Saturday, 18 April 2015

Fear and Loathing in LAS Ambulance


It is painfully evident from the outcry caused by the case of Edmund Daly, a beleaguered paramedic who could take no more and was thrown to the wolves for it, that things are horribly wrong within the practise of emergency pre-hospital care.

After reading about the case on various news outlets and offering an alternative (read: more accurate) interpretation of proceedings, I was taken aback by the response. My blogpost has, at time of writing, been viewed nearly 80,000 times and the discussion has reached in excess of 150,000 people across various social media. As I result, I was given the opportunity to write a more sympathetic view for Metro.

Concurrently, similarly concerned paramedic Annelies van Wamel working in another Ambulance Trust, instigated an online petition entitled, 'HCPC this time you got it wrong!', in which she identifies,

'The HCPC is there to protect the public against malpractice. That is good. However, the HCPC did not realize and/or recognize that this paramedic was not the problem; it was his employer who disregarded staff welfare in its pursuit of targets. The blatant lack of support for a senior member of operational staff is an indication of the real problem and should be taken into account.'

In less than two days, her initial target was far exceeded and she closed the petition at 2,000 signatures. I have no doubt it would have accrued many more had she let it run.

Quite clearly, the response from both ambulance clinicians and the general public shows that we were not alone in our concerns.

A Dangerous Precedent

Chief among these issues is the fact that Daly’s case sends a clear message to all operational personnel that their health and 'fitness to practise' is a secondary concern to the employing ambulance trust's ability to meet targets. The HCPC can be used by employers as a blunt instrument to fuel a culture of fear which leaves individual staff, already expected to do the work of many, trapped between the devil and the deep blue sea.

There are urgent questions that need an answer: where would paramedics stand if they were NOT to indicate their limits? That would lead to unsafe, irresponsible and even illegal situations with potentially far worse consequences for staff, patients and the general public (think of driving while exhausted).

Where should clinicians turn if they feel they are being abused? The London Ambulance Service chose to 'make an example' of Edmund Daly and sack him after an internal investigation, so clearly LAS staff can expect no support from their employer. The HCPC chose to pile on and point the finger of blame at Daly rather than the organisation who pushed him off the cliff. Union involvement in proceedings evidently made little difference to the outcome.

Year on year, staff have to listen to promises that things will improve as new recruits are pumped into the meat grinder, all the while more and more staff are leaving, voluntarily or otherwise. The daily reality is that, in the current environment, many staff - new or old - will only last a short while before they are also broken by a system more willing to replace them than ensure that they are fit to continue.

This has to end.

Helping Ourselves to Help Everyone Else

Annelies and I have spoken at length to discuss what next steps to take. We have resolved to push back in the hope that we can change this poisonous culture. We're hoping for your support and input.

We will be contacting the College of Paramedics for their advice and guidance and we will be taking the 2,000 signature petition to the HCPC headquarters in London prior to the end of their consultation period on 'revised Standards of conduct, performance and ethics' (period ends 26th June 2015). The precise date of our visit is yet to be decided, but your involvement and attendance would be most welcome.

We are determined to create a better working culture for front line clinicians and the staff who support them.

There is no reason for this to even be a debate. There is no one who benefits from the current situation; not the operational staff, not the ambulance trusts, not regulatory bodies, not the Department of Health and certainly not the patients.

There should be no debate. But sadly there has to be to effect a positive change.

The time for suffering in silence is over.


Co-written by Mathew Westhorpe & Annelies van Wamel

We can be contacted via the Broken Paramedic Facebook page or at m[underscore]westhorpe[at]hotmail[dot]com.

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65 comments:

  1. I worked for the ambulance service for many years. I left about 7 years ago. By all accounts, it is worse now than it was then. On many occasions I did my BM. Regularly it was less than 2. No breaks, no food, bums on seats run ragged by controllers under pressure to meet ridiculous targets. Abused by the public who think they pay our wages. Still trying to remain professional, but, there is a limit to what you can take, how long you can take it for. We should be supported, not victimised. Ambulance crews are people not machines. Who cares for the carer?

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    1. I completely agree with your points here about LAS, they are horrendous when it comes to caring for their staff, regularly have done a 12 hour shift which has turned into 14 or 15 because of late jobs and had no sympathy when calling asking for my shift start the next day to be delayed, however your BM was less than 2 and you had a high enough GCS to take it? I think your meter may have been wrong as i've never seen a patient with a BM less than two with a GCS of higher than 13.

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    2. Where does this idea that crews are 'run ragged by controllers' come from. They have no control over the workload and when you are being run ragged they're having a shitty chest pain inducing kind of day too. I really feel for road staff and the treatment of Daly is a disgrace - but please remember a controller has no choice but to assign available resources to the calls that come in. If there are not enough resources then inevitably crews are run ragged and shifts overrun - it's not a choice on the controllers part - if they fail to assign an available resource and it all goes wrong they will have to stand in front of the coroner and explain why.

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    3. Rubbish. It is clear and evident that dispatchers will orchestrate extending crews shift times, to allow them to create additional resources with which to attain the targets they have to meet.

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  2. I currently work for an ambulance service and have received zero support with a newly diagnosed health problem, and in fact regularly face the opposite of the support I desperately need. All the focus is on targets and not on staff welfare. This is not a new problem, but it does need to stop right now.

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  3. The more you write the more they may actually take notice ..... Its gone on for far too long, they can no longer rely on the caring nature and goodwill of the staff.. My trust is ranting about how Good the figures are yet care not a jot for the broken and demoralised staff that have achieved them .

