Welcome to EMAS Aspect

Welcome to the first issue of EMAS Aspect – our new online newsletter for people with an interest in East Midlands Ambulance Service (EMAS).

We take pride in the work we do for patients across our region. Whether it is our Accident and Emergency 999 Service (we

take 690,000 calls each year and rising), our Patient Transport Service for booked transport (1.6million journeys each year), or

our emergency planning and incident response work, we are an integral part of the local NHS and we make a major contribution

to the well-being of our population. We are a busy organisation.

Perhaps as a consequence of this, we have not been especially good at telling people about ourselves – the work we do,

where we ‘fit’ in the system, our challenges and our achievements.

This newsletter is a first step towards remedying that situation. We want everyone to know how EMAS makes a difference!

We want to engage more comprehensively with you as people and organisations who, like us, deliver or shape services to

the people of our region.

And wherever we can, we’ll back up the information flow by visiting and talking to people.

EMAS Aspect will be a monthly publication and three months in we will seek your feedback on its content and anything you

would like to see more of within its electronic pages.

But you don’t need to wait for that opportunity – if you want to get in touch please engage with us at communications@emas.nhs.uk

I look forward to hearing from you!

Paul Phillips

Chief Executive

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What our patients say about our 999 service

Our patients are our number one priority at EMAS. So what patients say about us is important. Recently we asked people seen by us after a 999 call what they think of the service they received.

We randomly selected 200 Category A ‘life-threatening’ call patients and 200 Category B ‘non-life-threatening’ call patients seen between April and September 2010 and sent them a questionnaire survey.

We received replies from 54 and 48 people respectively. Here are the headlines:

Whilst the number of participants in the survey is relatively small at 102 people, bearing in mind that we are on course to receive over 700,000 ‘999’ calls this year, this is a positive picture and weare repeating our survey each quarter and build up a stronger picture of how our patients see us.

You can see the full survey findings in our Trust Board papers, alongside our figures for compliments and complaints received, in reports by our Director of Nursing and Quality, Karen Glover.

Take a look at our latest Trust Board papers here. 

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Working through winter

The appalling weather experienced across the region from November into the New Year period placed the East Midlands Ambulance Service under unprecedented pressure. Our region was especially badly affected and Lincolnshire and Derbyshire

in particular experienced particularly heavy snow falls and ice.

Call rates for December 2010 alone were up around 40% on the previous year and this increased workload has continued into

the New Year. January is seeing some reduction, but call numbers are still high as the flu outbreak continues.

The increased workload was caused partly by increased slips and falls on icy surfaces along with higher numbers of traffic incidents. However, the region also reflected the national upsurge in flu-like illnesses in all sectors of the population. This brought high numbers of patients with breathing difficulties, chest pains and other serious conditions, causing the service’s Category A

call rate (the most urgent call category) to rocket.

This increase was not as marked in the less urgent call categories.

Poor road conditions affect ambulance movements as much as other vehicles. We went to great lengths to counter this with measures such as the provision of special traction aids for our double crewed ambulances and having more 4x4 type vehicles available.

Our staff made outstanding efforts to get to patients and we have thanked and commended our teams for their efforts. Some slept

at their stations overnight, others walked long distances through snow to get to work and to patients, whilst others worked full shifts and then returned to help rescue stranded vehicles or clear snow.

One paramedic in Lincolnshire walked 2 miles through snow to deliver a baby when a mother in labour couldn’t be moved out of

her house.

Clearly, in spite of best efforts, the situation has affected our response times. The Category A rate for the service as a

whole dropped below the annualised target of 75% but began to recover as the situation eased - we are currently responding to  75.38% of Category A calls within the 8 minute target.

In addition, the extra workload had a significant financial impact, as we incurred around £400,000 in additional expenditure. This is attributable to the extra calls and the need to have extra staff on duty to respond, and the need for some external providers and some hire of 4x4 vehicles. 

As the weather and the flu outbreak has abated, performance is recovering and workloads are returning to more normal

levels. We were able to put into practice some valuable lessons learned form the previous year’s snow when planning

for this winter and this experience stood us in good stead to meet this year’s challenges.

Pictured: One of our 4x4 vehicle battles with the heavy snow in Blyth, North Nottinghamshire

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Providing care in your area

Over the past year we have educated more than 250 new frontline staff - many of whom are now completing their clinical education and are out providing care across the East Midlands.

Each year we experience a 5% increase in demand for our services and the ongoing recruitment and education of frontline staff is essential in enabling us to meet demand whilst continuing to provide high quality care to patients in need.

Since April 2010 our Education and Development centres in Derby, Leicester and Lincoln have educated:

86 Paramedics. Our Paramedics respond to a wide variety of emergency calls such as patients suffering from a heart attack, road traffic collisions and elderly people who have fallen. They usually respond as part of a double crew on an ambulance or solo in one of our Fast Response Vehicles (FRVs).

28 Emergency Care Assistants. Our Emergency Care Assistants support Paramedics when attending emergency calls. When on scene they help assess what is happening and what clinical kit is needed to care for the patient.

36 Ambulance Care Assistants. Our Ambulance Care Assistants provide non-emergency patient transport – collecting patients from their homes and taking them to their hospital and outpatient appointments. They also transport patients with long term conditions to their ongoing treatment and care appointments.

