Saturday, 16 May 2015

Visiting London Ambulance Service HQ (Part Two): The Chief Executive and Operations Director on Dealing with Staff Pressure

My visit to London Ambulance Service's headquarters a fortnight ago arose from my concerns regarding the treatment of its under-pressure front line staff, suggestions of a culture of fear, and in particular its handling of the Edmund Daly case - a  respected 30-year veteran paramedic who was dismissed for gross misconduct for refusing to attend a 999 call after 11 hours without a break.

As a result of my criticisms, I was invited by LAS communications officer Anna Macarthur to learn more about LAS's culture and to speak with the chief executive Dr. Fionna Moore and Director of Operations, Jason Killens.

Earlier this week, I discussed my initial preconceptions and the first part of my day in 'Visiting London Ambulance Service HQ (Part One): Lion's Den or Temple of Enlightenment?', which I would recommend you read as a primer for this, the second part of my account.

Preparations & Expectations

From a personal perspective, it is fair to say that the short ride-out I experienced in the first part of my day was very much within my comfort zone. It was a familiar activity and one which made me wistfully remember my years on the front line. It took conscious effort to remind myself of how painful, exhausting and infuriating it was toward the end of my 12-year career. Despite the positivity and enthusiasm I had encountered from most LAS staff throughout the morning, it was those darker memories I needed to remind myself of if I was to be able to represent the disenfranchised and the beleaguered road crews I felt were being swept under the carpet.

If attending a couple of 999 calls was in my comfort zone, an audience with two of the most powerful people in the UK ambulance firmament absolutely wasn't. I was keenly aware of what an unprecedented opportunity it was to bring to their attention the problems which have been laid bare by the countless frustrated comments and emails my work thus far has solicited, but I would be a fooling myself if I was to say I, a rusty paramedic and itinerant blogger, wasn't a least a little intimidated.

Dr. Fionna Moore, LAS Chief Executive
I'd done my homework, studying LAS figures and understanding the roles that Fionna Moore and Jason Killens held. I'd even communicated with various sources regarding what to expect from the two execs. Fionna seemed highly respected and well-regarded, but it was Jason about whom I had the most concerns. Reports I'd received, along with my impressions of him from studying the Edmund Daly case, made it hard for me not to view him as an adversary. Possibly quite a hostile one.

However, on being escorted into the meeting room by Anna Macarthur, I was greeted warmly by Fionna Moore and Jason Killens. The four of us sat and a brief, polite conversation saw Fionna show her credentials as a knowledgeable clinician as she explained to me some key indicators of my career-ending retrolisthesis (or 'slipped vertebra' as I call it). The topic soon slid into more LAS-specific territory almost without me realising, at which point I started recording.

Attrition, Utilisation and Opportunity

It soon became clear that my carefully prepared list of questions were not going to define the format of the interview as Jason Killens took centre stage, taking up the baton from Fionna's opening pitch describing how paramedics are 'much more valuable and saleable assets in the employment market because they can get jobs not just in other ambulance services but also in other parts of the NHS.'

Jason Killens, LAS Director of Operations
Jason was quick to show that he too had done his homework, describing the changing face of the paramedic job market in relation to the start and end of my career. Pre-empting my concerns about LAS's rate of staff attrition, he explained, '...when we analyse the leavers from here, around half of them are going to other NHS jobs not in ambulance services. And that would never have been the case in 2000 or in 2010. It's good for the individual because they've got greater opportunities, it's good for the profession, because it makes it more credible as the profession grows. So the individual gets a benefit, they get a better job - enhanced scope of practise and so on, it's good for patients as a result of that. But it's good for the paramedic profession because they've got greater opportunity to support the health system outside of what would traditionally have been done back in the 90s and the 2000s.'

In past interviews (The Spectator, Aug 2014), Jason has been very focused on this opportunity-rich job market as a leading cause of his front line staffing challenges, but I was keen to see what other causes he was aware of.

'I talk about four reasons why people leave. Okay, so you’ve got pressure of work, you've got career opportunities, you've got environmental stuff; kit, equipment, vehicles that kind of stuff, and you've got leadership. Four reasons. You could bolt on cost of living if you wanted to. ... So you've got pressure of work. Certainly from a London perspective, we've got the highest utilised ambulance service in the country. Our average ambulance utilisation is at about 85%, peaking at 95% at the weekends. So pressure of work is a real issue for our people because they can, if they want to, choose to go and work at an ambulance trust that are on our borders, so East of England, South East Coast, South Central.'