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  4. We had a station manager who looked after the staff and refused to be a yes man to the senior mangers. He looked after his staff and we were supported by him. Sickness was down to nearly zero and morale was high. Management did not like his way so as soon as they could he was reduced back to LA. The new manager, who was a yes man, undid everything that had been put in place. Sickness went through the roof and morale down to zero. Then staff started to hand there notice to quit in. What did management do? Nothing. They did not give a damm

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    1. Why am I not surprised at this! I worked in the service for 25yrs. Managers that are not a yes person never get on in the service. Favouritism has always been around when people are promoted,even though they are not capable of the post. I could not imagine the Armed forces take on some of the incompetent managers the Ambulance Service have.

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  5. Glad to see the comments on the page are placing responsibility forthe issues where it actually lays rather than ranting aobut how the Government have destroyed the NHS ( conveninently forgetting the state it was left in by the Union Shills 1997 -2010 )...

    The NHS across the board is, in my opinion, under-led and over-managed . This is all the more acute in the NHS given the traditional training of models of road staff and the presence , in some services at least, of personnel without a road or HCP background in jobs which should be be for those with both clinical and management skills ...

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  6. Whilst I fully sympathise with the plight of the paramedic and petition (i am myself married to one ) I find it in bad taste a picture of a severe fatal rtc involving an eca who was entirely blameless is being used it would Insinuate the accident was caused by a tired driver . However it was the actions of a driver who ploughed into the ambulance at speeds exceeding 90 mph who effectively ended the carer of the eca that day and left them with life changing injuries perhaps some thought should be made when using pictures and perhaps a quick Google into the story and is this picture really right to use

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    1. I apologise for the insensitive use of a photograph of a crashed ambulance (sourced from Google) without considering the implications for those involved. I have removed the photograph from this blog and appended the associated Facebook entry with some explanatory text.

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  7. This is something I put on another site, but think you might be interested. I showed "The Broken Paramedic" to a lawyer friend of mine, he could not believe it! His response was "I accept that emergency services have an Emergency Exemption, but no employer is exempt from UK law. The paramedic had worked for 11 hours 20 minutes without a break, he informed his employers that he was too tired to continue, which was the correct thing to do. The fact that his employers then sacked him and his professional body upheld that decision is totally unacceptable! If he had continued to drive and killed someone, his employer and the professional body could be guilty of corporate bullying and manslaughter. UK law is designed to protect employees and the general public, this is an abuse of the emergency exemption,!" I personally worked at a Major Incident for over seven hours without a break, no problem, as I believe that is what the exemption is for, not to overwork dangerously tired members of staff! Why are the Unions not involved, even if the paramedic was not a member, they should be involved and help protect his fellow colleagues! Unison, your silence is deafening!

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    1. And this is my point. Thanks for posting this. We need to challenge these decisions through the appropriate Courts, and when the case is found against the Trust, to have those responsible for making the decision held to account. We put up with far too much!

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    2. If he is a Unison member then the deafening silence would strongly suggest a legal challenge is being mounted. Under such circumstances, it is correct to say nothing openly as it could jeopardise the case. Although mouthing off would probably not have a negative impact, the chance is not worth taking and would be extremely unwise. To call for a knee jerk condemnation is naive. Frustrating as it is, there is no choice.

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  8. Perhaps Ed Daly should be helped to take his dismissal to an industrial tribunal, I am sure that the law would uphold his case!

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  9. After 27 years as a Paramedic in the LAS I had a breakdown. I was suspended for shopping whilst my patient was being cared for by my partner. My blood sugar was 2.3 after 2/3 of a shift done with no rest of food,just water. The call was a faint. Soon after this I was given Advice and Guidance for having Thrush,a common problem with badly managed Diabetics. i have type2 diabetes. With both of my parents passing away in less then a year I was falling apart. The straw that broke the Camels back was being sent to a possible head injury.On arrival at the call There was a male sitting on the pavement. He had just had his liquid breakfast and was on his 4th can of Larger. At this point I broke and was suspended for having a Haircut. I was suspended by an officer who was previously a Nurse. No contact was made and I proceeded to have a nervous breakdown. Having been sent to Occupational Health Department the Doctor s advice to the LAS was that I was unfit to be interviewed. After being intimidated by staff I resigned and Retired from all Paramedic Work. The Union were no use and stated that all staff went sick. Even the Secretary of the union said I had to be interviewed.Unfortunately at this point i attempted to kill my self. I have no recollection of what happened. Only now I am feeling up to working after 2 years of pain. To add insult to injury the HCPC struck me off and the press had a field day. The HCPC are a crew uncaring body. Most Ambulance trusts have at least one member appointed to the HCPC. When the HCPC were formed I supported it but wanted al. Ambulance Staff to be regulated. They are now used as a tool to install fear in all Paramedics. If you upset us we will have you struck off and you will loose you Job. Speaking to some Paramedics this is there fear.
    I am glad I am out of it. I still owe the trust £166 for Wages owed. This is because after giving my notice they decided to have a hearing with no input from me 2 days before the last day of employment. Well I hope the press see this. I declined to be interviewed by the BBC. I sympathise deeply with the Staff of the LAS who have been hammered so Managers can tick there boxes.

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    1. If indeed you are the paramedic who did his shopping and had a haircut while on calls (I remain to be convinced you are and not someone throwing a spanner in the works). You must admit this is very strange behaviour even for someone suffering a breakdown or having a hypo (did he not drive the patient to hospital after shopping?)

      There are limits to what anyone can defend and I think this case when the defendant was reported by his own colleagues is an entirely different and unusual case to Mr Daly and others.

      While I may sympathise if you are suffering from some breakdown, medical or mental illness and not been appropriately supported for your condition I think my support and probably others is really aimed at supporting paramedics who have been disciplined when they have done nothing wrong.

      A Paramedic.

