Week away

Just a quick blog this week due to a change of plans I was due to visit friends but due to a last minute hitch they have fallen through.  I have treated nyself to another week in Llanberis Snowdonia.
The weather looks good for the week so I have a few walks planned.

Will post some pics in next week's blog
Stay safe

Cyber attack

Writing this brief blog on my phone as the NHS is currently experiencing severe IT problems due to an international cyber attack.
I don't pretend to understand some of the geek speak from the IT whizzes but they need to put a patch in place to prevent systems being infected. The problem seems to lie with systems running Windows and that includes all sorts of things.
Whilst this is being sorted frontline staff continue to deal with patients and it's business as usual even if that means pen and paper in some areas.

Stay safe

Events

Already in to May where is the year going?
Easter is a memory, as is the May Day however looking forward more and more local and national events start to populate the calendar many of them being held in the SWAST area.

Locally events start to take place on Poole Quay, the regular Tuesday bike nights have already started and the Poole Boat Show is fast approaching. Running jointly is the European Maritime Festival and conference. I attended table top exercises for both these events this week. These were to look at how the event organiser and staff would cope with a variety of scenarios from bad weather to lost children. Predicted numbers for the joint events are around forty five thousand over the three days. This will be a large influx of visitors to the town and can only be of benefit to the local economy.

This weekend sees me on lates and night on Monday and Tuesday covering our operational commander or duty officer role. The mixed weather can bring a variety of incidents alongside the normal day to day management of the sector. Whilst I have been on leave the team have dealt with a number of significant and high profile incidents.

As the operational commander we can still be tasked to incidents as an initial response and we still attend the same development days and shifts with the learning development officer as our teams do. This ensures we deliver a high standard of care to our patients. In addition to this we receive additional training as operational commanders and our competency is assessed in this role again to ensure we are able to deliver a high level of care through our overall command and control of an incident. High quality patient care does not just stop with the hands on clinical bits!

Stay safe and have a good week.

Week away

Hi All
I have just come back from a great week away in Snowdonia, that is why there was no blog last week. Despite the poor weather and very cold conditions manged two 3000 ft summits. Add in a day out on the ffestiniog Railway and two evenings of climbing at the fabulous Beacon centre and you can tell why it was a great week.

Considering that the average daytime temperature in Llanberis was 5 degrees and with snow visible on the summits all around some very poorly equipped people were heading in to the mountains. Even at the lower levels the weather was very changeable with driving rain, low cloud or mist and strong winds one minute and brilliant sunshine at others. The strong winds also added to the windchill with the temperature on the summits feeling like minus 12.

I have another few days off until back to work on Thursday and hopefully can get out for a couple of local coastal walks.

Love the mountains, so I will leave you a few pictures until next week when normal service will be resumed.

Stay safe.

Four day weekend and it is sunny

As I start to write this weeks blog it is Good Friday, I have some family time before starting the first of three nights over the weekend. Like many other shift workers in the emergency services, medical profession and many other occupations, night, weekend and bank holiday working is accepted as a normal occurrence. This is in addition to the many volunteers who give up their time to support their local communities and worthwhile causes.

However for many people this is a long weekend with both the Friday and Monday off. Many will be dragging out the barbecue, others starting DIY projects or just off doing whatever activity they enjoy to relax. The sun is out, so what could go wrong? Just a few easy to remember tips :

Don't light barbecues with petrol.
Be careful if using steps or ladders for DIY.
Take care on the roads and look out for each other.
Only bathe at beaches with lifeguards.
Stay away from cliff edges if visiting the coast.
Don't drink and drive.
Don't text and drive.

Just a few simple tips to help keep you safe and hopefully avoid you meeting me or my colleagues. This list is by no means exhaustive and could run to several pages just ask any of the emergency services.

The weather forecast looks to be reasonable for the next few days so this means the local area will be busy with both residents and visitors. This always adds to our call volume, so please only call 999 in a genuine emergency.





Why 999?

The 999 number was introduced in 1937 so is 80 years old this year. The number was chosen as the 9 digit was easiest to locate in the dark on a rotary dial telephone and also to avoid miscalls if other numbers were used.

What ever you are up to over the next few days enjoy and stay safe.

