Christmas Day

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Well the big day is here and I hope that you are all enjoying time with your family and friends. I like many others am working today, providing essential services to their communities. I would also like to mention and thank all those who give up their time voluntarily throughout the year to help and support the local communities.

These volunteers are often the unsung heroes who quietly go about their business in the background with little or no recognition. When you see a collecting tin please try to spare some change to support the important work these people do.

A public thank you to all those people who give up their time to help other people in a wide range of settings.

As I have said before in my ramblings please think about helping a charity by volunteering. You don't have to be at the sharp end, there are many backroom rolls which need to be carried out as well.

I hope you are all enjoying your day where ever you are and whatever you are doing.

Happy Christmas, stay safe.

Christmas is really coming

A few things have gone on  this week  a planning meeting for a table top exercise in the new year, collecting my daughter from uni for the Christmas break and some Christmas shopping. I have a few more days off before returning to work on Friday.
Like many others in the NHS, and other emergency services I will be working on Christmas day. When I joined the ambulance service almost twenty years ago Christmas day was dare I say it .... no just the Q word and there was very little else going on. Boxing day would have been busier but as the years have gone by Christmas day almost seems like any other day of the year, Boxing day even more so. Across the country more and more people are having to work over the festive period and I think this is a sign of our 24 hour culture.

With less than a week to go before  the big day  the festive shenanigans will be in full swing, please have a think about how prepared you are, no I don't mean have you got a big enough turkey or sprouts to feed a small army but more along the  lines of have you got sufficient stocks of prescribed medication if you need them? What about over the counter remedies?

Have you checked your car if you are off on a journey to visit relatives or friends? Have you filled up with fuel? What about the screen wash and the tyre tread and pressures?
Off to a party? How are you getting home? Have you a designated driver? What about booking your taxi?

So much to think about besides getting the reindeer carrots sorted and a mince pie for Santa. If you needed an ambulance at night could we find your address? Can we see your number from the road? Unlike Santa we do really on the mark one eyeball to find you, not a glowing nose!

       

Please stay safe and enjoy the festive period.

Help us to help you

I've had a few days off this week which was nice as it gave me a chance to catch up on a few jobs at home and I also had a nice meal out with friends.

The cold weather has continued and Emergency Departments continue to be busy. As regular readers will know part of my role is to manage ambulance  handover delays at the two local acute hospitals. This can be challenging at times, whether that is due to a lack of bed capacity in the hospital, high call volume to the ambulance service, delays in patients being seen and triaged in the Emergency Department or a combination of all three.

The trust I work for is committed to Right Care and the overarching aim of this programme is to ensure that patients receive the right care, at the right time and in the right place. This may not always be hospital and in fact locally  only around 38% of the patients our clinicians see are actually transported to hospital. Many of them are given advice or treated at home. They may be referred to their own GP or the Out Of Hours Service for follow up. Many callers to 999 may also be triaged  over the phone and advised to seek help from other NHS services. All of this work is in place to try to ensure that those people who really need and ambulance get one in a timely manner.

As we move nearer to Christmas there are a few things that you can do to help us to help you:

Also please:

Ensure you have a stock of everyday over the counter medicines.

Ensure that you have sufficient stocks of prescription medicines to see you through the holiday period

Seek advice for health problems now , don't put it off. Many everyday problems can be dealt with by your local pharmacist.

If you are having relatives to stay make sure they have their medications with them if needed. Do they have any specific needs? If so how will you cope with them?

Help us to help you , stay safe

Christmas is coming!

As I write this we are in December and another year is fast drawing to a close. Where has the year gone? What have I achieved? What did I miss out on doing?

This year seems to have flown by with lots going on throughout the year with Exercise Velocity a highlight for me. Day to day duties proved challenging in the early part of the year with hospital handover delays, demand carries on increasing and we have had the introduction of the electronic patient records system along with Mobimed monitoring, alongside a new response bag system. All of these have been on top of the everyday issues. Staff have dealt with this admirably.

