Sunday, 30 September 2012

Writing for The Mail on Sunday



Earlier this week I was contacted by The Mail on Sunday and offered an opportunity to raise awareness on a national platform of my concerns about the ambulance service cuts. For some time, The Mail has been campaigning against A&E closures around the country and was interested in the impact the cuts were having on the ambulance service. It goes without saying that the simultaneous depletion of two key emergency services are linked.

Presented with the opportunity to write in a national newspaper, I was conflicted. I wrestled with my conscience - was it the right thing to do? Would giving account of my morale and health-destroying experiences and the tremendous pressure my former colleagues continue to face be constructive and lead to a better ambulance service for patients and staff? I know many ambulance personnel would have come forward already, but for fear of their jobs. Because of my back injury, as of August this year I am no longer employed, so there is no such fear remaining for me. My attempts earlier in the week to appeal to the EEAST chief executive, Hayden Newton, had seemingly fallen on deaf ears.  Perhaps this is the last service I can do for my former colleagues.

I had to try.

Thursday, 27 September 2012

An Encounter with the EEAST Board of Directors

...except front line crews.
Your feedback from my previous article, Why the Public Should Care About the Institutionalised Abuse of Their Ambulance Workers, has been overwhelming and emotive. It is patently clear from the comments left anonymously by many practicing frontline ambulance personnel that the UK ambulance workforce is beleaguered, demoralised and pushed to breaking point.

The deluge of comments left in the last few days make for powerful and poignant reading. In review, there were a number of common themes and all were in agreement of the intolerable bleakness of the current situation:

"The workload is relentless...Many workers are over 50... and are expected to keep going at this pace ' til they reach the age of 68."

"The ambulance service is broken. The staff are tired, demoralised and miserable."

"...work load is up, sickness is up, but rather than cover for this the management drop the shifts to save money, this only puts more strain on those few on shift, because the call volume does not decrease when we are crews down."

"Staff are not cared for as they should be..I have lost several colleagues over the years due to the job..."

"I will not stay in this job for much longer. It is killing me. It is killing my friends and my crewmate."

"It won't be long now before the 'shock horror' headlines will be relating to stories of ambulance staff dropping dead when attending the public."

Thursday, 20 September 2012

Why the Public Should Care About the Institutionalised Abuse of Their Ambulance Workers

Regional Ambulance Trusts in England

In conference rooms and administrative buildings around the country, statisticians and logistics experts pore over figures, maps and budgets in an effort to squeeze maximum efficiency from available ambulance resources. Like every business in the UK, the era of austerity has meant even the emergency services are required to tighten their belts.

The problem of how to cope with rising ambulance calls in the face of budgetary reductions seems an impossible task.  According to Hayden Newton, East of England Ambulance Service chief executive, closer analysis of population distribution, social behaviours and trends in call history are "paving the way for the rota review and revisions which, using sophisticated modelling technology, tell us where and when vehicles are needed and what type." Assuming this miraculous technology is capable of what Mr. Newton says, this will lead to "ambulances not being cut overall, but matched to where the demand lies.”

Aside from the flippant thought that - if the "sophisticated modelling" is so accurate as to know where the emergencies will be before they happen, why don't they use it to stop the accidents in the first place - there seems to be a touch of messianic delusion at work here. With the government-stated requirement of East of England Ambulance Service to reduce expenditure by £50m over five years, Hayden Newton is essentially proposing to perform the ambulance equivalent of feeding the five-thousand with a few loaves and a couple of fish.

As far as we know, the EEAST chief exec does not have access to divine powers, so with £50m-worth of resources disappearing from his coffers, where does he think the ability to continue delivering pre-hospital healthcare worthy of a first-world nation is going to come from? Fortunately, like every ambulance service figurehead in the country, Hayden Newton believes he has access to a miraculous fountain of endless resources.

The front-line workforce.

Tuesday, 18 September 2012

North Norfolk's Hollow Victory


North Norfolk are celebrating making East of England Ambulance Service “rethink” their new deployment strategy which proposed the removal of full-time ambulance cover from the towns of Cromer and North Walsham. According to the Eastern Daily Press “they are taking another look at the controversial shake-up of cover and they have already agreed to amend heavily-criticised proposals.”

The “efficiency” proposals announced earlier this year were met with public outcry which gained momentum as MP for North Norfolk Norman Lamb and some notable celebrities added their voices to the cause. Now the decision-makers at East of England Ambulance Service have apparently U-turned after rising demand “triggered a clause in their contract”, leading to an extra £3m in funding which has allowed the provision of 2 (almost) full-time ambulances at Cromer and North Walsham.