Demand

Back on nights this weekend and Saturday night was busy across the patch with road traffic collisions and the more normal incidents.
The sunny weather has bought people out and also the start of the school holidays has seen more visitors around. This increase in the "population" adds to the workload of the ambulance service, hospitals and out of hours service. To cope with this particularly over the Easter period  we look at previous data for call volumes and demand this is mapped out and extra resources are put in place at peak times and key locations.
I also attended a planning meeting for a major incident exercise at a local venue. It was a really productive meeting and lots of good ideas for the scenario. More details on this as it develops.

I talked about the changes to the way newly qualified paramedics will be working, along side this change is the trust rota review. The trust have employed a company to look at our demand and match our resourcing to it. This change has to be delivered within the current financial envelope so  will involve changes to rotas. Since the beginning all three stations in our sector have been looking at the options for rotas and thanks to the hard work of the staff representatives staff are almost ready to vote on which rotas they are in favour of.

Well off to bed now , hopefully up in time to enjoy some of this lovely weather.

Enjoy what ever you are doing and stay safe

Changing times

As the year rolls on changes are a foot. Paramedics nationally have moved in to pay band six with all that entails. All paramedics in band six are going to be expected to act as mentors and carry out station duties, many of which have been carried out locally by Lead Paramedics.

One of the biggest changes will be for our graduate paramedics who will now be classed as newly qualified Paramedics and will be in band five for 24 months. This will build on the current preceptorship period that our new graduates already undergo. During this period they will receive additional support, be expected to complete a portfolio to prove their competencies and also have certain of their clinical decisions for high risk patients, who they wish to discharge at home verified by a senior clinician. Also as part of the changes our current Advance Technicians will formally take rota positions as  lead clinicians.

All of the above are national initiatives and guidance to ensure Paramedics are recognised for the high degree of clinical skills and expertise in the pre- hospital and unplanned care environment. As the Paramedic role continue to develop the vital role we play will continue to be recognised. Another operations officer and myself were talking this week and when we both joined the Paramedic role was restricted to the ambulance service with very few opportunities out side of the service. Now days Paramedics are in high demand across the whole of the health care environment and we are seen as having transferable skills.

This week will see three of my colleagues attending Operational and  Tactical command training in Exeter further developing their skills and competency.

Today is April first, the clocks have gone forward giving lighter evenings and the sun is shining. All of this combined means lots of people out and about. Around the harbour there is a frenzy of activity getting boats ready for the summer season. This time of year also sees more motorcycles out and about. Many riders may not have ridden over the winter months and may be a little rusty. With this in mind guys take your time and maybe even think about some additional training, there are lots of options out there IAM, ROSPA, Bikesafe all offer training and ride outs. Go on your never to old to learn.

Stay safe

The ultimate sacrifice

A short blog this week., after the events in Westminster my thoughts are with all those involved in this tragic event.

It took just 82 seconds for the carnage and loss of life to take place. The after effects will be never ending.

The response by both the public and the emergency services typified everything that is British and I am sure I am not the only one who wants to thank all those involved, one of whom paid the ultimate price defending democracy and doing his job.

I thank you all.

Stay safe, stay vigilant

Back room services

As the financial year begins to draw to a close the normal events and reminders start to pop in to our inboxes. The joys of the annual stock take, reminders about completing mandatory training and the requirements to complete career conversations ( Appraisals) with staff all signify this time of the year as much as the first mince pies in the shops indicate the coming of Christmas.

Most of my blogs focus on our operation team and responses to incidents but I thought perhaps I should look at the "backroom" services. these are essential to the running of a large organisation like ours their hard work and support behind the scenes enables us to respond and deliver high quality patient focussed care.

So who do we start with? I think our scheduling team who are tasked with getting the correct people in the right place to provide 24/7 cover are a core function. Wait.... what's that the fleet team ensuring we have vehicles for staff to go on. NO.. No ... our stores team ensuring that our staff have drugs and consumables to use once deployed to a shift and on a vehicle. The HR team for recruiting those staff in the first place.......the research team  for ensuring we are using best evidence based practice running alongside the Clinical team who work with all our local stakeholders to develop care pathways and also contribute to national programs. What about our resilience team who ensure we are able to respond to significant or major incidents, provide expert support and ensure we can continue to deliver business as usual during significant incidents. We also have a 24/7 logistics desk which a "one stop shop" for accessing our backroom teams out of hours. Alongside this like any normal business we have a procurement team, finance team, payroll, and all the normal everyday administration functions, all of whom contribute to the day to day running of SWASFT and delivery of patient care.