102 Accident & Emergency Clinical Students. Our A&E Clinical Students have joined EMAS on a pathway to become paramedics within three years. The A&E Clinical Student course is the first step on this pathway and once completed participants receive mentorship from qualified paramedics during a development period.

The latest cohort of A&E Clinical Students successfully completed the 13 week course in Derby shortly before Christmas.

The course included ten weeks of clinical education and three weeks emergency driving training and enabled the students to learn essential clinical skills and develop confidence in treating patients. As part of the course the students visited East Midlands Airport and took part in a major incident practice exercise with the fire service. They also gained an insight into other ambulance and health service roles by spending time in our 999 ambulance control room and observed a post-mortem at Queens Medical Centre, Nottingham.

The students are now supporting crews in Derbyshire and Nottinghamshire as they continue developing their experience in providing frontline care.  

Find out more about the variety of roles within the ambulance service here.

Pictured: Successful A&E Clinical Students (back row l-r) Course Director Amy Rollason, Sam Kennedy, Andy Minchin, Dave Howis, Martin Coleman, Dave Potter, Cheryl Taylor, Terry Thompson, Tutor Richard Tune (front row l-r) Paul Hourigan, Lorraine Mason, Angella Shimwell, Emma Mitchell, Grant Taylor. 

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Calling an ambulance

We know that dialling 999 and calling an ambulance is something which is outside the experience of most people. The average person in the East Midlands will only have contact with an emergency ambulance once every 17 years.

So it’s understandable if people don't always understand what actually happens once the three nines have been dialled, how the service works and responds to calls and what to expect once the call has been placed and help arrives.

When you ask for an ambulance, you are immediately connected to our control centre team who are based in either Nottingham

or Lincoln. The call handler will ask you some preliminary questions – firstly, “What’s the problem?” followed by your location and your phone number so we can call you back if necessary.

This is the point at which we begin to dispatch an appropriate response vehicle if necessary. The call is passed to a dispatcher whilst the initial call is still on-going: we don’t wait until you’ve given us all of the details, as this could cause a delay. The call handler will probably still be on the phone at this point, getting more detail which is entered onto our system and passed to the vehicle whilst it is in transit and – as importantly – giving you advice on how to react and help the patient before the ambulance arrives. How you react at this stage could be vital.

When help arrives, it may be a double crewed ambulance (DCA), a Fast Response Vehicle (FRV) – a single paramedic in car, or may even be a community first responder (CFR)  -  someone who lives nearby and can get to you very quickly especially in rural areas. CFRs are always backed up with additional support which will be on its way as rapidly as possible.

These early interventions can be vital if the patient is injured, bleeding, having a heart attack or having trouble breathing.

When we arrive, our crew will assess the patient and administer any immediate care as appropriate. If necessary we will

transport the patient to an appropriate hospital nearby. However, there are alternatives, and in many cases we may treat and leave the patient at home, transport them to a facility such as a local Walk-In or Urgent Care centre or make contact with a GP or out-of-hours service to provide further treatment.

In non-life threatening situations, this “blue-light” response isn’t appropriate. Our control team can assess the situation over the phone and arrange for a non-emergency attendance from an ambulance crew, or arrange for one of our fully trained triage

nurses to call back to offer advice and suggest the best treatment.

The whole 999 response cycle is a team effort. From the moment we receive your call, our call takers, dispatchers, triage nurses

and – of course – the crews themselves all contribute to ensuring your emergency receives the fastest, most appropriate and professional response so that you can be assured that you are in safe hands.

Pictured: One of our Emergency Medical Dispatchers ensures that we send the most appropriate ambulance resource and can provide instructions about immediate life support until our crew arrives.

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Bravery award for heroic efforts

EMAS Paramedic Chris Davey has been presented with a Queen's Commendation for Bravery award after risking his life to help others following a plane crash in South America.

Chris and his wife Debbie were on board the plane as they ended a two-day tour at the Canaima National Park, Venezuela in

April 2009. The accident happened less than a minute into their flight when the aircraft, with 12 passengers and crew on board, stalled and fell from the sky into the forest below. Chris said: “The plane did a sudden steep dive to the left - we could see it

through the cockpit window - a mass of trees and bushes coming at you. When we stopped, there was silence at first... then screams and bewilderment... then sudden realisation of injuries and pain."

The plane was ripped apart by the impact and there was a real danger that the spilled fuel could ignite at any moment. But Chris organised the passengers and locals to free the injured from the wreckage and deal with cuts and broken bones. He stayed

with many of the casualties as they were airlifted to hospital to make sure they were properly assessed and treated.

Chris, who works within our Hazardous Area Response Team (HART), has nearly 20 years experience as a paramedic and

said: "My training just snapped in. I have trained for the worst possible scenarios - and that was definitely one of them."

Chris was presented with his bravery award at Ilkeston Town Hall on 7 January. Leader of Erewash Borough Council Chris

Corbett said: "On behalf of the borough council and all residents, I would like to extend our congratulations to Mr Davey on

receiving the well-deserved Queen's Commendation for Bravery. He showed incredible courage in what must have been a terrifying situation - ignoring the risks to his own life to go to the help of others."

Find out more about our HART team here.

Pictured: Above - EMAS Paramedic Chris Davey and - below - the crash scene in Venezuela.

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