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Found 90 results
  1. Content Article
    The purpose of this study was to identify which, and to what extent, demographic and operational factors are indicative of likelihood for a new call handler or paramedic to remain in role within the first two years of employment at an ambulance trust using data held in the trust’s bespoke data warehouse. Several factors showed a significant contribution to the likelihood of remaining in post within an ambulance NHS Trust. Among the findings, short-term sick leave in the first two years of employment was associated with increased retention for paramedics. In addition, female call handlers were found to have increased retention and paramedic retention increased with time outside of ‘job cycle time’ (JCT) activities (ie, activities other than responding to calls). This study presents a method for extracting new insights from routinely collected operational data, identifying common drivers and specific predictors for retention among the ambulance NHS workforce. It emphasises the importance of workforce-centred retention strategies, highlighting the need for non-JCT time, which in turn would allow paramedics to have time to reflect and recuperate to avoid burnout and attrition. The study also suggests that a lack of sick leave might indicate a lack of trust and self-care culture, potentially leading to paramedic staff attrition. Our approach to retention analytics provides a new mechanism for trusts to monitor and respond to their attrition risks in a timely, proactive fashion.
  2. News Article
    Paramedics have complained of a “disrespectful” instruction to listen to podcasts while queuing to hand over patients to A&E, HSJ has learned. Staff at South Western Ambulance Service made the claim to an NHS England review of the trust, which also heard concerns about “a lack of effectiveness” in the executive team, “fragile relationships” at senior levels, and a “punitive culture” against speaking up. The report does not make clear who “asked” the paramedics to listen to podcasts during handovers, but CEO John Martin said neither he nor the executive teams had given such an instruction. NHSE’s “well led” review of the trust, released to HSJ following a freedom of information request, said: “We heard examples of staff being asked to read [internal trust communications] or listen to podcasts when they were queuing for handover. Staff were not keen on this, as they felt it was disrespectful towards patients, and they preferred engaging with the patients whilst waiting.” It appears to refer to podcasts featuring internal updates. The organisation has been a national outlier, with large numbers of very long handover delays – when ambulance crews are required to queue for hours before they can transfer their patient to accident and emergency staff – particularly over the past three years. Read full story (paywalled) Source: HSJ, 24 April 2025
  3. News Article
    Paramedics across England are watching patients die in the back of ambulances because of delays outside emergency departments, according to a survey by Unison. The gridlock of patients in some of the country’s hospitals has led to queues of up to 20 ambulances outside casualty departments in certain areas. In a number of cases, crews have been forced to wait more than 12 hours before handing over patients. The survey of nearly 600 ambulance workers reveals the toll of the waits on patients and the crews looking after them. Unison warns that “car park care” is increasingly becoming the norm, with hospital medical staff tending to patients in the back of ambulances. More than three-quarters (77%) of paramedics and emergency medical technicians said they have had to look after people in the back of ambulances in the past year while stuck outside emergency departments. Two-thirds (68%) have waited in hospital corridors, or in other locations, with one paramedic often caring for several patients to allow colleagues to respond to other calls. More than two-thirds also reported patients’ health deteriorating during long waits, and one in 20 (5%) said people have died in their care because of long delays in being admitted. Gavin Taylor, 58, a Unison representative and ambulance worker in the north-west of England, said it was now a regular occurrence to be waiting several hours to hand over a patient. He said: “It’s heartbreaking because we are here as a caring profession and the delays have an impact on the care and wellbeing of patients.” Read full story Source: The Guardian, 6 April 2025
  4. Content Article
    An ECG is a test that records the electrical activity of a patient’s heart. It needs to be correctly carried out and accurately interpreted to determine the patient’s condition and potential diagnosis. This Health Services Safety Investigation Body (HSSIB) investigation was prompted by the case of a 29-year-old woman with chest pain. Her ECG was misinterpreted and she later died of a heart attack.  