We have recently had the coldest weather of the year so far and this will increase demand on all services, I wonder if this is a sign to of things to come? Looking forward this month will see party season moving in to full swing in the run up to Christmas. Please consider how your going to get home and as throughout the rest of the year don't drink and drive. As an aside to this road side detection of drug driving is also on the increase with many more roadside tests being carried out.

Just a thought about cold weather , please make sure you check your car before setting off and ensure that your windscreen and lights are clear. Please also adjust your driving to suit the conditions and drive to arrive.

I have only just seen this on the TV and thought I would share it with you

straight talking and to the point!!

As always stay safe

Multi agency working

Yesterday saw me at a meeting of the Poole Harbour Islands Safety Group. We meet twice a year to discuss issues and problems facing the inhabitants of the islands. There are around twenty full time inhabitants this number can swell to over two thousand when the visitors decend on Brownsea Island.
Just because you live on a island doesn't mean you don't get ill, suffer accidents or other emergencies. You can still.be a victim of crime or have a fire. The inhabitants still dial 999 , 111, 101 or contact their GP in the same way that you and I do. They also expect the same level.of service although all realise the logistics of living on an island will impact on this. So this is where the PHISG comes in to ensure as responding agencies have robust plans in place to respond to the island communities.
The group is made of of the emergencies services , island owners and staff, the harbour commsioners  and other interested parties. Good progress is being made with all the inhabited Islands now having defibrillators and training , fire fighting equipment and training. The plans produced by both the islands and the responders are reviewed and in the new year we will be holding a table top exercise to validate these plans and seek improvements. 
Planning is well underway for this and it should prove to be an interesting  day for all involved.

Stay safe and remember Xmas is coming.

Training and rain

This week saw CBRN refresher training and this weekend as operational officer for East Dorset.
It's already been a busy day across the patch with hospital handover delays and heavy rain adding to the mix.
As I write this it is throwing it down outside and according to the forecast it is set to get worse overnight please make sure you drive to the conditions.
As much as our crews are a friendly bunch they would rather not meet you.
As you know I have a couple of pet hates drink driving and mobile phone use while driving, this week has seen a concerted national campaign to highlight the dangers of mobile phone use while driving with multiple prosecutions across the country.
You take the keys off someone you think is drunk but not a mobile phone? Both can lead to fatal events and the sooner people realise this the sooner our roads may become safer.
As always stay safe

Remembering

My thoughts this week are for all those involved in several tragic incidents across the country, those who have lost their lives, those that are left behind and those who attend as part of their job to protect and save us.
As part of a service which provides this care I feel incredibly proud of those who I work with, across all of the responding agencies and not to be forgotten the voluntary groups who provide hours of support both during an incident and after it.
The time after an incident can be the most difficult to deal with both for the victims , their families and the bereaved. It can be months years , if ever that people begin to come to terms with the tragic events they have been exposed to.
You may have noticed that I didn't include the responders in that group; "Its our job" , "I'm OK" and similar are often heard. This is not the case and we are just as likely to affected by an incident as anyone else Our green superman or whatever colour uniform you wear does not make us invincible!
All agencies have in place a support network to enable staff to speak to someone if they have been affected by a incident or things that may have built up over a period of time.
It is not weak, it is not failure, it is not brave to bottle things up. In fact it is the complete opposite to recognise that you need to talk to someone and ask for help.
Using the old British Telecom line again "It's good to talk"
Today is also Remembrance Sunday and will see those who have fallen in conflicts across the ages and the world remembered for their sacrifice. Included in this will be all those from the emergency services who lost their lives while doing their job and protecting us.

Please take a moment to remember all those who have given their lives to protect us whether during conflict or on home soil.

For The Fallen

With proud thanksgiving, a mother for her children,
England mourns for her dead across the sea.
Flesh of her flesh they were, spirit of spirit,
Fallen in the cause of the free.

