget or become hurried in their 

recording. Then when it’s time to 

turn in the register, it’s difficult to 

decipher. 

Not to mention that paper 

tracking is more challenging 

to oversee. This lack of 

transparency can allow for 

the misuse and theft of drugs. 



31

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Ambulance UK February 2023

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