Health and Safety

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             Pre-Hospital Healthcare Providers                  

It was recently reported in the media, that when some Paramedics offered to carry out voluntary work overseas, their offer was declined because “we don’t need ambulance drivers”; which mirrors a common misunderstanding about what Paramedics and other ambulance clinicians actually do during their shifts, despite a recent programme about London Ambulance Service receiving great applause; which is why I will endeavour to paint a picture about pre-hospital clinicians, who just happen to also drive ambulances.

The pre-hospital healthcare worker is just that; a person involved in the provision of healthcare to others outside of a hospital or clinical environment. The day to day

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Calls In Progress

Members of staff are still voicing their concerns regarding the service dispatching crews to presumed emergency calls with blue lights and sirens.  This situation has been a “hot potato” for a very long time and is exacerbated by the pressures placed upon ambulance crews to meet clock-stopping targets while we have insufficient qualified clinical staff and vehicles to realistically provide adequate cover to our vast area of 7,500 square miles.

The advice which we received from the Association of Chief Police Officers (ACPO) was not acceptable to the Trust despite the advice making rational sense. The situation was escalated to the extent that the Department of Health became involved which brought about them meeting with the seniors of all three emergency services.

Post Bag December 2014

Christmas is just around the corner and the sub-zero temperatures have already made an appearance. We have seen an increase in staff numbers, some from other Trusts and some new to the service in general. With this in mind I have collated the most talked about subjects into this month’s Post Bag, in no particular order of preference or importance.

Footwear: Operational members of staff are entitled to have two pairs. This is to enable them to allow them to dry out and air between shifts, which also reduces bacterial growth in the materials. Members of staff should submit a replacement request in sufficient time for the replacements to arrive before the existing ones become unusable. If footwear or other parts of uniform are removed by the Police for forensic purposes then replacements can also be requested and hastened.

Senior Paramedics and Senior Technicians: This has been well received across the Trust and forms an essential part of staff development & progress. There will be no changes to items of uniform however those members of staff that have been upgraded are entitled to have “Senior Paramedic” or “Senior Technician” on their Trust Identity Card.

Violence and Aggression: The Trust Health and Safety committee would be grateful if members of staff that have suffered violence & aggression during the course of the work, which resulted in the assailant facing charges and being sentenced or having other sanctions imposed, could inform the committee by passing details to Anne Wright or Danny Daniel.

Allocation of Calls: The Trust has issued ESOP 25 which gives directions to EOC staff in the allocation of calls to ambulance crews who have passed their meal break or shift finish time. When a crew are assigned to a call and have passed their meal break (or shift finish time) they CANNOT be assigned to another call (even of a higher category) unless the dispatcher first contacts the crew to ask if they are prepared to accept the next call.

If the crew decline the next call, they are to be left on their original call. If the crew accept the next call, they will THEN be stood down from the original call and given the next call which they may have to see through to completion including the conveyance of patient to hospital. If this call is then cancelled the crew cannot be given an additional further call or returned to the original call.

This will prevent situations whereby the crew have been stood down and expect to have their meal break (or to go home) only to be given a further call which has caused problems in the past.

Lowestoft Fire Stations: Members of staff working in the Waveney and East Suffolk areas now have an additional Response post on the north side of Lowestoft. Access is only possible if the vehicle has a Fire Service authorised key fob on the ignition key ring. No Fob? No access. Simples !

Meal Breaks: The agreement is that EOC should confirm the meal break time to crews at the start of their shift. Once this allocated time has been passed to the crew it cannot be changed by EOC unless it has first been discussed and agreed with the crew.

EOC can contact the crew and offer them the opportunity for an earlier meal break if the call volume is low; likewise if a crew are at a response post and nearing their meal break time they can contact EOC and offer to start their meal break earlier if the call volume is manageable.

