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

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