Unison to have representation at this crucial meeting.
The transport for the visit was arranged by the Trust, but the itinerary received from VCS / Ferno stipulated a prompt arrival time at the VCS premises of 0930 hours. The journey was a predicted 200 miles with travel time each way of 4 hours; this therefore required an 0430 alarm clock with an 0530 departure, to meet up with John Stone at Longwater Depot where a Fleet vehicle would be waiting.
Despite all best intentions, rural traffic, speed restrictions and delays, we made reasonable progress and arrived at approximately 1000 hours, but we were not the last to arrive. (Of note: the meetings finished at 1730 hours and we eventually arrived back at Longwater at 2100 hours and I finally arrived back home at 2130 hours, after being on the go for some sixteen (16) hours. It is my humble opinion that knowing the distances involved and in the interest of health, safety and welfare of its employees, the Trust should have arranged accommodation for the night of the 16th February so that we were well rested, fresh and not faced with an excessive return in the hours of darkness.
As it was, we arrived back safely despite having to take sudden manoeuvers to avoid being struck by another car which veered into our path to avoid an errant articulated lorry which forced to move sideways towards us. Lucky ? I think it was fortuitous that the incident happened earlier in our journey and not later when we might possibly not have responded as quickly as we did.
The main issues that road staff had been raising with regard to our current Fleet and equipment centred around to much kit being ion the response bags, the weight of the response bag, kit being removed from the response bags to lighten the load and not always being practical to carry the response bag as intended using both shoulder straps; additionally, the cleanliness of the response bags has also been an area of IPC concern.
The first part of the visit took place at the VCS premises where we looked around the production line and were able to see other ambulances in various stages of being fitted out to different corporate specifications. We were afforded a fairly open and unrestricted access to the production line and this enable us to get up close and inside the vehicles during their various stages of completion. This level of access enabled us to observe the different stages including base level fitments, wiring and plumbing, insulation, surfaces and also interfaces, accompanied with a host of explanations and options to ask probing questions; which we did.
The vehicle group then moved a short distance along the road to where Ferno had their main offices and it was here that we were able to view the potential equipment that could ultimately be incorporated into any concept ambulances that any service in the UK (or elsewhere) might wish to create.
The group were able to consider stowage of PPE for the ambulance crew, seating arrangements, stretcher innovations, storage options and also different ways to reduce the amount of equipment being carried in the ambulance, without needless over-provision which could ultimately reduce the weight of the response bags and ultimately reduce the overall weight of the vehicle.
The Ferno concept ambulance (being considered as a trial vehicle for new and innovative systems) is being designed on the Fiat Euro-6 base vehicle. The specification includes the consideration of a 90Kg person on each seat and also on the stretcher; the Fiat model has a two seat cab, and in the rear patient saloon area there are two single seats on the nearside, a rearward facing chair/seat and also the stretcher; this places a demand criteria of 6 x 90Kg = 540 kg.
The group looked at a different method for storing medical equipment in modular units on a wall mounted tracking system, which apart from providing extremely strong crash resistance can enable the crew to move the modules within the rear saloon to accommodate the different needs which they might encounter during their shift. This system also has the ability to attach grab bags of different sizes to the tracking but also enables it to be quickly and easily removed if needed at very short notice.
The modular system incorporates snap-shut pouches which are mounted within lightweight cases, which are secured by a zipper and have a handle which has magnets incorporated into the handles so that an opened case can quickly be closed while the user changes location without having to fully secure the contents by using the main zipper facility.
The Ferno concept ambulance has a base floor level which is much lower than the current Mercedes and with the new Power-load stretcher, the tail lift or ramp is no longer a requirement. The stretcher is effortlessly loaded by a person of small stature, with minimal training and without the need for increased body strength or mechanical aids, thus reducing the risk to employees of lower back pain or other musculoskeletal injuries which might otherwise result from unnecessary lifting or carrying.
So let’s get down to the basics; the staff want an in car entertainment system so that the monotony of long journeys can be broken, there must be adequate height-tilt & rake in both crew cab seating positions, he rear doors must remain fully open when required without being blown shut by the wind, there must be no water ingress during jet washing of the exterior, the ride in the front cab and rear saloon must be comfortable and not noisy… the road staff raised their comments and the working group raised these issues during the lengthy specification meeting, which did not stop short at the wish list.
The Ferno concept ambulance configured with the Power-load stretcher should mean that the attending crew could deal with a multitude of different patient scenarios, including patients who would otherwise require a dedicated bariatric vehicle and crew; there will be no more double-skinned windows incorporating a window blind for privacy because the windows will have intelligent glass which rapidly changes from clear to opaque at the touch of a button. The wall mounted cupboards in the rear saloon will have clear fronts fitted with gas struts to keep them open, but they can be secured with a tell-tale tag which can show if kit has been used and needs restocking, while in the crew cab, a storage unit will be provided utilising maximum secure space for personal items.
The group took an oblique look at the current method of carrying equipment from the ambulance to the patient and the Ferno system includes lightweight cases of different colour and sizes. Checks have shown that by only carrying the correct level of equipment and not carrying equipment which is randomly needed, the overall weight of the response kit (currently a 13.5Kg grab bag) can be reduced. A primary case could weigh 10.5Kg, a secondary case could weigh 10.0Kg, the tertiary case would be the same at 13.5Kg but the Paediatric case would slide in under the radar at just 5.7Kg. The cases are IPC compliant; the modular pouches are also IPC and can easily be removed for use or cleaning.
Access to the cases is via a large sliding door on the nearside, which also gives access to the rear patient saloon area. The cases are in dedicated shelves, easily reached, and from the rear saloon area, the secure cupboards can also be accessed. Additional response cases can be fitted on the bulkhead adjacent to the main cases store.
The two attendant seats in the rear saloon area will primarily be facing forwards but will have the facility to turn inwards to a maximum of 45 degrees, which will meet the requirement for facing forward seating. The seats will be on a floor based track system which enables them to be slid backwards or forwards to meet individual needs at the time.
How will this impact at the start of shifts? The integrated management system will incorporate the self-test of electrical systems, the cases and cupboards can be tagged to show they have been stocked and checked at 100% accuracy by the responsible preparation teams. The sirens will have a muted system to enable the circuit to be tested without causing noise distress, an acoustic tube will direct the siren noise towards and out from the centre of the grill, blue lights when activated will come on at Low Power setting with the ability to increase the intensity if the driver decides it is needed but they will default to Low Power in hours of darkness. The floodlights will remain on and the vehicle will see the return of the Run-Lock facility which enables the engine to remain on when the ignition key has been removed.
The Ferno ambulance is a “Concept” vehicle of innovated design and includes a vehicle management system and cctv / video recording system which is integral to the design. These systems which have the potential to provide evidence of violence and aggression against employees, evidence of dangerous driving; may provide evidence for individual clinical improvement and also defence against fraudulent or malicious claims against individuals or the Trust. There is also the potential for these systems to provide material which might be used against individuals within or outside of the Trust. Until such time that the Unison agrees to these systems being adopted and incorporated into our ambulance fleet , the Trust has reassured the vehicle working group that these systems will remain dormant and will not be activated or brought on-line.
East of England Ambulance Service
Branch Health and Safety Officer
19 February 2017.