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    2. The crew he was 3rd manning with reported Mr Daly! Maybe we should all have a little think about that.....!

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    3. So your basically calling her a liar. Show her the same concern you share for your patient's. The benefit of the doubt.

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    4. The Paramadic sacked in this case was male so I too am dubious

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  10. A colleague of mine has just made a suggestion and I thinkbit should be taken seriously. Why don't we start a petition for a vote of no confidence in the HCPC?

    And that legal argument mentioned needs to be forced through. This cannot stand!

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  11. What would happen if all the UK paramedics were to vote a no confidence in the HCPC and hand their registrations in? Obviously they wouldn't be able to legally practice but it'd make HCPC look awfully silly and maybe review their code of practice.

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    1. Years ago you did not have to be registered! It is a way of making money. If everyone registered as a Paramedic refused to pay the fee. What would they do!! No paramedics on the road!! Mmmm don't think so somehow

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    2. Years ago you did not have to be registered! It is a way of making money. If everyone registered as a Paramedic refused to pay the fee. What would they do!! No paramedics on the road!! Mmmm don't think so somehow

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  12. This poor chap has been represented at the HCPC by an entirely ineffective advocate. I represent at the HCPC and I have a 100 percent success rate in terms of people keeping their registration, and generally I am able to assist to ensure that the HCPC drop the case at preliminary stage, the most recent being only 3 days ago. It is necessary to use the HCPC's own rules against them. These are the standards that you are judged by. Standard 1. You must act in the best interests of service users. Attending a call where you are expected to think clearly and act correctly when tired, dehydrated and starved is not acting in the best interests of service users. Therefore the HCPC have got it wrong in applying this rule. Standard 12 states "You must limit your work or stop practising if your performance or
    judgement is affected by your health" Your state of health is a transient matter. It depends on rest, mental pressured, hydration and glycaemic status. Refusing further work because your health has deteriorated on shift is what is expected of you. I give you a scenarios - young paramedic party girl, has 4 hours sleep a night. Is bullemic, underweight and devoid of energy. Accepts a call, makes a fatal decision. The facts of the case that due to her mental and physical wellbeing which she has failed to manage, a foreseeable incident occurred and she has breached standard 1 and 12 and thus her fitness to practice is impaired. The ambulance service being vicariously liable would have a defence that they simply did not know and had no control. If in this case a fatal decision was made, then the ambulance service would be vicariously liable. Charges of standard 5 of the Health and Social Care Act, Misconduct in Public Office, Corporate Manslaughter and Aid/Abet the act of Gross Negligence Manslaughter would be considered by the prosecuting authorities - the police, the CQC and the HSE. cont

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  13. cont from previous Further, the requirement was that the paramedic take themselves at speed to meet an artificial timescale that does not reflect the emergent life threatening nature that would justify claiming an exemption for speed. There is the further offence under S89 (4) Road Traffic Offenders Act “If a person who employs other persons to drive motor vehicles on roads publishes or issues any time-table or schedule, or gives any directions, under which any journey, or any stage or part of any journey, is to be completed within some specified time, and it is not practicable in the circumstances of the case for that journey (or that stage or part of it) to be completed in the specified time without the commission of such an offence as is mentioned in subsection (1) above, the publication or issue of the time-table or schedule, or the giving of the directions, may be produced as prima facie evidence that the employer procured or (as the case may be) incited the persons employed by him to drive the vehicles to commit such an offence” Additionally, if a tired driver under duress from the employer - financial duress is sufficient, has an accident and it is determined that his tiredness caused the accident, then the offence is dangerous driving – the attitude of the driver is at fault, and his employer stands as second defendant. I am taking a unique and novel approach against an ambulance service at the moment to charge ambulance managers and directors with the offence of misconduct in public office – the elements of the offence are wide and all emcompassing. a public officer acting as such
    wilfully neglects to perform his duty and/or wilfully misconducts himself
    to such a degree as to amount to an abuse of the public's trust in the office holder
    without reasonable excuse or justification
    This will flow from a case I have been representing in all week which was a partial success and will be subject to appeal on legal rather than factual grounds. The health professionals involved will all face their regulatory bodies, and those deemed to hold public office will be reported for the consideration of the question of prosecution. The ambulance service management and the HCPC are a runaway juggernaut barrelling downhill with nobody at the wheel. The brakes need to be put on them. http://www.derbytelegraph.co.uk/Medic-cleared-sex-assault-sacked-fairly-8211/story-26350594-detail/story.html

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  14. A couple of things needs to happen.

    Strike action is put firmly back on the table, not regarding salary, but working conditions.

    Union leaders need to be held accountable to their members wishes, and if they're not delivering what we want, they should be ousted and replaced with people who are prepared to stick their heads above the parapet and not cosy up with management

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  15. Steve, I've been representing before the Employment Tribunals against ambulance services since 1998 and before the HCPC, or the old HPC since 2004. There is a new trades union being created as we speak which will overcome the hurdle of ambulance trusts refusing to allow me in to disciplinary and appeal hearings because they prefer their UNISON stooges to assist to conspire to dismiss. I won one last year against WMAS and all of the senior managers involved are now no longer NHS and trying eek a living as "consultants" with their own private companies run from their home addresses. I also caught three of the managers involved in this weeks case in a pub drinking alcohol after the case had concluded. I have reported them to the Trust and will be reporting them to their regulating bodies. There is one rule for everyone and these people are not above any law that I know of.