The investigation focused on paramedic education, training and competence in ECG practice and the task of carrying out and interpreting an ECG in the context of the patient’s clinical signs and symptoms. The investigation spoke to key stakeholders to understand the safety risks that may be present in this area. The way 12-lead ECGs are undertaken and interpreted was identified as a growing area of concern, with systemic safety risks that can have a significant impact on the outcome for patients. HSSIB identified safety learning for ambulance services to help train qualified paramedics. It has also made a safety recommendation to the Health and Care Professions Council and the College of Paramedics to improve undergraduate teaching for paramedic students, to reduce this safety risk for patients. HSSIB makes the following safety recommendation HSSIB recommends that the Health and Care Professions Council and the College of Paramedics work in collaboration with relevant stakeholders to improve the undergraduate teaching of 12-lead electrocardiograms by reviewing and updating any relevant standards, guidance, and curricula to provide clarification on: the level of education and expected level of competency and assessment required of student paramedics in relation to electrocardiograms any minimum expected standards for electrocardiogram education in higher education institutions, including the time spent on electrocardiogram learning, methods used, and subject matter expertise required of teaching staff how patient protected characteristics, health inequalities and other specific patient factors are taught in relation to electrocardiograms how effective feedback mechanisms can be developed between higher education institutions and ambulance services. This is to help improve consistency in the way paramedic students are educated about electrocardiograms. HSSIB makes the following safety observations Ambulance services can improve patient safety by including patient protected characteristics, health inequalities and other specific patient factors that can impact on the task of carrying out and interpreting a 12-lead ECG, when developing refresher training. Ambulance services and national organisations can improve patient safety by providing and supporting protected time and resources for paramedic training and continuous professional development, while understanding the potential impact on operational performance. Ambulance services can improve patient safety by providing additional support to paramedic students and paramedics through exposure to a range of clinical scenarios that help develop and maintain 12-lead ECG competency on a regular basis. Acute hospitals and ambulance services can improve patient safety by developing local mechanisms to share information about patient outcomes where paramedics have undertaken a 12-lead ECG. This can help to support learning for paramedics and provide feedback on where their practice may be improved.
  5. News Article
    Crowded accident and emergency wards mean only 15% of department heads are confident they could deal with a major incident such as a terror attack or rail disaster, new research has revealed. In a survey of clinical directors and consultants at 71 emergency departments in England, all said their A&E was crowded, with more than 70% saying patients had to wait in corridors or ambulances at least half the time. Only 11 were confident they were “adequately prepared” to respond to a major incident. The results, published last week in the Emergency Medicine Journal, came from a survey conducted in March last year by academics at Derriford Hospital in Plymouth and the Royal Centre for Defence Medicine in Birmingham. Read full story Source: Guardian, 11 January 2025
  6. News Article
    Paramedics in England cannot respond to 3,500 urgent 999 calls every day because they are stuck outside hospitals waiting to hand over patients, putting other lives at risk, a Guardian investigation has found. Here two ambulance service workers describe their experiences on the frontline that they say “feels like a war zone at times” amid the worst NHS winter crisis in years. Read full story Source: Guardian, 12 January 2025
  7. Content Article
    Over the past three decades, more advanced pre-hospital systems have increasingly integrated doctors into targeted roles, forming interprofessional teams. These teams focus on providing early senior decision-making and advanced interventions while also ensuring rapid transport to hospitals based on individual patient needs. This study aimed to evaluate the benefits of an inter-professional care model compared to a model where care is delivered solely by paramedics. The results suggest that the targeted deployment of interprofessional teams led by doctors in the pre-hospital care of critically ill or injured patients improves patient outcomes.
  8. News Article
    Violence and abuse against paramedics and emergency call handlers is on the rise, with reported cases up by more than a third since 2019, the BBC has found. Almost 45,000 assaults were recorded by ambulance services across England over the last five years, with staff saying they had been punched, kicked, threatened with weapons and subjected to racist, homophobic and religious abuse. Paramedic Nutan Patel-West, 41, said she had been racially abused "multiple times" while on shift and, during one call-out in 2021, narrowly avoided serious injury after a glass ashtray was hurled at her. The government said there was a "zero-tolerance approach to this type of behaviour" and warned that those who assault emergency workers can face up to two years in prison. Mrs Patel-West, who has worked for North West Ambulance Service (NWAS) for more than a decade, said: "I've been verbally abused, racially abused, punched and had a knife drawn on me. "On one job a patient said 'you need to go back to your own country, you're not welcome here' before he threw an ashtray at my head. He missed by inches. "I signed up to this job to help people, not this." Read full story Source: BBC News, 4 December 2024
  9. Content Article
    Authors conducted a before and after, retrospective, observational study using anonymised, routinely collected, patient-level data from a single English NHS ED between April 2018 and December 2019. The primary outcomes of interest were the proportion of admitted patients, that is, the admission rate, the length of stay in the ED and ambulance handover times. They used interrupted time series models to study and estimate the impact of removing the 4-hour access standard.