I pointed out that front-line staff in the services he mentioned were also experiencing intolerable demand and that things weren't much easier there. He referred to the utilisation figures as evidence that it's worse in LAS. After detailing some specifics regarding each of the reasons for staff 'voting with their feet', he went on to explain how the problem is being addressed.

'[W]e're doing more 'hear-and-treat' in London now than any other ambulance trust in the UK. We're doing over 50% of the country's hear-and-treat here in London. We're doing three-and-a-half to four-thousand calls a week that are being dealt with on the phone and not getting an emergency ambulance.

'We've got investment this year, recently announced two weeks ago... we're just in the final throes of securing a £27m investment package this year from Commissions. That is designed to bring ambulance utilisation down to the middle of the national pack, so when you benchmark us against other ambulance trusts it gets us about in the middle. Which is good from where we are at the minute as the top-end outlier.'

How Long is a Career?

This sounded encouraging, but with LAS's Category A response times being so far short of the 75% target (as low as 48% in December 2014), surely even a significant increase in resources would be absorbed by the need to improve those figures over utilisation concerns, meaning that little benefit would be felt by any individual crew.

In response to my concern, Jason described a new 'non-emergency transport service' which would deal with 2,500 calls a week. He and Fionna described 'growth' in their front line staffing numbers, despite the attrition. Where in previous years they had experienced a decline in numbers, that has now been reversed, with roughly 150 additional posts being filled this year. 'In the last quarter we've had more joiners, nearly double the number of joiners than we've had leavers,' Killens explained. 'We have to get utilisation of the fleet down, for a whole bunch of reasons. And one of them, at the top of the list, is about the experience that the employee, paramedic, our people, our workforce have. At the moment we are a national outlier and we need to fix it. So, as starters come in, utilisation goes down, attrition goes down, people feel better about the place.'

100 Aussie paramedics are already on the road, 100 more coming soon.
Of course, much of this success could be put down to the induction of paramedics from overseas, particularly Australia, which could be viewed as a short-term fix papering over the problems of the rising attrition rate. Would these 'cohorts' of international paramedics really make much difference in the medium- to long-term, given that both Fionna and Jason accepted that many would likely return home in 3 years? We talked about this ‘churn’ (expected to rise from 12 to 30 staff per month), with Jason describing the in-flow of clinicians from various sources, the 'old EMT route', the more modern 'UK domestic paramedics from universities' and the internationals. He finished with, 'what I would say is that gone are the days where the majority of the people that join the organisation are in for 30 or 40 years. That's gone.'

On questioning further this worrying belief that staying 'on the road' is no longer viewed as a viable career-long prospect, they returned to the explanations of the migration of skilled staff into other roles, with Fionna providing South East Coast Ambulance as an example, 'they are seeing a significant number of their paramedic practitioners, so the ones who are undertaking placements in GP's surgeries, getting jobs in GP surgeries. They're very attractive to primary care.'

So it would seem that there is an accepted belief that working on the front line until retirement age is not something that is expected of staff any more. Which is bad news for those who are still out there clinging onto the expectation of doing exactly that.


Where Should You Turn?

Assuming that, as claimed, half of LAS's leavers are as a result of moving onward and upward, what about the others? I was concerned that this not insignificant proportion of the the workforce was being ignored, predicted to wither away as a result of a job they're not expected to be able to withstand in future decades. I brought up the worrying volume of staff who I'd been in contact with, who felt under-served and abused, the rising evidence of Post-Traumatic Stress Disorder among staff unable to find respite.

Fionna Moore said, 'I think that it would be fair to say that the vast majority of people working in the service are proud of the LAS, they're proud of what the LAS has achieved and the reputation the LAS has as a world-class ambulance service. I think they would also say that it's been pretty tough over the last year or so. And, as always, that there is always more that we could do to support staff. We've got lots of initiatives in place. I mean, if you look at the things we done to try and reduce the pressure on front line staff, both in terms of going out trying to get more investment, in maxing the hear-and-treat, introducing schemes like the LINC scheme [Listening, Informal, Non-judgemental, Confidential], which is I think really very successful. It's supported by us but very much driven by the staff.’ She described other initiatives such as ‘employer assistance programmes’ and ‘childcare vouchers’. She emphasised that staff welfare is very much a concern, ‘So yes, this is a priority for us. Could we do more? Yes of course we could. Any organisation could.'