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  16. the problems are from top to bottom. Control are under pressure to send resources and have their bosses on their back if the don't mobilise quick enough. Control's bosses have people on their back demanding answers..frontline crews get nailed due to inappropriate staff numbers..
    We're about to have 12 hr shifts re- introduced due to spikes in demand not being addressed. I can't think of anything more detrimental right now than 12 hr shifts ( currently on 10 hrs) especially with the current workload.
    The AFC stitched ambulance crews up by offering band 5 , especially seeing we are now doing above and beyond that. I'm sure band 6 would keep some staff but it goes further than money.
    I don't know what the answer is but something is going to give. And soon

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    1. Some people think working on the front line on an Ambulance would be a sought after job. You wouldn't do it for the money! Targets! You have a minute to be mobile. What happens if you are in the toilet! No excuses! I was oncall and got a job and couldn't get into the vehicle as the remote control went wonky. Me and my colleague were spoken to the next day! How can it beour fault that we cannot get into the vehicle. I feel sorry for control. They have a very stressful job. Sickness, single crewed vehicles, not enough resources.

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  17. The problem is managers. If they do not rock the boat, they get promoted into none jobs and earn more money. The incentive is money. For instance, one of the mangers involved in the case I represented in last week was a band 8 "Director of Nursing and Quality". The ambulance service does not have nurses which are part of its core work. She has now moved on to be Director of Nursing and Quality for not one but 3 Clinical Commissioning Groups on much more money. This ladder climbing and is a recipie for corruption. The Chief Executive was a nurse. She has not chosen to keep her hard earned registration up. The reason for that in my view is the same as lots of health professionals de-register when they get to choose the wallpaper in their office. It means that they cannot be put in front of their professional bodies for breach of relationships with fellow health professionals. The Trust in last week's case instructed one of the top 10 legal firms in the UK who shipped in the top Employment Barrister in the country from Wales. Their solicitors were travelling first class from Birmingham every day. This use of public money is not acceptable and they will be called to account for it at the Public Accounts Committee in due course. I am determined that these people will not move out of the organisation and escape what is coming to them and the change in Regulation 5 of the CQC regulations mean that they can be disbarred from holding a directorship if their previous management decision making anywhere else is called into account. In other words, I can use the CQC as my attack dog.

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  18. Having also had the delights of experiencing LAS from both an operational and control side, there are no better words to describe them than corporate bullies. Even with the union it took years of fighting before they finally admitted full liability for ending my career. Their "sorry" still left me in debt. I loved my job, but you simply cannot run a service as a business. This core point has been long lost and forgotten over the years by both the service and government. I will take to my grave many of the things I had to deal with throughout my years with LAS, sadly a lot of that will also be with my experiences of them as an employer, as well as the calls and lives lost. I have so much respect and admiration for those that continue to prop up the sinking ship - and so much guilt for abandoning it myself at times, when I see the desperate need for those with my skills.... However, I was once told that nothing is more important in life than to have your health- and sadly, in trying to ensure others kept their's, under the hands of target/money driven bullies, i as good as all but lost my own! It was a 'chosen' reluctant goodbye to Goliath in the end! ... I will always look back on it with sadness though that it frankly, above all else, for sanity- became too intolerable to stay! The more that speak out about LAS the better. There is no need for any company to treat its employees the way they do. It's a bully boy culture of face fitting and target hitting, with little care for people. It's a service that's a business. Where the statistic of how fast we got to you means more than if you live or not. There's no getting away from the fact like any other part of the NHS it's incredibly over managed and understaffed but that there is also a big funding issue as when you raise the budget in line with inflation, but expect more from a service with greater costs to that service- you've effectively implemented cuts! (and they have to come from somewhere, which they always say aren't front line , but the knock on across the service makes frontline work so unbearable, that you inevitably end up impacting frontline staff!) How LAS bully and treat their staff on ground level and I'm sure the many more stories you will receive from staff not just from LAS but UK wide I think has helped you get just a small sense of proportion on what Is the tip of a very huge iceberg you've hit! A lot needs to be done and I hope this can be an actual real start to it, listening!

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  19. I was going to sign this as anonymous, but as I was one of the few people to do my job, its obvious who I am.

    I previously worked for the LAS for 21 years, at the end of my time with the service I was the Trusts Security Manager (2006-2009), this is how they 'engineered' my departure.
    Every year, every trust has to report the Violence Against Staff (VAS) figures, for 5 years prior to my taking the role the security manager (who refused to qualify) kept reporting the figures as getting lower and lower (his initial report was about 1200 assaults a year, and by the time he left they were down to 200!) - he even got an award for this!!!
    When I took over, I reported the correct figures - being about 1400 assaults. I was told by my manager and the assistant director, that I was reporting them wrong. The definition of an assault is 'any form of unwanted physical contact' - that could be from someone spitting at you to some breaking your arm - this is the definition used by the Counter Fraud and Security Management Service (now known as NHS Protect), the Police and any other form of legal body. But, the previous security manager only reported an injury as a physical assault if it involved a serious injury or assault. This effectively shifted the figure dramatically!
    I was starting to make some headway in helping staff when assaulted and was told that moral was beginning to pick up because staff knew that someone cared. My department manager told me that what I was doing was not liked!
    Because I refused to bow down to their pressure, management concocted some story that I had recorded a meeting with the director of HR (which wouldn't actually be illegal if I had) and that I told him that I was going to use it against the trust! How this was meant to have been beneficial to me I will never know! I was suspended for 8 months pending their 'investigation' - now that was a joke, their investigation involved interviewing my manager and a colleague and only recording the facts that they wanted to hear. My colleague told me that they left out half the information, relevant to my defence, from his statement when typed up and he was told to sign it or else!

    The assistance from the union officers was none existent, and when I raised the issue of what it was actually all about, I was told that that was not relevant!!
    Ask any staff member (operational) and they will tell you that senior union officers are more for the management than the staff, as they are more worried about loosing their position as union officer and having to go back on the road and do some real work.

