Ambulance Nut works for the Trust mentioned in the last post and has a few important things to say, things not reported by the news story that I linked to.

It's important to see how media reports differ from reality.

(Thanks go to Ambulance Nut for drawing my attention to this).

For those that are interested, I was invited onto the Radio 5 Live show to talk about this very sad story. The BBC are lovely so I had a cab to a studio in London, while the presenter sat up in Manchester. Stephen Nolan the presenter obviously plays the devils advocate while I play the voice of reason.

As is normal with talk radio there are some… interesting viewpoints, although I'm quite sad that no-one surpassed the first caller in comparing me to the Nazis.

You can listen to it again here, my segment starts 1:08:50 into the stream. I don't think it will be up for too much longer.

I am grateful to the ambulance and police workers who phoned in to support me - It just goes to show that I'm not mad, or at least I share my madness with other people.

London Ambulance Service celebrates best year, but urges public to ‘use us wisely’
SERIOUSLY ill and injured patients in the capital are getting a quicker response from ambulance staff than ever before, but those who do not really need emergency help are once again being urged to use the 999 system wisely.
The 2007/08 year was the best in the London Ambulance Service’s history, despite a further rise in demand which took the number of emergency calls received up to nearly 1.4 million.
A total of more than 943,000 incidents were responded to, an increase of more than three per cent on 2006/07, and included 315,700 Category A calls (assessed from information received as being serious or immediately life-threatening).
Of these, 79 per cent were reached within eight minutes, which represented the Service’s best ever performance against the Government’s national target of 75 per cent and was helped by improvements in the time taken to answer calls in the control room.
The news caps a very successful year for the capital’s ambulance staff. The Service was named the highest-rated in the country by the Healthcare Commission in October and the survival rate of people suffering out-of-hospital cardiac arrests in London has more than trebled in the last five years.
The improved speed in responding to patients was made all the more notable by the fact that November and December 2007 were the busiest months in the Service’s history, and that demand has also remained comparatively high since then.
Now, in an effort to remind the public of the other healthcare options available before calling 999, the Service has produced a newspaper advert to appear in a range of publications across the capital.
Chief Executive Peter Bradley CBE said: “Staff from every department in the organisation have played their part in what has been our most successful year ever, and we can be confident that the high-quality care and treatment we are providing to our patients is continuing to improve all the time.
“Londoners can also help us to help them by using us wisely and only calling us in an emergency, so that we can really focus on those people who genuinely need our help.”
The way in which ambulance response times across the country are measured changed at the beginning of this month, meaning that the ‘clock’ now starts as soon as a call is connected to the control room, rather than after key information has been obtained from the caller.
This new system – along with continued high numbers of calls from patients who do not really require emergency medical help – means that the Service will face a very challenging 12 months ahead.
Peter added: “The new way of measuring our response times is very good news for patients as it will require us to respond even more quickly to calls, and this should help save even more lives.
“What it does mean, though, is that more than ever we are urging those people who are not seriously ill or injured to consider other ways of getting help before dialling 999. This can include looking after themselves at home, calling NHS Direct on 0845 4647, or even making their own way to hospital, as arriving in an ambulance does not mean that they will be seen more quickly.”
The Service is now in the second year of an improvement programme running up to 2013 and which aims to move right away from a one-size fits all way of responding to patients.
Peter said: “We are planning to increase both our number of frontline staff and vehicles over the next year, and are looking to ensure that we can provide the most appropriate care for our each and every patient – whether that means caring for them in their own home, taking them to hospital or an urgent care centre, or to a specialist centre best placed to treat them for their particular condition.”

• In 2006/07, the Service reached 75 per cent of Category A calls within eight minutes
• Until the beginning of April this year, the clock started after the caller’s telephone number and the patient’s location and nature of their illness or injury had been established

Maverick ambulance service managers risked patients' lives in an over-zealous drive to achieve the quickest 999 response times in England, the government's health watchdog disclosed yesterday.

The Healthcare Commission said Staffordshire ambulance NHS trust used poorly trained volunteers to act as "community first responders" to get to emergencies ahead of paramedics. They were authorised to drive at speed, using blue lights and sirens, without the necessary advanced driving training.

The trust supplied ambulance staff and volunteers with controlled drugs that they were not legally allowed to possess, including the sedatives diazepam and midazolam. It also failed to keep proper records of medicines, which regularly went missing from ambulance stations. Patients were sometimes given larger packs of controlled drugs than they needed and told to dispose of the excess themselves.

It's not the London ambulance service, but it just goes to show what lengths trusts will go to in order to hit these targets. A strange first sentence though, "Maverick". Will the police be looking into whoever illegally supplied the Controlled Drugs?

It said Thayne, a former army officer, was described by senior staff at the trust as "a benevolent dictator".

From what I hear, that's not what the ambulance crews on the road called him...

The commission blamed regional and local NHS managers for not asking searching questions. "This complacency was brought about by the trust's ability to exceed the Department of Health's targets," it said.

In other words, "They were hitting their targets, so we didn't look too closely at how they were doing it".

I think that community first responders are a good idea, out in the country every little town can't have an ambulance sitting waiting for someone to become ill. However, they shouldn't be whizzing around on blue lights, not without training. And with blue-light training you may as well train them to ambulance technician standards - but, oh, that would cost money.

(Although as far as I know the legislation about driving an emergency vehicle is a bit wishy-washy - any experts reading this, please do chip in).