Solemn the drums thrill: Death august and royal
Sings sorrow up into immortal spheres.
There is music in the midst of desolation
And a glory that shines upon our tears.

They went with songs to the battle, they were young,
Straight of limb, true of eye, steady and aglow.
They were staunch to the end against odds uncounted,
They fell with their faces to the foe.

They shall grow not old, as we that are left grow old;
Age shall not weary them, nor the years condemn.
At the going down of the sun and in the morning
We will remember them.

They mingle not with laughing comrades again;
They sit no more at familiar tables of home;
They have no lot in our labour of the day-time;
They sleep beyond England's foam.

But where our desires are and our hopes profound,
Felt as a well-spring that is hidden from sight,
To the innermost heart of their own land they are known
As the stars are known to the Night;

As the stars that shall be bright when we are dust,
Moving in marches upon the heavenly plain,
As the stars that are starry in the time of our darkness,
To the end, to the end, they remain.

Laurence Robert Binyon, 1869-1943

Thank you have a good week and stay safe.

A bit of a rant

Another week nearer to Christmas!!!
This week has been a contrast in days frosty starts and sunny days. One day hardly a phone call the next the phone practically red hot.
Wednesday was a chilled day with the normal things to deal with  staff welfare deployment issues, liaising with hospitals and attending incidents. Thursday right from early doors the phone did not stop ringing, not content with using our dedicated duty officer number, my normal work phone was busy to.
The clocks going back means darker evenings, and despite it actually being dark I still cyclists without lights. Please if you are a cyclists or know a cyclist please , please make sure you have lights, bright clothing and a helmet.
As those of you who know my real pet hate is drivers using mobile phones. I'm sorry but nothing is that important that you need to use your phone while driving. Drink driving is considered socially unacceptable so why do people consider the use of a phone to be OK?
My personal view is; caught using your phone while driving equals a automatic 28 day driving ban and a retest. Would that be enough of a deterrent? I think so.
We all need to remember that driving is a privilege not a right and we all need to do our bit to contribute to safer roads.

Rant over! Stay safe

Joint working

Good morning all I hope you have had a good week. This weekend sees me covering lates 1100 until 2100. This shift normally brings a variety incidents and taskings.

Hospitals always seem to be busier over the weekend ( not a proven fact it just seems like it). As operations officers we liaise with our local hospitals to avoid and manage handover delays. East Dorset has two acute hospitals in our patch and this can often prove challenging. Our operations officers meet with both hospitals on a weekly basis to discuss any problems which arise and to work out solutions or changes to practice. These meetings are in addition to our daily contacts to deal with issues and potential problems as they occur.

The past few weeks has seen a large number of serious incident in East Dorset, which has seen joint working between all responding agencies. As more JESIP (Joint Emergency Services Interoperasbility Program) sessions take place over the coming months this will give the opportunity to train more commanders and refresh others in key skills.
JESIP ensures all commanders from the responding agencies use a common and systematic approach to command of an incident. All agencies will have their own roles and responsibilities at an incident but JESIP aims to ensure our initial multi agency response is more organised, structured and practised. Regular use of the JESIP principles at incidents and training exercises means that the principles are embedded into our every day practice and become second nature.

More information about the JESIP program can be found here www.jesip.org.uk/home

Regular meetings with organisations outside of our immediate teams also enables networking to take place and relationships to be built up which can only be beneficial to joint working.

The overarching aim of all our meetings, exercises and joint working at incident is to benefit patients and improve their outcomes by working together.

As always stay safe and don't forget it will be darker earlier due to the clocks going back.

Normal service is resumed

Sorry for the lack of blogs over the last couple of weeks, things have been a bit hectic at home and very little to report work wise.
Back on nights this weekend which will bring it's normal variety of incidents.
Movements and secondments within our team has opened up the opertunity for Lead Paramedic secondments. I had the pleasure of interviewing this week along with a college.The standard of applicants was high and all aquitted themselves well. Congratulations to the two who will be starting immediately and those in the pool for the new year. It is good to see staff develop and stretch themselves by taking on new roles or responsibilities.