Jason Killens followed up with, 'I think what I would say though Mat, is that people who are still working, from my perspective, those people who are working for London, if they're LAS staff, yeah, and they are continuing to work for us now, then they need to be talking to us, not you. And I don't mean that in a difficult way.'

So why weren't they?

Jason responded by talking about the national NHS staff survey and identified that staff don't feel that they are listened to or supported by their managers. '[O]ne of the other big changes we're going through at the moment is changing the entire operational management structure. So we've been operating the same structure for the last 11 years and the organisation and the system, the health system in which we operate has changed immeasurably in that time and it's just not keeping up the pace. So I'm changing the management structure currently to put more managers back on the front line, to have a static, named individual responsible for a station that's there from Monday to Friday which we don't have at the moment. And we're moving, from July this year, to have all of our team leaders, to have a named team of 1 to 16 staff and those team leaders will have 50% of their time protected, non-front line, non-operational, to do that welfare/pastoral support for their staff which doesn't exist now and hasn't for the last 2 years.'

Despite that, Jason was aware of the challenges that would face any attempt to provide support to staff, '[I]n a highly dispersed model which we and every other ambulance service operates across the country, getting sensible, decent leadership, management, whatever you want to call it, at the point at which a member of staff needs it is very difficult.'

Out with the Crew Room, In with the Manager's Couch


It is true that, in a pre-hospital emergency environment in which there is little opportunity for respite, the debilitating effect of endless stress and trauma is what leads to PTSD in ambulance workers. Fionna is aware of this, 'it's the drip-drip-drip of that for months and years that causes problems.' She also recognises the increasing challenges facing staff trying to deal with it without the ability to decompress at any time during a shift. 'It doesn't happen any more. You're in, you're out. So to some extend I think managers are taking that on even more seriously, because they are now fulfilling the role that used to be the coffee room chat.'

The problem that I foresee here is to do with the culture within the service as much as the logistics. Do staff feel comfortable discussing their darkest experiences and most intimate fears with management staff? Where would this contact take place even if they did? Outside A&E? When they’re rushing to book off of a vehicle to head home an hour late? And is a network of trained management staff even an appropriate alternative to having the opportunity to rest and reflect?

Both execs went to great lengths to assure me that there is no 'culture of fear' and that the vast majority of LAS staff are thriving in a culture of positivity and pride. That is certainly the environment that they ensured I witnessed during my visit. They also described other initiatives such as a private Facebook group which allows staff to speak freely about issues of concern, and their willingness to be engaged directly by staff without reprisal.

Jason emphasised this empowerment and the desire for better staff engagement, ‘This is our organisation. Not Fionna's, not mine. Ours. Our organisation. And our people are important to us. We've got a bit of work to do to rebuild trust because of where we've come from, but at the same time we've got to fix all these issues we've got about utilisation, about vehicles and all that kind of stuff, but we absolutely believe in our people, we want them to be out there being autonomous practitioners delivering high-quality care for patients and they do it day in, day out in difficult circumstances. And we want to create the environment where they can  do more of it to better standards. But it's not going to happen in a fortnight.

Answers? Or More Questions?

Overall, I got a sense that being at the heart of the organisation does engender a feeling of positivity, supportiveness and empathy. I recalled that same phenomenon when attending staff training and other non-operational activities. I certainly gained the impression that there are good intentions and a grasp of the issues at the top.

But it's lonely out on the road. The hours are long, the work is brutal, and front-line staff are a long way from the comfort of headquarters. It's almost like two different worlds exist within one organisation, and I'm still not sure that either is fully in touch with the other.

Furthermore, Dr. Moore’s and Mr. Killens’ assertions that the readership of this blog is a tiny, disgruntled, vocal minority in a sea of loyalty and enthusiasm gives me uncomfortable pause.

What do you think? Do Fionna Moore’s and Jason Killens’ words give you some encouragement? Could you escape to a job elsewhere in the NHS or do you feel trapped in the bloody hamster wheel of front line ambulance work? Are you confident of your employer’s efforts to support you? How much is it your responsibility to remain positive in the face of relentless working conditions? Just what is the workforce ratio of enthusiasm to despair?

Please let me know. Comments on this blog can be made anonymously and I would be very interested to read both positive and negative responses.

I’m sure both Dr. Moore and Mr. Killens will be reading.


