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Found 322 results
  1. Content Article
    In her latest blog, Sally Howard talks about the importance now more than ever of listening to and looking after each other. Making your voice heard. Listening to and appreciating those around you. Looking after yourself.
  2. News Article
    North West Ambulance Service has declared a “major incident” over a high number of calls. People were warned they could be asked to make their own way to hospital if their call was not life-threatening, while some patients faced delays. There were no signs the surge in demand was linked to coronavirus, a spokesperson for the service said. “North West Ambulance Service has declared a major incident due to the high level of activity in the North West region, in particular the Greater Manchester area,” the service said on Monday evening. “If your call is not life-threatening, you may be asked if you can seek an alternative source of care or make your way to hospital by alternate means," the statement on Facebook said. The Independent understands at one point hundreds of calls were live - which triggered the major incident alert. Read full story Source: The Independent, 3 November 2020
  3. News Article
    Ambulance chiefs have warned coronavirus precautions in hospital emergency departments are putting patients’ lives at risk because of long delays before patients are being treated. West Midlands Ambulance Service has written a formal warning to three hospitals in the region over the delays to handing over patients from ambulance to hospital staff. In one case, a patient was left waiting with ambulance crews for up to three and a half hours. According to the letter, obtained by the Health Service Journal, the delays are being caused because of tougher infection control measures with ambulance bosses warning the situation is “dangerous”. Director of nursing Mark Docherty said the delays meant ambulances could not be sent to “life threatening emergencies”, and warned: “Lives will be put at risk and patients will come to harm as a result”. He added: “I alerted you to a serious concern about patients being kept on ambulances outside your hospital. Of great concern is the fact that a hospital risk assessment identifies this process as a mitigation to reduce risk in your hospital…" Read full story Source: The Independent, 29 October 2020
  4. News Article
    Following a damning report by the Care Quality Commission (CQC), the East of England Ambulance Service NHS Trust (EEAST) has been placed into special measures. It comes after inspectors uncovered a culture of bullying and sexual harassment at the trust. As a result of the decision, EEAST will receive enhanced support to improve its services. A statement from NHS England and NHS Improvement outlined that the Trust would be supported with the appointment of an improvement director, the facilitation of a tailored ‘Freedom to Speak Up’ support package, the arrangement of an external ‘buddying’ with fellow ambulance services and Board development sessions. This follows a CQC recommendation to place the trust in special measures due to challenges around patient and staff safety concerns, workforce processes, complaints and learning, private ambulance service (PAS) oversight and monitoring, and the need for improvement in the trust’s overarching culture to tackle inappropriate behaviours and encourage people to speak up. Ann Radmore, East of England Regional Director said, “While the East of England Ambulance Service NHS Trust has been working through its many challenges, there are long-standing concerns around culture, leadership and governance, and it is important that the trust supports its staff to deliver the high-quality care that patients deserve." “We know that the trust welcomes this decision and shares our commitment to reshape its culture and address quality concerns for the benefit of staff, patients and the wider community.” Read full story Source: Bedford Independent, 19 October 2020
  5. Content Article
    Due to the concerns around ambulance waiting times, the Healthcare Inspectorate Wales undertook a local review of the Welsh Ambulance Service Trust (WAST). The review explored how the risks to patients’ health, safety and wellbeing are managed whilst they are waiting for an ambulance. It assessed how patients are being managed by WAST’s three Clinical Contact Centres across Wales, from when a request for an ambulance is received to the point the ambulance arrives at the scene.
  6. Content Article
    Human factors is a scientific discipline which is used to understand the interacting elements and design of a complex system, aimed at improving system performance and optimising human well-being. This book brings together a range of specialist authors to explore some of the key concepts of human factors related to the field of paramedic practice. The system elements of paramedic practice can include the patient, the paramedic and their colleagues, the environment, the equipment, the tasks, and the processes and procedures of the organisation. The relationships between these components are explored in detail through chapters which cover ‘human error’, systems thinking, human-centred design, interaction with the patient, non-technical skills of individuals and teams, well-being of the paramedic, safety culture and learning from events. This helpful and informative guide provides frontline paramedics and ambulance clinicians with practical advice and knowledge of human factors that will be helpful in supporting safe and effective practice for all involved. It will also be of interest to pre-hospital care professionals who are involved in education, learning from events, procurement and influencing safety culture. Above all, it shows how an understanding and application of human factors principles can enhance system performance and well-being, and ultimately lead to safer patient care.