As you can see this is just the tip of the iceberg of the teams that ensure operations can deliver the  clinical care to our patients. If I have not mentioned your team directly I apologise.

I have not mentioned our clinical hubs, 111 and the urgent care service which all form part of the SWASFT family delivering care to the residents and visitors to the south west.

The other thing the end of the financial year tends to signify is the start of the holiday seasons and the associated increase in population and call volume.

Just in case your wondering 281 days until Christmas!!!!!

Stay safe

What do we do in a day?

After the excitement of the past few weeks it's back to the main day job this weekend.
So as the Operational Officer, Duty Officer for East Dorset, what have I been up to during my shifts?
Friday morning  handover from the night officer a few minor things to be aware of. Vehicle daily inspection to ensure it is road worthy and has all the necessary equipment,  supplies and drugs and then preparation for our division daily conference call at 0800 our.

This call looks at each sectors performance , potential issues for the day including hospital bed states and handover delays. It also looks at staffing and possible influences from the weather or local events. As I had been off for a few days, once the call was over I had the chance to wade through my inbox and deal with any matters arising.

Then it was a trip to the other two stations in our sector and also the two acute hospitals.

I was then tasked to a incident on the beach and there was great patient focused , multi agency working between the ambulance service, police, coastguard and fire and rescue to bring the incident to a positive closure.

The afternoon became busier with some stacked calls and several vehicles at hospital leading to some  handover delays. A call letting me know a member of staff had gone sick and  regular monitoring of handover times and incidents bought the day to close. Handover to the night ops officer and the sector looks in a good position.

Saturday saw me covering the 1100 - 2100 shift lots going on in the patch including premier league football. After checking my vehicle and a trip down to the local acute hospital it was back to Bournemouth Station and  a productive day with an appraisal completed and written up, several minor problems around the patch easily sorted. A DATIX (adverse incident) investigated and closed with feedback to the the crew.Also mobilised to three incidents. Unfortunately I was then unavailable as the vehicle I was using developed a defect. Whilst waiting for the duty fitter to arrive I continued to monitor the hospital handover times and dealt with a couple of other problems by phone.

Handover to the night DO was done with little to pass over other than he was going to have to swap vehicles not the greatest of starts to his shift

As you can see a varied mix of things we do on a day to day basis. No two days are the same and each shifts presents a variety of challenges to deal with.

Back in today 1100 -2100 again so let's see what today brings.

Stay safe 

Commander Courses

This week I have been in Exeter at the Ambulance Special Operations Centre, home to one of  our Hazardous Area Response Teams and the Emergency Preparedness, Response and Recovery directorate of the trust.
Over the five days I attended the trusts new Operational, Tactical and Strategic training courses. These courses are designed to ensure all staff who may be called upon to perform a commanders role at an incident are suitably trained and have proved their competence against the national occupational standards. However this is only the start as all commanders will need to show continual professional development by attending both live and table top exercises, pre-planned events and live incidents.

In the normal way the days use sessions of interactive learning , group tasks and scenarios to develop your ability and develop key skills. Competency is assessed both using the scenarios and tests. The first two days are the Operational commanders course followed by two days of the Tactical Commanders course and finally the Strategic Commanders day. Although these roles vary in their focus at an incident the underlying principles used are the same. These core skills and processes can be used at any incident and are scaleable depending on the nature, type and complexity of the incident being dealt with.
The courses are being taught over the next eighteen months and the trust have been lucky to secure a highly experienced and respected tutor to deliver this training. All in all a great week with lots of learning, shared experiences and development. Courses of this type and development of the trusts commanders can only lead to improved patient care.

Thanks to everyone involved over the whole week.


Day one of the Operational Commanders Course

As always stay safe.

Exercise "Dolphin"

Bit of a busy week this week. I finished my three nights on Monday morning then met Rich Coleman from Dorset And Wiltshire Fire And Rescue in the afternoon for a final run through and check of things before Exercise Dolphin. Then down to the venue to set up the room.
After all the planning and preparation the big day had arrived. Tuesday morning saw myself and Rich at the port of Poole bright and early, by eight thirty we  had fifteen of the exercise participants already arrived and networking.