[NEXT: Jason Killens on the Edmund Daly case, '[H]aving done what he did, I had no choice. I believe that it was the right decision and I would do it again.']

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40 comments:

  1. They don't want to accept that staff aren't happy.... I talk to las crews and they are always saying how they are chased this way abbd that to perform.....as for Mr Daly, he made a tough choice and was punished for it, if he had killed someone through being unfit to work his head would have been on the block, in fact he was in catch 22 territory...

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  2. "As I waited to be collected in the foyer, I noticed a certificate on the wall, awarded by the Department of Health to LAS 'in recognition of the organisation's commitment to improving the working lives of staff."

    Awarded by the Department of Health for commitment...? Was this before Anne Radmore resigned to take up a “national leadership role” at NHS England?

    How many failed regimes congratulated each other with 'gongs' and promotion shortly before they were consigned to history?

    If it was an outside organisation that had given the certificate after an appropriate assessment you could possibly take it seriously.

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  3. Wouid not trust JK as far as i could throw him.

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  4. The management do not care about long serving staff
    illnesses and ailments associated with long term service and the change in the functioning of the body associated with age means capability not support

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  5. Some of your comments have brought up an issue I feel strongly about, and that is the support of those staff who are deeply engrained in the ambulance service they have 25-35 in and cannot see an end in sight they know they will be lucky to get to 60 never mind 68, they wont get another job elsewhere because they either don't want to or can't because the education has overtaken them and they are stuck, what do we do for these people who's lives are a misery and who's retirement is moving further away with only ill health to look forwards to. And none of the services will accept that their ill health is as a direct result of the work they do. Yes I am one of those people, I am ambulance through and through like a stick of rock, I never wanted to manage but I cannot see away off the road without ill health or dieing.

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    1. I feel the same as you, I have worked frontline for over 35 years. My paramedic course was six weeks long and thirty years ago and no matter how hard I try, I find it impossible to reach the knowledge of a three year university trained paramedic, but that is who we are compared to and judged against! I have decades of knowledge and experience, but this matters not a jot, as its only paper qualifications that count these days.

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    2. The people they talk about who leave to work elsewhere in the NHS have generally worked elsewhere in the NHS before joining the ambulance service and therefore have options for a way out. Unfortunately for the rest of us we are stuck. I joined 9 years ago with the intention of it being a career for the whole of my working life. This is what I wanted to do since I left school and I have very limited options to get out based on my Paramedic qualification alone and don't know what else I would want to do which leaves me feeling lost. I'm only 30 so my retirement is so far in the future I daren't even think about it and there is nowhere for me to go within the service as I also have no desire to become management. I have been clinically depressed due to the job, and I can tick off the vast majority of symptoms of depression in my husband and other colleagues who have all been in for at least as long as me or longer.

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  6. When they announced an increase in state pension age they stated that "uniformed services" and "front-line staff" would be excluded. Then we were shit on by parliament (MP's of all sides) when they voted not to exclude ambulance staff. The conservative Minister ultimately responsible was hereditary peer and former banker Earle Howe.

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  7. Very nicely written and also very concerning. What concerns me is that Mr Killens has openly stated that gone is the days that any paramedic or technician or other frontline staff are going to see out 30-40 years service, so why are we still expected to work till 67/68? Fair enough for him to say that paramedics can find alternative employment elsewhere in the nhs but what if you don't have that other qualifications or you are a technician?
    150 additional post! Is that frontline? If it is its a drop in the ocean, London is a big place it's not going to make any difference. It would probably just cover all sickness.
    So it's not filling me with any confidence.
    The only people out there looking after us is our own kind and you Mat, thanks for your support and keep up the good work.

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  8. No culture of fear? Why are refusing to publish the report on bullying in the service?

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  9. If I was still working for the LAS and I needed to debrief after a bad job, speak about any personal problem etc I would like to CHOOSE who that is. I certainly would not feel comfortable pouring my heart out to a 26 year old Team Leader. Can they get any younger? It seems to be all about qualifications, promotion, personal progression and nothing about those who want to be great at what they do for the PATIENTS and continue doing that in a safe, healthy enviroment. Good luck with that!