  7. News Article
    An ambulance service could be put in special measures after a damning report criticised poor leadership for fostering bullying and not acting decisively on allegations of predatory sexual behaviour towards patients. East of England Ambulance Service Trust failed to protect patients and staff from sexual abuse, inappropriate behaviour and harassment, the Care Quality Commission said. It failed to support the mental health and wellbeing of staff, with high levels of bullying and harassment. Staff who raised concerns were not treated with respect and some senior leaders adopted a “combative and defensive approach” which stopped staff speaking out. “The leadership, governance and culture still did not support delivery of high-quality care,” the CQC said. Read full story (paywalled) Source: HSJ, 30 September 2020
  8. Community Post
    During the COVID pandemic, it was clear that Emergency Departments across the UK needed to adapt and quickly, with my trust not exempt from this. We have increased capacity, increased our nursing and doctors on the shop floor, obviously with nurse in charge being responsible for all areas. We have different admission wards in terms of symptoms that the patient has, but also have a different type of flow, which i am getting my head around to be able to share I have seen departments split into 2 and various other ideas coming out from various trusts. Which got me thinking about patient safety and how well this is managed. So.... How is your department responding to the pandemic? Do you have any patient safety initiatives as a result of the response? Is there a long term plan? The reason why i am asking this, is so we can share practice and identify individual trust responses.
  9. Content Article
    The rate at which nursing and ambulance staff are leaving the NHS is increasing. The number of nurse vacancies has risen to over 40,000 – a record high. The ambulance service has recorded an 80% per cent increase in staff leaving the profession since 2010. These rates are unequally distributed across professions, specialties and geographical regions, introducing inevitable inequalities in patient care. This Efficiency Research project aims to use this variation to detect underlying contributory factors for better or worse nurse and ambulance staff retention, and determine its effect on patient outcomes. A research team from Staffordshire University will use their experience of applying ‘big data’ analytics and unifying large datasets from three previous studies on the effect of nurse staffing on patient safety. Projects began in 2019 and will run until December 2023.
  10. Content Article
    A memoir of the chaos, intensity and occasional beauty of life as a paramedic. Jake Jones has worked in the UK ambulance service for 10 years: every day, he sees a dozen of the scenes we hope to see only once in a lifetime. Can You Hear Me? - the first thing he says when he arrives on the scene - is a memoir of the chaos, intensity and occasional beauty of life on the front-lines of medicine in the UK. As well as a look into dozens of extraordinary scenes - the hoarder who won't move his collection to let his ailing father leave the house, the blood-soaked man who tries to escape from the ambulance, the life saved by a lucky crew who had been called to see someone else entirely - Can You Hear Me? is an honest examination of the strains and challenges of one of the most demanding and important jobs anyone can do.
  11. News Article
    Almost a million people waited at least half an hour for an ambulance after having a medical emergency such as a heart attack or stroke last year, NHS figures show. Ambulance crews responding to 999 calls in England took more than 30 minutes to reach patients needing urgent care a total of 905,086 times during 2019–20. Of those, 253,277 had to wait at least an hour, and 35,960 – the equivalent of almost 100 patients a day – waited for more than two hours. In addition to heart attacks and strokes, the figures cover patients who had sustained a serious injury or trauma or major burns, or had developed the potentially lethal blood-borne infection sepsis. Under NHS guidelines, ambulances are meant to arrive at incidents involving a medical emergency – known as category 2 calls – within 18 minutes. The Liberal Democrat MP Layla Moran, who obtained the figures using freedom of information laws, said: “It’s deeply shocking that such huge numbers of seriously ill patients have had to wait so long for an ambulance crew to arrive after a 999 call. It shows the incredible pressure our ambulance services were under even before this pandemic struck. “Patients suffering emergencies like a heart attack, stroke or serious injury need urgent medical attention, not to be left waiting for up to two hours for an ambulance to arrive. These worryingly long delays in an ambulance reaching a seriously ill or injured patient could have a major long-term impact on their health.” Read full story Source: The Guardian, 16 August 2020
  12. News Article