Exercise Dolphin was a table top exercise organised by the Poole Harbour Islands Safety Group to evaluate the National Trust's plans for dealing with a significant incident on Brownsea Island and also the emergency services and other agencies response to the incident. The exercise bought together representatives from all of the inhabited islands in the harbour, Poole Harbour Commissioners, local marine contractors, Perenco, Poole Borough Council, Dorset Police , South Western Ambulance Service, Dorset And Wiltshire Fire and Rescue, Dorset Civil Contingencies Unit, Dorset Wildlife Trust, passenger boat operators and representatives from the National Trust's Operational Risk Team. In total we had over thirty participants in the day and the depth of knowledge and experience in the room led to interesting and informed discussions.

The participants were split in to syndicates for the day and presented with the scenario and injects, they were then given tasks and asked to manage the incident using existing plans and using the Joint Emergency Service Interoperability Program principles. The day was well received and met the aim and objectives set during the planning stages. There were lots of learning points and suggestions throughout the day and these have been captured along with debrief documents from all participants. All this information will be correlated and an exercise report produced with suggestions for improvements and action points.

Thank you to everyone involved in the day I felt it was great success. It has been suggested we should have an exercise like this every two or three years.......

Networking before the exercise started.
   Group work and discussion with lots of                                                                                                     information to consider.

  Syndicates hard at work.


Tuesday saw me assisting the Paramedic Science Faculty at Bournemouth University with interviews for prospective students for the degree starting in September. An interesting day and I was impressed with the high calibre of the candidates.

Wednesday and Thursday saw me back at my normal day job covering the Operational Commander role for East Dorset on days. Lots of bits and pieces to deal with to ensure the sector performs including some hospital delays and two significant road traffic collisions.

Next week see me in Exeter on our trusts updated Operational and Tactical commanders courses.

Stay safe.

A mixed bag

After a hectic week at home, this weekend sees me covering nights. Last night saw me attending a variety of incidents to support the crews in the local area.

Next week sees the Poole Harbour Islands Safety Group table top exercise, this is  the culmination of several months of planning and work by the directing team. All the last minute preparations have been done so hopefully there is nothing we have forgotten.I will let you know how it goes next week.
I also have all my pre- course learning ready for my Operational and Tactical Commander recertification course in a fortnight , a bit of light bed time reading.

As I am sat here writing this we are already well in to the month of February and on the south coast where I live there are already signs of spring and its a lovely sunny afternoon.It is half term this week and there seem to be plenty of visitors around and soon we will be welcoming visitors for Easter and then the summer season. Time flies!! Two thing this also means is the start of the speedway season and Poole Quay Bike nights yeah!!!

More and more emergency and voluntary services are using social media to inform the public what they are up to day to day. I follow several of the local road police units and individual officers and whilst it encouraging to see the number of arrests made for drink driving and drug driving it is also worrying to see how apparently common theses crimes are. Throw in mobile phone offences, speeding and driving without insurance or without a licence and the trend looks even worse. I hope some of this is down to the higher level of publicity being achieved through the use of social media. This publicity will however hopefully get the message across that you stand a high chance of getting caught if you are up to no good.

Both the picture below are from Dorset Road policing units today!

81mph in a 50 limit will see this driver off to court

A positive drugs test saw this driver off to custody

It is great to see critical care being provided by the Doctors and Critical Care Paramedics of the Dorset and Somerset Air Ambulance during the hours of darkness when the helicopter is not able to fly. Swapping the the big yellow helicopter for four wheels sees the team bringing all their skills and procedures to patients across the county, this can only lead to improved patient care and outcomes Nice to catch up with last nights team at the local hospital.

Please remember that Air Ambulances in the UK are entirely funded by voluntary contributions so if you are able to help please donate to keep these vital services in the air.

As it says on the tin..........

Until next week stay safe.

Liasion working

This weekend sees me on nights covering the ops officer shifts for East Dorset. Cold weather has hit the south coast with low temperatures both during the day and overnight. We have even had a flurry of the white stuff and guess what ... so far the world has not come to a grinding halt.

As you will have seen from last weeks blog my daughter had her first job interview earlier this week. I am please to say she was successful and will be starting work in July as a diagnostic radiographer once she has completed her university course and becomes HCPC registered.