  10. Content Article
    A casually centred proposal identifying how Fire and Rescue Services can improve pre-hospital care and quality of life outcomes for burn survivors.  David Wales and Kristina Stiles have released this report looking at the burn survivor experience in the pre-hospital environment. The work makes ten operational recommendations and also two 'lessons learned' recommendations exploring strategic partnership working and the resulting fragmented services.
  11. Content Article
    NHS England commissioned a limited scope independent review into patient safety concerns and governance processes related to the North East Ambulance Service. Chaired by Dame Marianne Griffiths DBE, the review considered the facts surrounding a number of individual cases, reviewed the processes surrounding coronial investigations and reviewed the seven previous investigations and reviews undertaken by the ambulance service to determine if they were sufficient to fully understand and resolve issues. On 22 May 2022, media coverage in the Sunday Times alleged that the North East Ambulance Service NHS Foundation Trust (NEAS) was covering up evidence in relation to patient deaths and withholding key evidence from Her Majesty’s Coroners (HMC) linked to service failures. The news article made reference to seven incidents and the names of five individuals were included. The report said that families were not always told the full facts of the circumstances surrounding the death of their relatives. In addition, the whistle-blower who reported these concerns to the Sunday Times also alleged that he had raised concerns about patient safety in NEAS a number of times and that he was bullied and victimised as a result of his actions. Some of the concerns raised by the whistle-blower were known in NEAS and the wider NHS system particularly in relation to some specific complaints from families and the robustness of coronial processes and reporting. The alleged incidents took place between December 2018 to December 2019
  12. News Article
    Ambulance services in England have experienced a mass exodus of staff in the past year with nearly 7,000 leaving their jobs, figures have revealed. The number of emergency service crew leavers has risen sharply compared with 2019 levels, prompting concern for patient safety during the next NHS winter crisis. The government has been called on to launch an urgent recruitment drive before winter to cover the 2,954 vacancies across all ambulance services in England. Daisy Cooper, Liberal Democrats' health and social care spokesperson, said: “With patients struggling to see a GP at the front door of the NHS and unable to access social care at the back door of the NHS, ambulance crews are unfairly caught between a rock and a hard place, picking up the slack from a health and care system that is broken at both ends. “Patients who struggle to access the care they need, when they need it, are then left waiting for emergency assistance in pain and distress for an ambulance. The shortage of NHS staff has caused untold pain for millions of people across the country, especially those left to wait for hours in pain for an ambulance to arrive. “The government must begin an urgent recruitment drive before winter begins and our ambulance services are yet again put under unsustainable strain. There is no time to waste.” Read full story Source: The Guardian, 22 August 2023
  13. News Article
    An ambulance trust accused of hiding information from a coroner about patients that died is keeping a damning internal report about the deaths secret, the Guardian can reveal. A consultant paramedic implicated in the alleged cover-ups continues to be involved in decisions to keep the report from the public. Earlier this month, North East Ambulance Service (NEAS) apologised to relatives after a review into claims it covered up errors by paramedics and withheld evidence from the local coroner about the deceased patients. But a bereaved family left in the dark about mistakes made before their daughter’s death have rejected the apology. Now, it has emerged that a 2020 internal interim report on the alleged cover-up continues to be kept secret by the trust. The damning report by consultants AuditOne has been leaked to the Guardian after first being exposed by the Sunday Times. Paul Aitken-Fell, a consultant paramedic blamed in the report for amending information sent to the coroner and removing crucial passages about mistakes by the trust’s paramedics, remains in post. He also holds the gatekeeper role of FoI review officer, and as such has endorsed decisions to refuse to release the report to members of the public who ask for it. Read full story Source: The Guardian, 24 July 2023
  14. News Article
    A secret report has warned that the NHS is failing to protect trainee paramedics from widespread sexual harassment and racism at work, The Independent has revealed. A confidential NHS England report uncovered by The Independent has found that “extremely alarming” conduct and undermining behaviour are rife in ambulance trusts across the country, with trainees subjected to derogatory comments about their age, ethnicity and appearance in front of patients. There is a “worrying acceptance” that this is “part of the job”, with students hesitant to raise complaints about sexual behaviour by male colleagues in case it gives them a reputation as “annoying snowflakes”, the report says. The revelations come after a recent NHS staff survey revealed that thousands of ambulance staff had reported unwanted sexual behaviour from colleagues and patients last year. One