Mandatory Roadworthy Checks: Unison has been working with the Trust to establish a period of protected time at the start of the shift during which the crew will not be disturbed while they carry out the Mandatory Roadworthy Checks of their vehicles.  Initial discussions agreed that a trial period of 3 months should provide sufficient evidence to support how long members of staff require to carry out these Mandatory Roadworthy Checks. Once these checks have been completed the vehicle can be considered as meeting the legal obligations at that time and the crew allocated to calls.

Health & Safety Postbag

February 2015

Over the past three years a lot of my time has been taken up with issues and concerns in respect of ambulance crew safety.  My work has mainly been focused upon the impact of our crews as a result of:

  • The increase in 999 emergency calls
  • Pressures to meet “motoring” targets as opposed to clinical outcomes
  • Pressures to meet hospital turnaround times
  • Pressures of not being able to ensure the vehicles are checked at shift starts
  • Pressures of General Broadcasts reminding crews of outstanding RED calls
  • Pressures, pressures, pressures.

This may give the incorrect impression that my work has been solely focused on frontline crews. This is not so. I have visited many localities, met with staff and questioned them about their work environment and any issues which they may have been experiencing. From the responses I received it became clear that pressures from above are forced downwards, through the work force until they finally end up impacting on the road crews.

TRUEresult Blood Glucose System

A considerable number of employees have contacted me with regard to a new, smaller blood sugar testing device that has appeared on our emergency vehicles. The majority of employees have voiced their concerns that the TRUEresult system is not suitable for use by healthcare professionals based upon what is written on the accompanying poster. I have viewed the poster and the reference appears to apply just to the lancet, which we will not be using. However there are other issues which I have become aware of and these have been notified to management in line with best practices.

Whenever the management intend to introduce changes to the workplace, practices, procedures or equipment, there is a requirement to consult with the health & safety representatives elected to represent the employees that will be affected by these proposed changes. This consultation does not appear to have taken place and so the appearance of the new device was unexpected. The Trust has stated that staffside had been involved with the procurement and evaluation of the new equipment but this is not the case. Unison have not been involved in the processes.

I have been informed that the reason for changing devices is because “The company no longer make the discs containing the test strips”. I have sent an email to Bayer to find out if this is because the test strips were no longer financially viable, unpopular or if there were other reasons.

Health & Safety Update

Bases, Response Posts and DAP’s

Over the past few months we have seen an increase in staff of varying skill levels and clinical grades. Some have transferred in from other ambulance services while others have been external recruits or internal career developers. At the same time the service has continued to experience high call volumes and the added pressures that this brings. With the increase in staff and the influx of new ambulances the picture is beginning to look better, but the size of our region and the needs of the public remain the same. With all this in mind I take this opportunity to highlight a few areas and remind staff about what should be in place.

All members of staff should be in possession of a full uniform and this includes epaulettes showing their clinical grades. Operational members of staff are entitled to have 2 pairs of footwear provided and this allows for them to naturally dry out in between shifts. They should also be provided with a full set of PPE relevant to their operational role.

The maintenance and upkeep of all Trusts buildings falls within the remit of the Estates department and ANY member of staff that becomes aware of damage, faults or maintenance issues can send an email to the estates department responsible for that building. This ensures a swifter response and gets repairs carried out sooner rather than later.

All members of staff are required to undergo training in any new process or with any new equipment that they have not previously been trained on. This is to ensure that everyone is able to safely use the equipment, protects your crew partners, patients and the general public. If, during the course of your duty, you become aware of faulty or defective equipment, are injured by equipment or are involved in an adverse incident, you should raise a DATIX report either on the intranet or by calling the single Point Of Contact (SPOC). The Datix system is the method used by the Trust for auditing incidents and if the Datix is not raised the data becomes incomplete and potentially unreliable.

East of England Ambulance Service

DSA Survey Monkey - Conclusion

A total of 576 members of staff responded to the DSA survey monkey which ran for two months in early 2015. Some answers were anticipated and some were not, but there were some which give cause for concern. Of the 576 members that took part 89 (15.45%)  were ECA’s,  100 (17.36%) were Student Paramedics, 108  (18.75%) were Emergency Medical Technicians and 279 (48.44%) were Paramedics

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