    Because I wasn't doing what the senior management wanted - falsify the VAS figures, I was hounded out of a job that I enjoyed (at the time) - when you qualify as an NHS security manager you must adhere to 8 points, of those points 'Honesty' and 'Integrity' and 'Professionalism' are top of the list, I adhered to these but I know that the management didn't and from what I've heard, they still don't.
    Due to the stress involved in my prolonged suspension I left the service, having found another job (still in the NHS), one that actually seems to care about their staff.
    I'm often asked if I miss the service - I miss the people I worked with on the road, the support they gave each other - what I don't miss is the back stabbing from many of the managers (of varying levels) who are only interested in covering their own arses and not caring for the patients or supporting the crews.

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  20. Colin, you have the ability to make a complaint to the HCPC about the conduct of any paramedics involved in your case. Further, you can report the managers involved for Misconduct in Public Office and also to the HSE for "Failing to discharge a relevant duty" - that being risk assessments and recording of violence at work, particularly if they were RIDDOR reportable. Finally, you can report the managers to the CQC under regulation 5. They can order the Trust to remove any director who fails to meet the "fit and proper person test" http://www.cqc.org.uk/content/regulation-5-fit-and-proper-persons-directors#full-regulation

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  21. I worked for SECAMB from 1997 to 2014, I was always on the go but over the years working conditions became more and more intolerable. Constant attacks on our terms and conditions of employment added to the stress. The workload continually increased accompanied by undue pressure from a hard pressed control staff. Breaks were very rarely had at a reasonable time in a 12 hour shift and frequently interrupted. This all took a toll on my health and resulted in some long periods of genuine sick leave prior to taking early retirement. The mention of a "meat grinder" strikes a chord - I could not recommend anyone considering a career in the ambulance service to join.

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  22. Im married to someone in the service and its ridiculous. Hes late almost everyday absolutely shattered through not getting breaks and all they get told is nature of the job. They seem to forget people have familes and commitments outside of the job and that staff need rest breaks or even a chance to go to the toilet.

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  23. I was in the LAS for coming up to 25 years, yes I put a colleagues initials in the morphine book as a witness, he was present then the so called person reported me to a Team Leader who was now rubbing his hands. I was correctly disciplined and received a final written warning which to me was harsh, especially a)I admitted the charge. b) I showed remorse and c) This has been going on through the service even people who went on a similar charge got a lesser sentence. I was not happy. I was upset and stupidly made a comment and again it was reported and was continuously hounded by a certain AOM in the West, she was no angel, believe me, .HCPC didn't take into account my circumstances after having some personal problems, I even requested a transfer and this person who was on secondment to our complex to be moved, this was not carried out for a few months later, otherwise I would be in my 27th year? Again Senior Management were showing their bullying techniques trying to get rid of the older hands and keeping the wonderful university students. Yes there are some good ones but there are some terrible ones. But hey, we are all God's children. Eddie Daly was a great Paramedic and a gentleman and sadly he was yet another victim of bullying and harassment from the service. Duty of Care? My a??e

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  24. Interesting comments, but there are some worrying generalisations. There are some good managers. There are some good union reps. There are some bad paramedics. the political atmosphere we work in forces the good to be bad and the bad to proliferate.

    Good managers are not tolerated by their peers because they make them look bad and do not base what they do on artificial targets. Management training is pathetic and what little they get is based more on corporate administration than genuine caring and innovation. Poor managers issue ill-conceived edicts to get noticed by their superiors, do not interact directly with their staff and hide behind their incompetance by scapegoating and deflected responsibility. They are supported by corrupted reps and a management structure that owes more to tongue length and the Peter principle than to ability and posession of personal qualities like honesty, fairness and morals.

    Union reps compromise themselves when self interest creeps in. They engineer situations to enhance their careers by agreeing to bad practice, by slagging off their honest brothers and sisters and can be worse bullies than the managers they are sucking up to. But please do not tar us all with that brush. My career has been non-existent because I am a vocal and passionate rep (modest, too, by the way!) and I value my ethics above everything. We can all name colleague-bullying and management-crawling self interested reps, but it is the staff to blame for nominating them, supporting their union and tolerating their behaviour.

    We are not a patient led emergency service, we are a target-focussed failing business. This needs to be acknowledged by the Government, and until that changes we are just p*ssing in the wind trying to improve things. Staff will never be treated fairly and objectively while we are managed by dishonest and self interested individuals who cover their tracks with figure cheating propoganda and the old boys club.

    We are abused by the public, abused by the service and now abused by the regulatory body. No wonder we are stressed to hell, tired, hungry and leaving in droves!

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  25. Like many ambulance trust staff I'm going to post as anonymous due to the threat of reprisals thinly veiled by trust confidentiality policies.
    I worked at an ambulance station that made the national news some years ago, http://www.express.co.uk/news/uk/369074/999-crew-had-lunch-as-baby-lay-dying was the story among many papers, it was even a subject of editorials by Richard Madeley and Anne Widdecombe. This nearly led to some excellent and highly dedicated professionals leaving. The truth was very different from the reality. What was obvious from the case was that someone from the management of the trust had leaked this story along with the angle to the press in order to divert attention from organisational problems and money saving policies. This was, of course, vehemently denied by all in senior managment right up to the CEO.
    In a recent Board of Directors meeting, they patted themselves on the back as most of the staff in our annual staff survey said they would recommend their service (duhh!! who else do you call if you need an emergency ambulance??) but glossed over that an overwhelming majority of the staff would rather work for another employer, and most had considered or were actively seeking employment with other trusts or employers.
    This poisonous and corrupt environment is self-perpetuating, as anyone who hopes to climb the greasy pole soon realises that 'towing the line' and keeping your mouth shut other than to say 'yes' is the only way up.
    Being a paramedic makes me proud beyond words, and there is nothing more rewarding to me in this cynical world (even beyond money) than truly making a difference when needed. However, I am ashamed to work for an employee who has no regard for the staff it employs, and sees the public as mere targets and statistics in their tick-boxes.