healthcare leader described the findings as “harrowing”, warning that much more needs to be done to protect junior staff. The national report, which is understood to have gone through several edited versions and is marked commercially sensitive, was not due to be released until The Independent obtained the document through a freedom of information request. It found an “undercurrent” of bullying in some areas, with examples of students leaving their jobs as a result of inappropriate behaviour. Trainees reported feeling undervalued and unwanted while on the job, with one apparently told: “Your concerns don’t matter – we have to meet patient demands.” Ambulance handover delays have also led to student paramedics having less experience and training on the job, prompting fears that newly qualified paramedics do not have sufficient levels of experience in life-critical situations. Read full story Source: The Independent, 19 March 2024
  15. News Article
    The first time she was groped at work, Freya says she was 24 years old, a newly qualified paramedic, and was cleaning out the cupboards of the ambulance station crew room. "He came behind me without me realising. I was cleaning away, and he put his hands around my body and grabbed my breasts," said Freya, which is not her real name. "Then he said, 'Well, I won't bother doing that again'. "People just laughed, some didn't even look up from the TV. Like it was nothing, completely normal." Her story mirrors that of other current and former paramedics who, in several interviews with Sky News, painted a picture of widespread sexual harassment and a toxic culture of misogyny. The head of the College of Paramedics, Tracy Nicholls, said: "Problems exist in every [NHS] trust, across all four countries in the United Kingdom." NHS England told Sky News that any form of sexual misconduct was "completely unacceptable" and every trust had committed to an action plan to improve sexual safety. Laura - not her real name - is currently a paramedic for a different ambulance service. She describes sexual harassment as "incessant" in the profession. She says students and new recruits are routinely referred to as "fresh meat", subjected to sexual comments, questions and jokes - even in front of patients - and are continually sexualised by some male colleagues. "It's exhausting," she said. "You come to work wanting to help your patients but every day you're dealing with inappropriate behaviour and sexual comments." Read full story Source: Sky News, 8 February 2024
  16. Event
    The Patient Safety Incident Response Framework (PSIRF) encourages investigations across the NHS to apply SEIPS. This 3 hour masterclass will focus upon using SEIPS in paramedic – urgent & emergency care. The SEIPS trainer Dr Dawn Benson has extensive experience of using and teaching SEIPS, as a Human Factors tool, in health and social care safety investigation. She will be joined in this masterclass session by a clinical subject expert. Morning session: 9.30-12.30 Afternoon session: 1.30-4.30 Register
  17. Event
    until
    This virtual workshop will provide paramedics with background theory and hands-on practice in incident analysis using Root Cause Analysis (RCA) and in proactive risk assessment using Failure Mode and Effects Analysis (FMEA). Register
  18. Event
    until
    This virtual workshop will provide paramedics with background theory and hands-on practice in incident analysis using Root Cause Analysis (RCA) and in proactive risk assessment using Failure Mode and Effects Analysis (FMEA). Register
  19. Event
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    A Q Community webinar on Human Factors in paramedic practice. Register
  20. News Article
    Hundreds of people a day across London are waiting hours for an emergency ambulance to get to them, as paramedics warn that patients are dying as a result of delays. Patients in emergency calls classified as category two, such as those involving a suspected stroke or chest pains, should be seen by paramedics within an average of 18 minutes but are being forced in some cases to wait up to 10 hours. Even life-threatening calls where patients are in cardiac arrest and should be reached within seven minutes have experienced delays, with data suggesting one such call was waiting 20 minutes on Monday. Internal data shared with The Independent shows that London Ambulance Service is holding hundreds of open 999 calls for hours at a time with the service’s boss acknowledging in an email to staff that the service is struggling to maintain standards. Experts warned that the problems in the capital were reflected in ambulance services across the country. One paramedic told The Independent: “Patients desperately requiring ambulances aren’t getting them and, anecdotally, people are deteriorating and dying whilst waiting. Our poor dispatchers have to stare at screens of held calls, working out who gets the next available resource and who waits, suffers or dies.” Read full story Source: The Independent, 5 January 2021
  21. News Article
    We have been coughed on and shouted at by people refusing to wear face masks. We need more protection, says NHS paramedic Jake Jones. The outpouring of appreciation for NHS staff during the COVID-19 crisis has been extraordinary. Yet reports of a recent rise in attacks on emergency workers, including ambulance crews, in England and Wales suggests the Thursday evening applause was hiding a less positive reality. Abuse of emergency workers is a growing issue: a 2018 survey found that 72% of ambulance staff have been attacked on duty, and figures have repeatedly pointed to an upward trend. As an NHS paramedic for 10 years, this aligns with Jake's own experience. The consultation on increasing sentences for assaults on emergency workers seeks to discourage attacks on them. Jake's hope is that it will also challenge what has become an ingrained view – that being abused and assaulted somehow goes with the territory. Read full story Source: The Guardian, 1 September 2020 Read Jake's book 'Can you hear me? An NHS paramedics encounters with life and death'