Following  several incidents in our patch over the last few weeks please take care when on the road and remember driving is a privilege not a right. Several high profile road traffic cases have come to court  this week all of which resulted in lengthy bans and  upto dial sentences. However this does not undo the effect one action has on a family and neighbourhood.

Whatever you are up to stay safe.

Autumn is here

Another week gone and this weekend has seen me as operations officer for East Dorset.I have attended a variety of incidents to assist and support staff as well as monitoring the hospital handover times.
The beginning of the month also sees several regular audits and checks that have to be completed to ensure compliance with various policies and procedures,
As I write this the nights are starting to draw in and I am going to work in the dark. Traditionally the period after the school holidays in the run up to Christmas is a time of reduced demand , however this year that does not seem to be the case. Hospitals already have 'winter' escalation beds open that is if they have even managed to close them this year. The NHS is under severe pressure and we all need to take responsibility for our own well being  and health. Before calling 999 or visiting the local accident and emergency is there another service I could use? 111, the out of hours GP service, could I wait to see my own GP, a pharmacist or local treatment centre are all options to consider.


          



Please think before calling 999

Stay safe and have a good week.

Christmas is coming!!

This  weekend has seen me as the Operational commander for the local East Dorset sector.
Our patch is fairly  unique  within SWAST as it has two acute hospitals within one sector  at either end of the Bournemouth , Poole conurbation.

This can prove challenging especially when both hospitals are struggling to off load ambulances. Yesterday saw handover delays at both hospitals, luckily we had additional operational officer cover yesterday  which allowed us to have an ops officer at each hospital to liaise with the hospital staff and manage delays.
This was in addition to the team providing incident command support at a evacuation of a local swimming pool and leisure complex and at a complex trauma incident.

For those of you who hate the thought of Christmas look away now apparently its about 90 odd days away and counting, Christmas goods are in the shops! From an ambulance service and NHS wide perspective this means finalising plans to deal with anticipated winter pressures. This include plans to deal with increased numbers of 999 and 111 calls, handover delays at hospitals , disruption to services due to severe weather, planning for large gatherings on New years Eve,  alongside our business as usual functions. This is part of the role of our Emergency Preparedness, Resilience and Response  team who work closely with local managers, other agencies and NHS trusts to ensure we have robust pans in place to cope with expected pressures. The acute hospitals will also be forming their plans and they will look at expediting discharges, creating extra bed capacity and additional staffing at key times.to ensure that they maintain bed capacity in the hospitals. Jointly and nationally there are many initiatives in place for admission avoidance.  As you can see a lot of work goes on behind the scenes to make sure that patients receive the care that they need at the right time in the appropriate setting.

That's it from me for this week off for two days of training next week before covering the weekend.

Frequent callers

Risk assessments has been the main job this week. I have been completing the health and safety risk assessments across the three stations in our sector. Overall no real major problems identified but a wish list prepared for the estates team. There is one major piece of work related to this I am continuing with and more about that in the future.
If you are a regular reader of my blog (apparently there are some!) my last ramblings talked about the efforts made to reduce the volume of frequent callers. I attended a multi disciplinary meeting this week for one of the top five frequent callers for Dorset. Other agencies represented were the patients GP, community matron, Community mental heath team, district nursing team, physiotherapists and social services. This was to ensure that all agencies could share information and agree a joint approach.
This part of the process was to ask the the patient to sign a Acceptable Behaviour Contract. This is a voluntary agreement between the patient and the Trust with several clauses, all of which revolve around reduction in calls to the ambulance service and requiring engagement with other support services. It also requires the patient to be polite and non threatening to NHS staff whether in person or on the phone.  Despite the patients GP visiting the patient several times in the run up to the meeting, the patient did not attend  and a further date has been organised for the GP and myself to visit the patient at home.
 I will reiterate at this point, this whole process is to try to ensure the patient is engaging with the services available to them. This ensures that they receive the help and assistance they need. If this is in place the patient benefits and as a service we normally see a reduction in our call rate.
The frequent callers often pose difficulties to all agencies involved in both their care and  social situation. This often leads to the police being involved and they also have a similar process in place. In the past the agencies probably would have worked in isolation and the combined multi agency approach we now use ensures that these patients are not slipping through the net or being missed due to lack of information sharing. The ambulance service is often the first port of call for many of these patients and without the hard work of our small frequent caller team many of these patients would not be highlighted to the teams involved in their care.
I have a few days off this week with lots planned so whatever you are doing stay safe and have fun.