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    1. They did exactly the same to us in Scotland, same tactic! Senior Management hung the guy out to dry, were caught lying about what really happened to the family, yet nothing was done about it. They are playing with the lives of the public for their own ends. Play up to the scum press, lie to the goverment, leave your staff to get abused by the public in the aftermarth yet keep your jobs and pat yerselfs on the back for it. Would love to see how yous would cope in the private sector!!

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    2. In the private sector the management would not get away with receiving big fat pay cheques for doing nothing. I worked for Scottish ambulance service. They couldn't care less about their staff! Managers are not qualified to do the job. Some Leading Ambulance personnel think they are managers. No!!! They deal with administration that other managers cannot be bothered with.

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  26. Could Simon support Eddie?

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  27. Anon, an organisation I represent for is making an approach to see if he would wish for any help. This is the sort of case I would willingly take on and I have fairly high confidence in succeeding in having Mr Daly's suspension reversed. It will make no difference to his employment status with LAS if the time between his dismissal and application to an Employment Tribunal is in excess of three months, but it would mean that a reversal of sanction would mean he could work freelance on much better money. I would also be delighted to assist in using the law as I know and understand it in order to bring a variety of actions against the corrupt London Ambulance Management. Colin's inside management information could provide invaluable resources as, in effect, he knows where they hide the bodies and how they gloss over their misdeeds. This particular forum has enormous potential to bring about real change in the ambulance service. I would encourage everyone to share it as widely as possible as soon as possible.

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    1. I absolutely agree that your expertise in dealing with HCPC and Trust regulations would be invaluable to the cause of effecting a positive change. If there is any assistance or advice you could offer, we would be most grateful. I believe my colleague has reached out to you already and I hope we have the opportunity to speak in the future.

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  28. Absolutely agree; check your 'other' FB inbox.... I think that, even if Eddie doesn't wish to be involved again, we need to pursue our concerns - it is a matter of time before somebody else will get dragged through hell and back on these grounds!

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  29. I worked with a Paramedic who was very good at his job, had a great sense of humour and would watch your back,a great bloke you could trust. Then he became a manager what a change, not one person has a good word to say about him now. The job's destroyed his values and far worse his wonderful nature.

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    1. Oh no!!! What an idiot! I have seen this also. The thing to remember about managers ,they are the one in a vulnerable position. If he loses his position then he may have to work with the troops again!!

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  30. In the case I have just represented in, they appointed a useful idiot from a rural station - a PTL, to conduct the investigation. NHS Fraud washed their hands of it as it was a police matter, and EMAS did not appoint its own full time trained investigating officers to investigate a serious incident. The PTL under questioning by me admitted he had had no training, and it was his first ever investigation. It gets better, he was refused access to police witnesses but decided there was a case to answer anyway, and months before the disciplinary hearing, he met with the Head of Public Relations in order to thrash out a press release in case the press got hold of the story. They decided my client was an embarrassment and sought to distance themselves from him be a pre-determined decision to dismiss. That is why the chair of the panel was a weak an ineffective fleet manager - he buys and repairs ambulances. Corrupt from the top down.

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  31. Simon is one of our highly desirable reps specialised in HCPC advice and representation as well as employment tribunal work. We have discuss Eddie's case with Simon and he is happy to take instructions from us. If you know Eddie, please ask him to get in touch with us via www.the-siu.org.uk. As this is a case of interest to SIU and its Medic Members, we will cover the costs for his appeal. On the other hand please visit our website for benefits for Medics at http://the-siu.org.uk/medic.html.

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  32. Another way Ambulance Trusts bully staff is by sickness reviews that end up being 'capability' disciplinary panels.

    As an example of how some managers bully staff in this way EEAST in their Hertfordshire locality recently had a Technician retiring after about 30 years service and on his penultimate last shift the day before he retired he saw a manager arriving at his station. You may expect they were there to give him a send off and thank him for his years of public service, perhaps a wall plaque commemorating his long service or a thank you letter? After all, we are a caring profession.

    Yes, it was a letter - it was a written warning from his locality manager about his recent sickness because he had breached some sickness target score!

    What was the point of that, a shameful example to others not to go sick? As pointed out by a number of people they've blown out of the water their argument that the sickness policy is a supportive policy.

    Do you think it is likely the Trust, HCPC or CQC will do anything about this shameful, blatant bullying? Is this not so unacceptable and morally wrong that some standard, code or regulation has been breached?

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  33. I also recently left Hertfordshire locality( one of the many), to pastures new. Most of the managers do/did nothing, you cannot trust any of them. The reports of bullying by management in unison newsletter are all true. Goes way further than they reported.