  22. News Article
    An 'expanded workforce' will be delivering flu and a potential COVID-19 vaccine, under proposals unveiled by the Government today. The three-week consultation also focuses on a proposal of mass vaccinations against COVID-19 using a yet-to-be-licensed vaccine, if one becomes available this year. The Department of Health and Social Care (DHSC) is hoping new legislation could come into effect by October, ahead of the winter season. The consultation proposes to amend the Human Medicine Regulations 2012 to "expand the workforce legally allowed to administer vaccines under NHS and local authority occupational health schemes, so that additional healthcare professionals in the occupational health workforce will be able to administer vaccines". It said this would include 'midwives, nursing associates, operating department practitioners, paramedics, physiotherapists and pharmacists'. The consultation said: "This will help ensure we have the workforce needed to deliver a mass COVID-19 vaccination programme, in addition to delivery of an upscaled influenza programme, in the autumn." The consultation also said that "there is a possibility that both the flu vaccine and the COVID-19 vaccine will be delivered at the same time, and we need to make sure that in this scenario there is sufficient workforce to allow for this". Read full story Source: Pulse, 28 August 2020
  23. News Article
    The number of paramedics taking time off with mental health conditions has almost tripled over the last decade, a Guardian analysis has found. In 2019, paramedics took 52,040 days off due to anxiety, stress, depression and other psychiatric illnesses, up from 18,184 in 2011 – an increase of 186%. While the overall number of paramedics has increased slightly over the period, the rate of mental health leave has increased more, resulting in the average number of days taken off per paramedic in a year rising from 2.8 to 5.8. Unison’s head of health, Sara Gorton, said: “Crisis-level staffing has increasingly become the norm within the NHS in recent years, even before the pandemic. Working long hours without breaks, in demanding conditions, it’s no wonder it’s taken a toll on the mental health of workers across the health service. And the coronavirus challenges have piled on more pressure.” Read full story Source: The Guardian, 23 July 2020
  24. News Article
    Student paramedics are missing out on learning how to save lives because they are wasting hours in ambulances outside A&E instead of attending calls, it has been revealed. The College of Paramedics and ambulance directors say the hold-ups mean trainees are missing vital on-the-job experience, leading to fears over the safety of patients. Will Boughton, of the College of Paramedics Trustee for Professional Standards, said handover delays had become a problem for trainees’ development and exposure to real-life experience, meaning training had become “unpredictable”. If steps weren’t taken to increase training opportunities and address wider quality concerns in education, “it is very possible that patient safety may be at risk due to missed experience during practice education”, he warned. “A student could complete a regular shift and see lots of patients, getting lots of things in their portfolio signed off, or they could be the unlucky ambulance that joins the back of a queue and is then at hospital X for however many hours waiting to release that patient, so and it varies from county to county and service to service,” he said. Read full story Source: The Independent, 22 June 2022
  25. News Article
    The number of calls for an ambulance in England have almost doubled since 2010, with warnings of record pressures on the NHS that are seeing A&E patients stuck in corridors and many paramedics quitting the job. Ambulance calls have risen by 10 times more than the number of ambulance workers, according to a new analysis of NHS data carried out by the GMB union. An increase in people seeking emergency treatment, GPs unable to cope with demand and cuts to preventive care are all being blamed for the figures. While the figures represent all calls for an ambulance, some of which go unanswered and do not lead to a vehicle being sent, they reveal the increasing pressures that have led to claims that patient safety is being put at risk by ambulance waiting times. There has been a significant increase in the number of the most serious safety incidents logged by paramedics in England over the past year. Paul, a paramedic and GMB deputy branch secretary, said he had recently seen a crew waiting almost 10 hours between arriving at hospital and transferring a patient to hospital care. “They arrived at the hospital at 20.31,” he said. “They then cleared from the hospital at 05.48 in the morning. The impact of the lack of resources is affecting the ambulance service. “We are also seeing people become aggressive to the ambulance crew, because they’ve waited hours upon hours in an ambulance." Read full story Source: The Guardian, 12 June 2022
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