As any one who has seen the news , read a newspaper or been exposed to social media the NHS is making headlines for all the wrong reasons. I think it is important to acknowledge the hard work and dedication shown by staff at every level and in every directorate across the whole of the NHS. This continued hard work ensures that patients continue to receive high levels of care despite  the huge pressures faced on a daily basis. There is  always talk of winter pressures and it is being reported that demand on NHS services this winter is the highest it has ever been, however this follows a sustained period of pressure and high bed occupancy over the previous year.

From my perspective as a operations officer dealing with handover delays, as a team in East Dorset this has been something we have to deal with throughout the year to a varying degree. Close liaison with our two local acute hospitals, new ways working and regular meetings all mean that we work together to reduce delays and improve patient care.

One night down two more to go off to bed now.

Stay safe.

Social media a positive

After a weekend away at  Butlins Minehead for  Giants of Rock (If you like rock music this is a great weekend) I have had a few more  days leave.

After the 21st birthday celebrations last month my daughter is now feeling very old and adult as she has sent off her first job application. Interview next week so fingers crossed.

As some of you may know I am involved in the planning of a table top exercise for the Poole Harbour Islands Safety Group. The scenarios are all completed and the invites have been sent out. The countdown to the exercise is beginning and I will bring you more about how it goes.

The past few days have seen some very high tides and strong winds and  there have been several flood warnings for the coastal areas of Dorset. Publicising these warnings shows the benefits of social media alongside the more normal methods of alerting the public and responders.
Social media seems to have become s become a necessity for many people. News is now available to us 24 hours a day in the palm of your hand. It is also, almost instant reporting unlike having to watch television news or buy a newspaper. This can lead to information being available to us unexpectedly which you may unprepared for. This information can also be biased or unreliable depending on the source. The old adage that Sky News could have a film crew on scene at most incidents in 20 minutes has now been overtaken by Facebook Live, and video posting to a multitude of media platforms.

Social media can be used to good effect as can be seen from the many Facebook, Twitter profiles and blogs by many agencies  responders and organisations.

                      

Stay safe

Lots to celebrate

Great to celebrate my youngest daughters 21st birthday this week. Where has that time gone?

Its great to see one of our local Operations Officers return to a full range of duties as well this week.

I also attended a table top exercise to validate the latest version of the  counties site clearance plan. Great to see joint working and communications from all involved. Very interesting to learn about the assets and specialist skills and advice  that our local authorities can bring to an incident, both during the rescue and recovery phases but also going forward in to the long term restoration phase of an incident.

This weekend has seen me scraping the car before heading off to work to cover the East Dorset operations officer role . Please make sure  you clear your windscreen before setting off.

The hospitals remain busy but handover delays seem to have reduced which can only be good for patients.

I am away next weekend so you will get a break from my drivel but fear not normal service will be resumed the week after.

As always stay safe.

Winter pressures

A few days off this week and then back in for a  Learning Development Review shift with one of our Learning Development Officers.

All clinical staff will be observed once a year during a operational shift to highlight any development needs, check their driving meets the required standard and to give the staff member the chance to ask questions or go through things they may not be sure of . This is in addition to the day in the classroom we receive each year. Pleased to say my day went OK!

This week has seen continued pressures on the NHS as a whole and the recent cold weather has added to the  demand on services. Locally we were lucky with just low temperatures but no laying snow.
The term" winter pressures" is used to describe the spike in demand at this time of year, however  as call volumes increase , hospital admissions increase and social care come under increasing pressure it seems that it is almost year round pressures with no let up. When I started in the ambulance service almost twenty years ago you almost map the spikes in demand around holiday periods, bank holidays and special events. This is not the case now as the statistics show a continual rise in demand.

Is there a magic cure for this? Does more money need to be spent? Do the public need educating? do we all need to take more responsibility for our own well being and health care? Yes is the answer to all of those questions, however it will take time to implement changes and even longer to see actual differences.

All I and my colleagues in the health care profession can ask is that you do think about what is the best course of action if you are unwell, who do you contact, can you self medicate with over the counter medications? Can 111 help you with advice ? Can the pharmacist help you, what about a practice nurse? Can you be seen at a drop in clinic or minor injuries unit? Do you need to be seen by a GP? Do you need to go to a emergency department, do you need an ambulance?  As you can see there are a large number of people and facilities available to you when you are unwell or need health care advice. Please choose well and use the most appropriate for your needs.