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  10. I have recently moved to a different NHS ambulance trust after over 5 years in the LAS, best decision I've ever made. I already feel so supported and a valued member of staff, I've not had a single day where I've finished work in a bad mood, which was a regular occurrence previously. I was a bit apprehensive before leaving the LAS as I had become so worn down and almost brainwashed by the culture, but the grass is definitely greener for me :)

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  11. Having just left the LAS I would like to congratulate both Jason Kilins And Fiona Moore for the spin they managed to put on a dire situation. Battered from pillar to post for 12 hours every job could mean a disciplinary if a complaint comes in ( If a complaint is made you must have done something wrong is the start point of any investigation) Kit that should have been thrown out years ago Ambulances held together with micro pore. I bet every person you met was hand picked every job was vetted before handed out. Australians leaving after three years they dont care another jolly to Australia for another load and hey presto problem solved. I could rant on more but it would just sound more and more like I had an axe to grind but I left of my own accord to another service. As has been said why have they not published the study into bullying ? Could it be they have not managed to put a positive spin on it yet?

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    1. Give it time ......!

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  12. 'Having done what he did, I had no choice. I believe that it was the right decision and I would do it again.'

    Says it all really. No guilt or remorse that LAS is equally to blame? It's OK that working people for 11 hours without a break is 'normal' and staff are turned into an "85% or 95% utilisation rate"?

    Would employees in any other profession put up with such treatment? More like the way a 'master' would treat a 'serf'. Shell shocked and 'shot at dawn' as an example is the way to treat your employees? Unless you are a senior manager who screws up of course, then it will be hushed up and you will be given 'gardening leave' then a nice little redundancy package and another job elsewhere in the NHS where you can fuck up and screw your employees again.

    Jason Killens has turned into his own "Downfall" parody.

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    1. If you haven't seen a "Downfall" parody, here's a related one for a little light relief. Copy and paste this address into your web browser and imagine it as your local ambulance HQ Director of Ops :

      https://www.youtube.com/watch?v=7DGpF1yDvIQ

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    2. I'm sure the rest of you will get it faster than me, but to understand the youtube downfall parody you should know in German the number one is 'ein' and for overseas readers the 111 service ('ein, ein, ein service') as opposed to the 999 emergency service is a health advice and out of hours physician service. Often when you call this service the default option is to send an emergency ambulance (especially if the service is run by a private for profit company) because it doesn't cost them anything to send an ambulance whereas it does cost the company to give health advice or to send a visiting physician.

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  13. Very interesting read. The attitude of management seems to be that "if you don't like it, get a job elsewhere because there are always vacancies in other parts of the NHS". What about the staff who are being forced out of the job they love? A lot of us were attracted to the ambulance service because it was a far more attractive option than working in a Primary Care Centre or GP Surgery. In the Trust I work for, there is a definite culture of bullying and what I would term as subtle harassment of crews to reduce on-scene times etc. Added to this a definite "jobs for the boys" strategy which promotes people who clearly aren't fit to do their highly-paid jobs and you see staff get even more disillusioned and cynical. I think best summed-up by what someone said recently...."we do a good job for our patients in spite of the management, certainly not with their support".

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  14. Why was the case of Ed Dally not discussed, their treatment of him was disgusting. I have spoken to friends in LAS and his case and subsequent treatment, have left a feeling of fear and resentment. Fear, in that no matter how tired they are, they dare not put their head above the parapet. Resentment, because even after all the bad press over this case, there are no signs of remorse! LAS Management work in a bubble, because staff are afraid to complain!

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    1. Don't worry Steve, Eddie Daly was discussed at length, but I'll be covering that in a separate article. The above article is about 2,500 words and contains only a fraction of the discussion. We spoke for over an hour (at least 20 minutes of it about Eddie) and I've transcribed all 13,000 words (36 pages), so you'll understand that fitting it all into a single article would be impossible. I'll get other material out as soon as I can.

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  15. No climate of fear.....hmmm strange how all of the replies, including mine are anonymous? Why is mine anon, err because I've already been warned about speaking out!

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  16. Not so much a culture of fear - although most managers are too scared of the implications to speak out or challenge - but in my experience it's more a question of there being a culture of 'what's the point.' The senior team have been saying all this positive stuff for years, and some have actually been trying to make it happen. But so long as there are managers like Jason Killens saying all these glossy positive things in public but saying (and doing) very contrary things behind closed doors, things that perpetuate the bullying, 'just do as I say' management style seemingly preferred by him and many (although not all) of his top team, it will never change.