Sorry North Norfolk, but it's not nearly enough - at best, you've been given a sugar-coated excrement sandwich. For a start, if it has suddenly come to the attention of the decision-makers that demand was on the increase, how could they justify any kind of withdrawal of cover in the first place without checking the figures first? Why did it take a public outcry for anything more than fuzzy logic and assumption based on old figures to be applied?

Saturday, 15 September 2012

The Charge of the Ambulance Brigade


Since the dawn of civilisation, time has been a critical factor in the treatment of the infirm. Even before modern medicine, those caring for the badly injured and the seriously ill would be acutely aware of the urgency of the situation. There are no qualifications required to recognise pain and suffering. The only thing that has really changed is how those circumstances are managed.

Fortunately, for the most part, things have improved.

The Common Miracle

Hippocrates: The Father of Western Medicine
The evolution of medicine itself spans thousands of years, with the Ancient Greeks being responsible for the Hippocratic Oath which, even today, underpins the ethical and honest practice of medical treatment. The Greeks also did much to advance the understanding of human anatomy and physiology and the names of most of the organs and structures in the body are Greek in origin. Physicians through the ages have built on this, expanding the biological sciences and developing new skills, all contributing to phenomenal wealth of medical knowledge no single person could ever hope to absorb.

We are all extremely fortunate to be living in today's enlightened age, where there are specialist treatments and life-saving procedures for many conditions which would previously have killed. With access to the right equipment in a hospital environment, the modern doctor's ability to diagnose and treat would, in the past, have been viewed as miraculous. For some, it still is.

But for those who cannot get to that hospital, it is irrelevant. This is why the ambulance service was born.

Friday, 14 September 2012

Mission Statement

Today's UK Ambulance Service is something of which this nation should be proud. The ability to bring a professional standard of healthcare to homes, streets and fields nationwide is a privilege not found everywhere in the world. To be able to take comfort in the knowledge that our health and our lives - and those of our elderly and our children - are championed by a national service of dedicated individuals trained and equipped to cope with almost any emergency is something we should not take for granted.

Yet many people do.

With that comfort comes a complacency that the necessary help will be available whenever it is needed; should a parent have a heart attack, or if a child is knocked down in the street. Many people assume that an ambulance equipped to deal with an emergency is minutes away and it will bring with it skilled and alert individuals qualified to fix the problem or quickly take the patient to a hospital where they can be treated.

But what if that was not the case?

As a paramedic with a decade of experience in front-line emergency care but who has now been forced to cease practicing due to a debilitating back condition, I can only watch as services are re-organised in a manner I am concerned will be detrimental to the emergency cover the general public needs.

The principles underpinning the Ambulance Service are something I firmly believe in and those colleagues who remain on the front-line have my utmost respect and support as they attempt to do their jobs in the face of impossible pressure. They are swimming upstream with their hands tied as resources are withdrawn, skillsets are diluted and conditions in which they work are worsened by the erosion of common sense. They are certainly not to blame for the falling standard of ambulance care. In fact, they are the an immeasurable resource that is relied upon to keep things working in spite of everything. But they are only human. Eventually, even they will break.

The Aim of This Blog

In an effort to continue contributing something to the ambulance cause, I aim to use this blog as a platform to discuss this faltering service and to highlight the concerns that an employed Paramedic could not, for fear of employer reprisals.

To be clear, it is not my intent to be defamatory or unnecessarily negative. The opposite in fact - I will continue to honour the principles of the Ambulance Service and the professionalism of the Paramedic workforce and those that work alongside them and support them. I will uphold the standards of patient confidentiality to which all healthcare professionals must adhere. I intend to be constructive, but I will not shy from hard truths and I will do my best to see through the weasel tactics used to confound the public into thinking that all is well. I have seen first hand that this is far from the truth.

I aim to weigh up the pressures which today's Ambulance Services face and to provide an honest overview of how problems might be addressed. Over the coming months I will explore the various challenges that face patients, individual crews, support staff and the service as a whole. Expect recurring themes like public accountability, resource management concerns, the role of the public, and institutionalised abuse. I will offer my thoughts on possible resolutions and lessons to be learned.

The Critical Patient

Any healthcare professional will tell you that the human body is a complex system of organs whose vital functions can only operate if the cardio-vascular system is healthy. Blood is needed to transport vital oxygen and nutrients to every part of the body and to remove toxins and waste products. Blood contains the means to fight disease, repair injuries and sustain life. Just like the ambulance service.

If skills can be diluted, stations can be closed and the means of transporting patients can be reduced, then surely the human body can survive with less and weaker blood. You do not have to be a medical practitioner to know that this is the recipe for ill-health and eventual death, both for the human body and for the NHS.

Ambulance Services are the blood of the National Health Service and right now it's bleeding out.

This is my call for help.