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  34. I worked for the LAS up until recently when i decided to leave. It wasn't until I had left the LAS I realised just how unhappy, stressed and generally burnt out i was. What should have been a happy and exciting last few weeks left me feeling like no more than a number and just a bum on a seat. I have 2 very poignant memories of my last week that weren't particularly unusual of a normal week at work they was just as you say "the straw that broke the camels back".
    Firstly was getting a phone call on my way to work for a shift, which being on relief had been changed 2 times prior to this and was now of complex (by quite a distance). I had left for my night shift an hour and a half earlier than normal, after getting of late that morning. Stuck in traffic i phoned to tell them i might be late, at which point i was informed my shift had yet again been changed and i was now in fact at my base station. When i asked why i had not been told as i had checked my GRS before leaving work that morning, I was told it was my responsibility to keep up to date with any change in shift and that a text should be sent to me to confirm any further changes, which i had also not received. I was made to feel it was my fault i had not been contacted and not checked my GRS in the 10 hours i had been away from work. I found myself embarrassingly sat in my car crying with frustration over something let's face it very trivial (completely out of character). When mentioned to a manager he shrugged and said these things happen.
    Secondly on my penultimate shift i remember being sent an R1 transfer back into the centre of London on a friday evening in rush hour, TWO MINUTES towards the end of my shift. By the time they answered our RTS my shift had ended and we was faced with "are you refusing to attend this R1?" .........3 hours late of i phoned from station to ask for a delayed start the next day. Again i was made to feel i was in the wrong as it was my last shift......"i appreciate that, but i still need to eat, sleep and wash in the 8 hours i will have by the time i've travelled to and from work" again I found myself embarrassingly crying in my car like a little girl, I was burnt out.
    So i prepared myself for my exit interview, wrote down the key problems i thought there was in the service as i had heard they was conducting them to try and work out why people are leaving.
    The "interview" lasted a maximum of 10 minutes in which i handed over my uniform and paramedic bag whilst stood in reception of the office block, I was handed two pieces of paper to sign and then "right thats it you're good to go". No good luck, no thank you for your time, no hand shake, not even come in take a seat.......
    It took leaving the LAS to make me realise just how unhealthy physically and increasingly more mentally it was becoming. Bullying, favouritism, Fear of loosing your registration, fear of "rocking the boat", target driven, complete lack of support= drained, exhausted staff

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  35. As a result of this forum, I have received many contacts from people telling me their personal stories. One of these stories today had a very unusual effect upon me as it actually left me feeling distressed rather than my usual angry or furious. The issue is that nobody cares for the carers. There is a duty of care and it is being abdicated, vacated and deliberately ignored. Indeed managers are finding methods including using the disciplinary procedure, intimidation and bullying in order to ensure that they do not care for their employees. The result of these intentional acts made both individually by managers and collectively and institutionally by upper management is the reason this forum was born. The impotent and corrupt unions consistently fail to address the matter and sabre rattle over strikes, but everyone knows that no member of the ambulance service can afford to go on strike as they are one paycheck from serious debt, and any industrial action is addressed by bringing in private and voluntary outfits to make up the shortfall. The ambulance service is in the same position as the fire service - nobody would notice if you went on strike save for a huge disaster that overstretched the resources to the point that the press noticed. My proposal as a draft idea is to bring the matter before the Commons Health Select Committee, and further to arrange a meeting attended by interested parties to include the HCPC and the CQC. The CQC can remove from positions of authority managers who make bad decisions. They can also ensure that people who have a history of making bad decisions can never be appointed to another position - I use as an example Dave Whiting former Chief of YAS who had the anti-midas touch and ruined everything he touched. It was only after he refused to "recognise" UNITE union because they stood up to him that a strike was called during the Tour De France and the service went to REAP 4 as a result. He "left to spend more time with his family" as these people do when they are told by the board to go, and the new Chief has now recognised UNITE union once again. Anyone would be within their rights to demand to the CQC that they consider his removal from a similar post because of his past history of very poor management decision making. The management have been, up until now, immune from any sanction. When did you last hear of a manager being dismissed for bullying even after a collective grievance? This has the potential to mushroom very quickly. I ask that any further requests for assistance in respect of HCPC, Employment Tribunal, Disciplinary or Appeal matters as well as pending criminal prosecutions be directed to my partners at http://the-siu.org.uk/medic.html From the outside looking in as I am no longer NHS, I can say that a determined and robust approach to dealing with the root cause of ambulance crews being reduced to tears at work - the management, could result in management having no option but to change their inhumanity towards their staff. We are only a couple of weeks away from an election, and MP's, particularly new MP's will be looking for issues of worth to demonstrate their commitment to office. I am fairly certain that if everyone wrote to their MP in a co-ordinated lobbying exercise using a standard letter, personalised to their own experiences, that the matter would be discussed earlier in the next parliament.

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    1. Maybe Simon should provide a referral fee to Mat for all the unexpected work that has suddenly come his way? : > )

      Another more serious suggestion to Mat, is that he provides a 'donate' link. Any blog such as this can be all time consuming and it is too good a resource to lose.

      I certainly would donate say £20 to help keep it going if there was the option.


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  36. Can I please ask that people share this site amongst their colleagues. I would like this go viral countrywide. Its people's stories and experiences which are going to make the difference. Trust Management Cultures and individual managers need to have their misdeeds collated into "patterns of behaviour". Creating an "intelligence file" if you will so that it can be presented to the CQC to have them removed from management roles in accordance with Regulation 5, and also to present evidence of sick management cultures within ambulance services. I would instance relish the chance to rid the West Midlands of its mafia like management. The Medical Director raised his concerns and was rounded upon, disposed of and further stopped from responding for BASICS in his own time. They took a volunteer pre-hospital doctor away from the public because of their spite. Who knows what difference he could have made to some people had he been allowed to continue to respond. The coming together of this blog, the petition for Ed Daly and other factors mean that there has been perhaps no more opportune moment to the present one to act. Using Mid Staffordshire as a Model, patients came to harm because of an oppressive management culture and many, many incidents of individual management bullying. A nurse who finally spoke out was appointed by government as an advisor. I am going to contact her this week and see what input she can offer.

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  37. Mat, we would like to sponsor this page. Would you please get in touch with us on contact@the-siu.org.uk. Many thanks.

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  38. I am grateful for any support and representation that ambulance staff can be offered, and Mr Hoyle's contribution to the discussion has been very valuable. I hope that he continues to do so.