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  17. I swither whether to comment, as I fall into the category of downtrodden and broken, and an now an ex-NHS ambulance worker. However, I still feel very strongly about the service I was forced to leave behind.

    I saw the same sort of behaviour from managers in my service. They certainly can talk the talk. One night I spent 4 hours composing an e-mail to the Chief Exec. 4 hours to make sure it wasn't a babbling rant. I finally pushed send at 5am (and no, no alcohol was involved!) I was so fed up with the constant mismanagement, lack of interest in staff welfare and lack of interest in the service being provided to the public (unless a journalist was listening) and I felt no-one was listening. I had tried the appropriate channels to report the mistakes, and after a number of years of nothing being fixed, I felt backed into a corner while desperately trying to fix it. I would have thought it had all fallen on deaf ears if it wasn't for the fact I had become labelled as a bit of a trouble-maker.

    The response I received was much like Mr Killens. Telling me that they were listening to staff through the staff survey etc etc, and that there were wonderful initiatives in the pipeline that were going to make everything better. Blah blah blah. Much like the previous initiatives that had not worked properly, the working groups that had been set up to fix problems and were disbanded before achieving anything, like the whistleblowing policy that staff were too scared to use because of the consequences.

    Why do ambulance staff have such a finite career length? I don't believe that is the case across all medical professions. Experience is important to frontline ambulance staff. We've been trying to become a proper profession for some time now. This should not be a fleeting career. By even mentioning that and trying to justify it, I feel Mr Killens is completely missing the point.

    I feel sorry for everyone left but also pleased that someone remains to look after the family and friends I left behind when I had to leave the country to continue working in the profession and earn a steady salary. I'm not ready to stop being a paramedic yet. I feel I was both too weak and too strong to continue working in that environment.

    Like I say though, I'm one of the broken ones.

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  18. I have followed this with interest, OUR service is broken and unfortunately the "SMT" run a programme of "just do it" we all accept change but when at the restructure meeting we asked why we were told by mr K because it is time to change. We are not solving the problem just changing who listens to it.

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  19. Can't think of many employers who would be happy or resigned to the fact that all their professional, experienced employees are going to leave before retirement.

    If that is the attitude and culture of a senior manager no wonder we are in the shite. Can we please replace such managers with supportive managers who will try everything in their power to make it a pleasant place to work by encouraging and supporting their professional employees to stay and do the job we love to do.


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  20. This comment has been removed by a blog administrator.

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    1. Sorry John, I keep finding your comments in the spam box. I'm not sure why, perhaps the spam bot doesn't like your use if quotation marks or something. I responded in more detail in the Seeking Crowd-Funding Patrons to Support Broken Paramedic discussion thread.

      Thanks again for your support.

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    2. Yes, suspect it is because I am signed in to wordpress under another name, please delete this if you wish as have answered on the other thread.

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  21. This is all so evident on jobs. Fire Brigade are supported by senior ranks in many incidents. Police officers are congratulated and supported during or immediately after incidents by sgt's or inspectors. Ambulance staff staff are abandoned with no officer or team leader support and chased by technology, 14 minutes and EOC for the next job. I see Police getting food day and night in many different boroughs. Ambulance staff are completely unable to get food or even grab a tea/coffee, fearing they will get the sack walking to the costa coffee at the other side of the Hospital. Myself I've left, and others have left, one barely newly qualified paramedic gone to a police service. The blissful inability to grasp frontline issues and the chatter pumped out by top levels is like a politician ignoring the question and chattering ignorantly away about this and that.

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  22. written article but you were fed the same old reasons by Killens who should have been a politician as he is able to put a positive spin on anything and appears to be Teflon coated when it comes to taking any responsibility for all that's wrong with our service . He has overseen the services failure to reach its targets for the first year in memory and the most damming staff survey ever and frankly some of his reasons for such a embarrassing staff retention rate just shows how out of touch with reality he is , a large majority of staff that have left in the past four years failed to receive a exit interview that's how interested they were in finding out why they were leaving . his view that the disgruntled staff are in the minority is again far from the truth and yes there is the LIA Facebook page but its full of his sycophants who hang on his every word as anyone who puts any negative comments on there is ridiculed and driven off ( I know many staff who have left the site for this reason). Staff are currently working rotas that are having a detrimental effect on there health /work life balance that were enforced upon us as he sold us out to receive his extra funding . I believe there is a petition going around several complexes for a vote of no confidence in the current EMT/SMT in taking this service forward and is being signed by a large majority of staff . His restructure of the management team has appeared to target the wrong people and certain local managers that staff respected have lost there roles ( our new ADO for the east was a former scenes of crime officer /salesmen ) I think he's miss under stood when reading staffs comments regarding not being listened too or supported they were referring to him and his senior managers at waterloo not local level. Until we have a total change at the top I am afraid we will never get back to the great service we once were . were often described as a world class ambulance service on Saturday I responded to a call where a 97 year old male who had fallen in his back garden and waited 7 hours for a vehicle !!! WORLD CLASS A