Hectic

Back from my leave and despite the school holidays finishing demand is still up and the NHS as a whole is still very busy.
I have been involved with dealing with a "frequent caller" this week. This is some one who is contacting 999, 111 or the out of hours GP service on a regular basis, they may also be contacting the police. To reduce these call levels the trust have a dedicated team who identify this type of caller this information is then passed to the local operations teams who attend meetings etc on behalf of the trust.
Once identified the trust will contact the patients GP to gain more information about them. Often the increase in calls is due to patient having a ongoing medical problem which may have worsened or changed in the way it is presenting. It may give new symptoms including falls or pain. Often with the help of the GP and other agencies these callers can receive the help assistance or changes to medication that they need. It may be that the level of home care they are receiving needs to increased or the times of visits altered to help avoid falls.
 However there are those that despite this combined approach their call volume continue to increase at this point the team write to the patient and their GP to inform them of the continued number of high calls and again to try to identify the cause for this continued call volume. At this stage often a multi disciplinary, multi agency meeting may be held to discuss and review the patient.
 To put this in perspective at this point it is likely that these patient will be calling 999, 111 or the out of hours service at least once a day if not more, on average. At this type of meeting all agencies and healthcare professionals involved with the patient will be represented and information , current treatments and inputs from community teams will be discussed to see if there is more that can be done for the patient. Often these patients will be well known to the teams and alternative care plans will be formed to try to help these patients.
The patients well being is central to these discussions as there is normally an underlying reason for there call volume and there are multiple methods that may be used to try to gain the patient the help that they need from one or multiple agencies or disciplines.
If that fails to reduce the call volume  further action then take place and I will outline those  in my next blog.
I hope you have all had a good few weeks while I have been away.

Holidays

An early blog this week as I am off on holiday for 2 weeks. By the way if anyone would like a long range weather forecast let me know, as after several weeks of dry sunny weather, first day of my holidays and its raining. This is a normal occurrence when I book leave!

This week saw me as Operational Commander / Bronze officer for 3 days and attending a variety of incidents including a collision between a bus and car. Only 2 minor injuries, 1 dealt with at scene and 1 transported to hospital for further checks.

Another incident saw joint working between ambulance crews and Dorset and Wiltshire Fire and Rescue to extract a patient who had fallen whilst working on scaffolding. Great patient focused team work soon saw the patent safely packaged and on the ground, ready for onward transport to the hospital.

When I use the term "packaged" I don't mean cardboard boxes and packing tape. The term packaged means ready for transport and this can be simply that the patient is on a carry chair and blanketed ready to get them out of a property. It can also mean as in this case the patient was secured on to a combi board and immobilised before being placed in a basket stretcher. One of the most difficult tasks that ambulance crews can face is how to get a patient safely from their current location to the ambulance, they  have a variety of equipment directly available to them and also via other agencies.

              Carry chair                  Combi Board

       Stretcher

Above are the basic tools of the trade for moving patients to the ambulance.

This weekend in Bournemouth also see the Bournemouth Air Festival an annual event drawing huge crowds to see some spectacular flying all for free.

Whatever you are doing over the next couple of weeks enjoy the bank holiday weekend and stay safe. Normal service will be resumed in a fortnight.