Stay safe

Mrs Miggins journey

I hope you have all had a good week. How are the New year resolutions going?
I have been on four night this week and along with the normal clinical incidents, staffing and fleet issues, the main focus of the week has been dealing with hospital handover delays.

As you have probably seen in the press this is a country wide problem with very few hospitals not experiencing some sort of delays. Within East Dorset we have two acute hospitals and both have had delays all week.

As I am sure you understand hospitals have a set number of beds (capacity) this can be added to by using what are known as escalation or winter pressure beds. Capacity can be affected by a variety of factors such as  weather, time of year, local factors or acuity of patients.

So lets look at Mrs Miggins ( the well known ambulance patient and pie shoppe owner ) journey from 999 call to discharge.

Mrs Miggins rings 999 at 1430 on a Monday afternoon. Her call is answered by a call taker in the clinical hub and the Pathways triage tool is used to determine the response needed. It is decided that she will need an ambulance to assess and probably transport her to the local hospital.
The ambulance is dispatched and the after a clinical assessment decide that Mrs Miggins will indeed need to be sen at the local hospital.
Once at the hospital the crew complete a handover and Mrs Miggins is transferred on to a hospital bed. She is then undergoes a examination by the Emergency Department doctor. His finding show that Mrs Miggins will need to be admitted to a ward. The bed manager is contacted, a bed on a ward is arranged. She is then moved to the ward where she is a inpatient for 3 days. Once her condition has been stabilised and she is ready for discharge the discharge team are asked to arrange a package of care to be put in place to support Mrs Miggins for the first week or so once discharged from hospital. Once all this is in place transport is arranged to return Mrs Miggins home.

As you can see the Journey involves a large number of steps all reliant on one another. Recently ambulance services were experiencing 20% increases in demand so this may have delayed Mrs Miggins arriving at hospital. The ED department may be full and the crew not able to off load. Once seen and a clinical decision made there may not be capacity in the hospital so  a transfer to the ward may be delayed. Once fit for discharge if social care in the community is needed it can take time to organise and community beds in hospitals or care facilities can take longer. At every stage of the process a delay can be introduced which can affect patient care and outcome.

Up and down the country health care staff work tirelessly on a daily basis  to ensure that the patient journey is a smooth and problem free as possible and I for one am proud to be part of that team. the system is not perfect but but our local management team work with both acute hospital to reduce handover delays. This is both by changing the handover process so that it works better on a daily basis as well as supporting the hospitals during acute periods.

So what can you do to help to reduce delays? There are many people you can contact before ringing 999 or attending a Emergency department.

         

Please think before calling 999 or attending an Emergency Department.

Finally a thank you to all the staff working hard to ensure patients receive the treatment they need in a timely manner across the country.

Mrs Miggins went home and the Pie Shoppe is open as usual.



Stay safe.

Happy New Year

Happy New Year every one. What will 2017 bring us?

When I started this social media trip I didn't really know what to expect, I am learning as I go along hopefully developing what I publish and Tweet. I now have over 200 followers on Twitter and people are reading my blog so I can only assume I am doing something right.
My aim was to try and highlight the work of the emergency services and  voluntary services. As those of you who do read this blog regularly you will have noticed some themes around drink driving, how you can help us and also how my role as an Operations Officer is varied. Thanks to all of you who take the time to read my ramblings or follow me.

I had aimed to blog once a week and I have almost achieved this over last year. This year will hopefully be the same, perhaps with a few longer more detailed pieces thrown in.

How was 2016 for you? Mine was pretty good with lots of challenges and achievements. looking forward to 2017 I have lots to look forward to both at work and family wise. As the year goes on I am sure I will be writing about some of them.

I would also like to congratulate local Dorset PC, Chris Smith @dorsetbikecop for his Queens Police Medal for services to road safety announced in the New Years Honours list. Well deserved!!

Every body is different at this time of year, many people take New Year as a opportunity to look back and take stock of the year gone by, other to look forward and make New year resolutions. Whichever you are I wish you health and happiness for 2017.

Please stay safe

Howard