    However, I feel staff should be free to seek that representation from wherever they so choose and there are capable representatives also available from other organisations with whom many staff are already members. Endorsing a private interest on these pages would undermine the values of a paramedic-led campaign for a positive change.

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  39. I fully understand your position. My dealings with the SIU predate this forum and plans were already put in place to work between ourselves to move forward and offer HCPC and Employment Tribunal representation on a much wider scale for the SIU membership, and further to develop the SIU into a fully fledged Trades Union. The purpose of this is to offer an alternative to the current unions, and to train our own reps and investigators up to a proper, necessary standard. This means that the Trusts cannot seek to exclude representation if they are worried by them. Contractually, they are obliged to allow an accredited Trades Union rep accompany the member throughout the disciplinary and appeal process The Head of the SIU is also an IHCD Technician. The plan is to simply do what I have been doing for the last 17 years on a much, much wider scale. What I do know is that I cannot deal with all of the cases coming my way on my own, and with things as they stand with the current climate in the ambulance service and with the HCPC, that workload is going to increase to an unmanageable level. In the future, we hope to offer an alternative to the "exercise in mediocrity" that is the current landscape of union representation that Trust managers rely upon that they can run roughshod over.

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  40. Just revisited, bit scared, everyone knows about this I think up to the CEO and of course Eddy. I think this is great work but how could LAS staff and managers help if anonymous. We have seen careers of people finished. Thanks to those that are pushing this. Can I just say Eddy is the best and in my over 20 yrs have not met such a true professional. The story is if you can sack Eddy you can sack anyone. Motivating and empowering your staff? I think not. Shame on them to be ruthless in this manner. Another 2 staff of exceptional standard resigned this week and for them the stress is gone. Can I just say none of us joined for targets or to screw people but how could this possibly change now? Simon J Hoyle for CEO? Anon as have to be, stood up so many times before, sorry. Looking for a new job as this will never get fixed and want to live a long and happy life. What would the public want or are we just plebs?

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  41. Everything that happens in the ambulance service also happens in the police service, even more so, as the Chief Constables, need to shed staff who have security of tenure. The bullying and harassment to rid themselves of excess staff is truly immoral.

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  42. I should have said are we just all plebs? Other emergency services included. I keep on saying out loud not Eddy Daly, the kindest, warmest gentleman you could ever meet and an exceptional paramedic team leader. He proved a point but got screwed, a man with 30yrs of dedicated service instead of asking why and supporting him to make it better for all of us. They screwed him. Rule number 1, never refuse a call. Everyone knows that, this has to be an exceptional circumstance. It does prove however what your employer thinks of you, maybe Eddy thought enough is enough. A true leader? Maybe I am getting carried away but he stood up for what was right and what was right for the staff. He was a first line manager a highly valued team leader of which the role will now have more responsibility. A respected, experienced, professional role model should have been listened to. He and others like him are the very fabric of Ambulance services and they wonder why people leave. I know Eddy, we all miss him, the workplace is not a better place by this decision, the people of London are 1 less super paramedic of 30yrs investment. The sacking was not about the job it was about control of your staff and maximising every effort from them to reach targets that are not real, even coming to work treating people that are healthier than you, this still makes me laugh though. Some big wages to an even bigger management team that can't work it out. I blame the ambulance staff as they should work harder, not actually need any breaks, fit going to the loo time somewhere else but not in hospital turnaround times and of course be greatfull for 1% pay rise. Who on earth would want to do this job? Not just a job though is it?Especially when you know if things go bent and they will your leaders are intent to bring you down. Just can't work that out, wrong way around. Eddy Daly will never be thought of as depriving the public of an ambulance or of any malpractice by any of us. We all feel tired but hey keep it going until your 67, any less and we will deduct 5% of your pension per year. Who exactly is looking after ambulance staff? I will tell you what, two things from reading other comments: 1. PTSD probably after 10yrs or less. 2. Live long? Then leave. There is life outside ambulance services. Eddy got away, good luck to him, it is our loss. Sorry Eddy, you deserved better.

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  43. Anyone seen this article in the Guardian with a link to an interactive map of response times?

    http://www.theguardian.com/news/datablog/2015/may/01/find-speed-ambulance-response-times-uk-postcode

    The article states;

    "The areas surrounding London such as Watford, Cheshunt and St Albans generally wait fewer minutes for an ambulance than their neighbours in the capital".

    The interactive map data says the opposite! In fact EEAST response data looks the worst of the lot. Am I reading it wrong or is there something wrong with the data?

    Something seriously wrong here, whenever you see pronouncements from EEAST very expensive communication or "good news" department they tell us their response times are some of the best. Have they fallen into the trap of believing their own propaganda? In fact if you believed all EEAST propaganda you would probably think their Chief Exec shits gold response time turds in the morning!

    Am I wrong?

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  44. I left some time ago after serving many years in both London and an out of county the culture is the same in both!
    Bullying management that like spoilt children when they can't get what they want have a knee jerk reaction which is usually threats and abuse, staff are constantly striving to keep a crumbling service which has had daily increases of pressure put upon it, but does the staff receive any thanks Ha NO of course not what they are given is more threats if they don't manage the rediculous and totally unachievable, I suffered for years working for those who you would think strive to help people it's such a miss guided notion that the very people who are there 24/7 365 a year are treated so badly!
    After going through hell and back being wrongly accused of something I supposedly did which took them nearly 2 years to reach the verdict there was no evidence and nothing to answer for not content with this the management continued to hound me like I've seen them do to so many others until eventually I left a broken person with little left in me anymore any thanks for well over 20 years service NO not a thing no long service medal (which strangle enough I'm still waiting for don't hold ya breath mate)
    No just letters even years after leaving containing threats.
    How very sad!

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