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  23. Sack them all and start again Fionna. You don't stand a chance of turning it around with that shower directing operations. Be strong start from scratch promote caring people.

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  24. It was Fionna Moore of course , who when quizzed at the seven seven inquest.Criticised a first on scene medic at a major incident for not treating a patients as he assessed the scene as gold medic. The fact that he was doing what he should be doing ASSESSING ! The scene and reporting to EOC seemed to have escaped her.LAS management's logic regarding cases like Eddie Daly is simple.If you are not fit to be at work go sick .If you go sick you will be sent to occupational health.If occupational say you are unfit to perform your duties you will be sent for a capability hearing .If you are deemed to be incapable of performing your duties you will be sacked .Here endeth the lesson.

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  25. Yes, all staff are dispensable, ready to be cast aside at the slightest transgression. Roll on the next young, eager and enthusiastic replacement to be used and abused in the same manner. And the management's 'bubble a mucker' scheme is going great guns too. You couldn't make it up.

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  26. We have huge numbers of new staff in EEAST but they are not qualified (they are mainly student paramedics) and it's putting even more strain on the qualified staff who don't even have the luxury of a crew mate they can rely on. They are leaving in their droves because they feel isolated and can't cope with the pressure. There are EMT'S who are expected to mentor these brand new students with zero experience (I've seen them not knowing how to work the BM machine and other basics) and there are often situations where one qualified staff member has two students because there are not enough qualified staff to put them with. Extra staff is not necessarily the answer to the problem...

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  27. I think this blog is great, and I hope with all my heart that it's a thorn in the throat of anyone who's not sincerely working to improve the lives of all frontline ambulance staff.

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  28. Not sure whether anyone can clear this up, but HCPC findings state they were given the call at 05:20 before a 6 am finish. If they were on a 12 hour rostered shift and hadn't had a break shouldn't they have been R1 only at that point? Surely a 25yo nausea and vomiting with dizziness is at best R2?

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    1. They were a split crew that had no break from a 18.30 start so would be Red 1 only at 05.45.
      Being a split crew means one person was due to finish at a different station from Mr Daly (a situation only bought about by so many fed up staff already having left) so he would need to drop them off and still need to get back to his own station to finish at 06.00 having had no break all night. They should never have been sent the job, let alone when it was 10 miles out of their own area. If they had done the job they would have worked more than 13.5 consecutive night shift hours. But Killens thinks that's fine and don't dare to stand up for yourself, your colleague or the public safety when you are fatigued and tell control they will make you into a patient by expecting you to continue working.
      It wasn't even a R2 at the time - it was an amber call.
      Does a caring and reasonable employer place such demands on its staff? I doubt you will find any other one even trying it.

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  29. Management appear to say all the right things in all the right places, make the appropriate noises and gestures, while nodding their heads in conversation - so why does it always feel this serves only to sell the illusion that they care or are listening?

    I don't think they ever have, save a very (and I stress that adjective) few people who show some degree of sympathy with the staff.

    The attitude has always been, "...if you don't like it...," and this has come to bite them on the proverbial because staff have been doing - and continue to do - exactly that. It surprises me that even with this current situation, they still offer no sanction or diminishment of their ever robust management style.

    I don't imagine this current crisis will improve any time soon; it will likely deepen further.

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  30. Forced to travel One and half hrs to do a twelve hrs shift, into a congestion charged area when you are not paid the London weighting wages, you won't get the congestion charge of £22 refunded, imagine as normal routine you are bound to finish shift at least 30 minutes to an hour late!!! add on the one and half hours drive back home to sleep on time for your next shift that same day!!! Fifteen to Sixteen Hours For a Day shift !!! Work on until your retirement age of 68!! Very LAS patriotic!! You think I will miss the opportunity to jump this ship whilst I am still ALIVE!! They are breaking us apart!!

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