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.

Summers here

So it seems summer is finally here and a heat wave is predicted for next week. The local area is busy with visitors and locals making the most of our beautiful part of the world.

Our local lifeboats, coastguard and lifeguards have all been busy over the past few weeks with Poole lifeboat being tasked every day for ten days running. The local fire and rescue service have also been busy with several heath fires and persons reported dwelling fires.

The NHS ? we have been busy with our normal level of demand added to by visitors to the area. All of our emergency services and also voluntary agencies work hard to keep you safe and assist you. Many of them going about their tasks in the background, our unsung heroes.

With the increase in demand please ensure that you choose well when deciding if you need to call 999 or is another option more suitable?

Dorset and Wiltshire Fire and Rescue gaining access to a flat to begin a search for the occupants.

Who you gonna call?

Some ideas to help you decide.

Have a good week and  enjoy the weather. Don't forget the sun tan lotion and a hat.

Weekend days

A lovely day on the south coast today with lots of visitors around.
A incident at the local airport this morning saw a light aircraft land safely.
Also tasked to a local park for a cardiac arrest on arrival patient was conscious and breathing after great bystander CPR and two shocks from a community defibrillator. Patient now in hospital. Well done to all involved.
This incident shows the importance of early CPR and early delivery of shocks. Could your business,school or club house a community defibrillator if so contact your local ambulance service.
Apologies for the lack of blog last week was a bit busy.
Enjoy the sunny weather and stay safe.