    Ambulance chiefs are looking at alternative defibrillators after coroners highlighted confusion over how to correctly use their existing machines. London Ambulance Service (LAS) Trust has received two warnings from coroners since 2016 after the delayed use of Lifepak 15 defibrillators “significantly reduced” the chances of survival for patients, including a 15-year-old boy. Coroners found some paramedics were unaware the machines had to be switched from the default “manual” mode to an “automatic” setting. The first warning came after the death of teenager Najeeb Katende in October 2016. A report by coroner Edwin Buckett said the paramedic who arrived had started the defibrillator in manual mode and did not detect a heart rhythm that was appropriate for administering the device, so it was not used until an advanced paramedic arrived on scene 24 minutes later. The report stated the defibrillator had been started in manual mode but it needed to be switched to automatic to detect a shockable heart rhythm. The coroner warned LAS that further deaths could occur if action was not taken to prevent similar confusion. But another warning was issued to the LAS in March this year, following the death of 35-year-old Mitica Marin. Again, a coroner found the paramedic, who was on her first solo shift, had started the machine in manual mode and had not detected a shockable rhythm. It was suggested this caused a four minute delay in the shock being administered. Coroner Graeme Irvine said this was “not an isolated incident” for LAS and noted the trust had reviewed other cases of delayed defibrillation. They found that the defibrillator’s manual default setting was a “contributing factor” to the delays. Read full story (paywalled) Source: HSJ, 10 August 2020
  13. News Article
    A dedicated team of 32 volunteers are hitting the roads across North Wales assisting the Welsh Ambulance Service in dealing with fallers. Based out of the Ambulance headquarters in St Asaph, the Community First Responder Falls Team was launched on 30 April this year and has already assisted almost 250 people. The team was created to use the talents and experience of the familiar Community First Responders (CFRs) who had to be stood down from their normal duties at the start of the Covid-19 pandemic. Read the full article here.
  14. Content Article
    The Whole System Flow programme has been accepted for presentation at the International Conference of Integrated Care in San Sebastien in April 2019. This poster provides an overview of the programme’s structure and outputs. We will be opening applications in April for the next group of systems to work with on a system pathway that they choose.
  15. Content Article
    Richard Smith is a trained paramedic who now works as Head of Quality and Safety at Addenbrooks Hospital. In this interview with East England Ambulance Service General Broadcast, Richard talks about his recent paper on incident reporting in the ambulance service. He asks if we have a blame and fear-free culture when concerns are raised, the value of feedback and highlights the importance of reporting the positive incidents too.
  16. News Article
    Ambulance services have been urged to look at how suspected overdose and poisoning cases are prioritised after paramedics took 45 minutes to reach a woman with known mental health problems. Helen Sheath, 33, had been discharged from a mental health unit in early July last year and was still waiting for an outpatient appointment with a psychological assessment and treatment service when she took a fatal dose of sodium nitrate on 20 August. Her father called an ambulance at 6.20pm when she had locked herself in a bathroom and was threatening to take the sodium nitrate. But Bedfordshire and Luton senior coroner Emma Whitting said her father could not tell whether or not she had taken it, and that in view of her history of suicidal ideation, the call should have been treated as a category two – with an 18 minutes response target – rather than a category three incident. The first ambulance which was sent to her was diverted on route and it was only after a second call to the East of England Ambulance Service at 6.48pm, that the call was upgraded to category two – when the call handler selected a different set of questions, after being told she had ingested the chemical. A rapid response vehicle arrived at 7.05pm and the mental health street triage team attended six minutes later. Shortly afterwards she became acutely unwell and was taken to Bedford Hospital, where she received treatment but died shortly afterwards. In a prevention of future deaths report Ms Whitting said: “If the first call had been coded as a category two, it seems likely that the rapid response vehicle, mental health street triage team (and even possibly the double staffed ambulance) would have arrived on scene much earlier (potentially just before or just after Helen had ingested the sodium nitrate) which could potentially have altered the outcome.” The case comes just months after two other ambulance trusts were criticised in cases involving suspected or threatened overdoses. The prevention of future deaths report was sent to the Association of Ambulance Chief Executives and the emergency call prioritisation advisory group, which is run by NHS England. Neither would comment other than saying they would respond to the coroner. Read full story Source: HSJ, 15 June 2020
  17. Content Article
    Sebastian Hibberd, 6 years old, became ill on Saturday 10 October having developed intussusception of the bowel. He deteriorated over the weekend. His father sought medical advice on the Monday from NHS 111 and from his GP's surgery. Sebastian's condition went unrecognised as being life threatening. There were several missed opportunities for him to receive life saving treatment. Sebastian suffered a cardiac arrest and transferred to Derriford Hospital where he sadly died in the Emergency Department shortly after his arrival on the 12 October.