The commission report has this to say,

Some of the problems may have arisen because the trust perpetuated the belief that the role of a CFR was broadly equivalent to that of an ambulance technician. Although the trust, when compared with other ambulance trusts, provided more training for CFRs, this was not comparable to the training given to ambulance technicians.

From the Healthcare commission themselves,

The Commission points out that the trust was a good performer in terms of response times for emergency calls. It was considered to be innovative in its introduction of new equipment and services and had good relationships with patients and the public.

But, the investigation found that these achievements were undermined by a culture and approach that did not prioritise safety and that put patients at risk.

So once more, evidence that the ORCON target puts patients lives at risk,

Today's blogpost is elsewhere.

Little does the crew know that the woman has just told the call-taker that she has a knife and is going to kill the paramedic about to come through her door.

-----

The Guardian asked me yesterday to write about violence on ambulance staff, this was a strange coincidence as that was the exact subject I was going to write about today.

Here is another example of how Call connect is a danger to ambulance crews that wouldn't fit into the article.

It's nine a.m. in the morning, we have been sent to a young male with a 'head injury' in a residential property. WE have no details of how this occurred so I ask Control if they know anything.

They have to ring the patient up again to ask him. He's been assaulted and the assailant is still with him. The caller promises that the person who inflicted the injury is not going to be a danger to us.

What makes this dangerous is that Control had to ring the patient back, they didn't note that the injury was caused by an assault when the call first came in.

All in an effort to get us to the scene to stop that all important ORCON clock.

It would not surprise me if some time this year an ambulance person is killed because of there not being enough information gathered before they arrive on scene. I'll also predict that the trust involved will use the phrase 'Lessons have been learned'.

Here's a thing - when there is an ambulance news story I often get emails from people asking if I've seen it. I've yet to see as many people email me over a story as this one. (And I like getting these sorts of emails, as sometimes I'll have missed the story).

An elderly couple say they are distressed as an ambulance worker wants to sue them after falling during a call to their Lincolnshire home.

The technician fell over on 82-year-old Joan Boardman's driveway in Louth as he went to fetch a stretcher.

The Boardmans have now received a letter from his solicitors saying he is seeking damages for personal injury.

Now the important thing is that I don't know any details of this case - so anything that I have to say on the subject is pretty much guesswork and supposition.

The first thing that I would suggest that if the ambulance worker suffered an injury, he would be off work on full pay for quite some time (I think it's six months down here in the LAS).

Secondly - I would suggest that if he had injured himself in a place of work, say a factory, then yes - health and safety law applies. I don't think, and I am certainly no lawyer, that health and safety law doesn't apply to homeowners in their own home. There isn't, as far as I know, any legislation saying that a path on private property has to be well lit.

Thirdly - We work in inherently difficult situations, lighting is often poor, sometimes there is a lot of rubbish around the place we work and occasionally there are some everyday hazards, like loose carpeting and the like. Accidents sometimes happen and falling over is often no-ones fault but your own.

I would also disagree with the comment from the Unison person who said,

"I can understand people finding it hard to believe but of course if someone is injured during work then somebody has got to take liability."

Now a disclaimer - I don't like Unison - but even with that said, has there ever been a dafter thing said? We don't live in a perfectly predictable world and sometimes things go wrong for no reason apart from blind chance. Actually without that randomness of life my work would be a lot more boring.

Sometimes I trip over my own feet - should I try to sue the maker of my boots? Or should I sue my mum for giving me 'clumsy' genes?

It all sounds incredibly silly to me. I'd sue a business if I went up on their catwalk and it collapsed, and I'd sue someone who assaulted me when I'd been sent to help them, but to sue because I fell over on their path is just plain wrong in my eyes.

Of course if a lawyer wants to point out how everything I've written here is wrong, they are welcome to leave a comment.

---

Second disclaimer - if the above makes no sense, my apologies. I've just got in from a long twelve hour shift and I'm utterly shattered - especially as we got a late job out of our area.

E. Gary Gygax died today.

For those who have never heard of him, he was the co-creator of the original Dungeons and Dragons Role-playing game.

This makes me incredibly sad - without D&D I wouldn't be the person who I am today. Gaming has taught me a lot, and not just those jokey '1001 things I learned from playing D&D' type lists.

I don't think I'd be blogging if it were for the effect that RPGs have had on my life.

Wil Wheaton says it best.

Rest In Peace.

I'm a twit sometimes.

Take yesterday. I'm supposed to be working four night shifts, so I arrive in work with plenty of time to spare (and so I can pop across the road and get my dinner, a half-pound heart attack in a bun).

My crewmate turns up, we get our kit on the ambulance and wait for the first call.

Then the resource center (who handles the staffing of vehicles) phones up my crewmate and tells her that she's single and they are sending someone to work with her.

The shoe drops - I'd booked these four nights off early last year so that I could go to SXSW, but then money became a problem so I couldn't go. I'd then forgotten to cancel the leave.

What a nice surprise.

I'm back at work on next Thursday - so I have a chance to do a load of things that I've been putting off because I haven't had the time.

---

Just a quick comment on the news that the report on 24 hour licensing is to be positive.

It's not my opinion, there has been a 12% increase in alcohol related calls to the LAS in the last two years (without an increase of resourcing to deal with it). The Information Centre shows that admissions for alcohol have doubled in the last decade. And anecdotal evidence would suggest the same.

It just shows how detached from reality our policy makers are. Or how blatant the conspiracy between government and alcohol producers has become.