  18. Content Article
    Ben Burke is a Critical Care Paramedic for South East Coast Ambulance Service. He shares with the hub his practical tips when transferring critical care patients via ambulance.
  19. News Article
    Some seriously ill COVID-19 patients in London may not have been taken to hospital by ambulance because of a system temporarily used to assess people, a BBC investigation suggests. Patients could have "become very sick or died at home" instead, a paramedic claimed. One family said they had to plead to get hospital care. Medical professionals use 'NEWS2', as one way of identifying patients at risk of deteriorating, a check normally used for sepsis patients. Under normal circumstances, ambulance teams would blue-light anyone with a score of five or above to hospital. But on 18 March, LAS workers were told to apply the NEWS2 check to suspected Covid patients and that many of those with a score up to seven could be "suitable for community care", even if there were issues with breathing rate, oxygen supply and consciousness. But one paramedic, who wanted to remain anonymous because she did not have permission to speak to the media, said she believed that as a result of the NEWS2 advice, crews went to patients "who may have been seen by ambulance before and then suddenly became very sick or even just dropped dead." Read full story Source: BBC News, 23 April 2020
  20. News Article
    The coronavirus crisis has led to a sharp rise in the number of seriously ill people dying at home because they are reluctant to call for an ambulance, doctors and paramedics have warned. Minutes of a remote meeting held by London A&E chiefs last week obtained by the Guardian reveal that dozens more people than usual are dying at home of a cardiac arrest – potentially related to coronavirus – each day before ambulance crews can reach them. And as the chair of the Royal College of GPs said that doctors were noticing a spike in the number of people dying at home, paramedics across the country said in interviews that they were attending more calls where patients were dead when they arrived. The minutes also reveal acute concern among senior medics that seriously ill patients are not going to A&E or dialling 999 because they are afraid or do not wish to be a burden. “People don’t want to go near hospital,” the document said. “As a result salvageable conditions are not being treated.” Read full story Source: The Guardian, 16 April 2020
  21. News Article
    Ambulance staff are being put at risk by a lack of protective equipment to guard them against coronavirus, according to a trade union. GMB says its members are "scared" about their own safety and their families. The union claims one in five ambulance staff in London are off sick with coronavirus-related sickness. The government says hundreds of millions of protective items have been delivered to NHS staff around the country. According to the GMB Union, 679 frontline ambulance crew in the London Ambulance Service are off sick due to Covid-19-related sickness. Among those at work, some say they feel unprotected either because of a lack of or inadequate personal protective equipment (PPE). Read full story Source: BBC News, 8 April 2020
  22. Content Article
    These resources, set out by NHS England, give guidance for ambulance trusts on the following: assessment and diagnosis management - suspected coronavirus (COVID-19) cases infection Control discharge COVID-19 patient transport services: requirements and funding.
  23. Content Article
    This guidance set out by Public Health England is for possible cases of COVID-19 where an emergency ambulance response is required.  Content includes: identification of possible cases on-scene clinician precautions personal protective equipment (PPE) patient assessment conveyance and patient handover post conveyance decontamination.
  24. News Article
    There is significant variation in ambulance response times to patients with serious conditions such as suspected strokes or heart attacks, which is not fully explained by how rural an area is, an HSJ analysis has revealed. The exclusive analysis represents the first time ambulance performance for category two calls, which have an 18-minute response time target, have been broken down to clinical commissioning group level. Category two, known as emergency calls, covers a wide range of conditions, including suspected stroke and heart attacks (except cardiac arrests), major burns and epileptic seizures. They account for well over half of ambulance responses. The findings — described as “alarming” by the Stroke Association — lay bare the incredibly long waits which are usually hidden, because average waiting time data is usually published for ambulance trusts, which cover far larger areas than CCGs. Mark MacDonald, Deputy Director of Policy at the Stroke Association, said: “It is alarming to hear that in some cases ambulance staff are taking over an hour to reach patients because when it comes to stroke, being assessed quickly and then, if necessary, transferred to hospital, is really important.” Read full story (paywalled) Source: HSJ, 5 March 2020
  25. Content Article
    The Royal College of Anaesthetists (RCoA) and the Difficult Airway Society (DAS) have collaborated to create the video resource Capnography: No Trace = Wrong Place.  Presented by Professor Tim Cook, the video shares the important message that during cardiac arrest, if a capnography trace is completely flat, oesophogeal intubation should be assumed until proven otherwise. 
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