Earlier this week I was contacted by The Mail on Sunday and offered an opportunity to raise awareness on a national platform of my concerns about the ambulance service cuts. For some time, The Mail has been campaigning against A&E closures around the country and was interested in the impact the cuts were having on the ambulance service. It goes without saying that the simultaneous depletion of two key emergency services are linked.

Presented with the opportunity to write in a national newspaper, I was conflicted. I wrestled with my conscience – was it the right thing to do? Would giving account of my morale and health-destroying experiences and the tremendous pressure my former colleagues continue to face be constructive and lead to a better ambulance service for patients and staff? I know many ambulance personnel would have come forward already, but for fear of their jobs. Because of my back injury, as of August this year I am no longer employed, so there is no such fear remaining for me. My attempts earlier in the week to appeal to the EEAST chief executive, Hayden Newton, had seemingly fallen on deaf ears.  Perhaps this is the last service I can do for my former colleagues.

I had to try.

Uniting Agendas

After speaking with the journalist covering the case and discussing the broader issues, I wrote and submitted an outline of the article I felt would make best use of this opportunity. However, David –  the experienced  journalist – pointed out that I was trying to squeeze in too much. My outline would have better suited a book. I knew he was right and I set to work on writing something with a more narrow focus that would highlight the plight of today’s emergency medical services without delving into the history of the NHS and into the causes of every problem and idiosyncrasy.

Over the next few days, I wrote a piece that I felt best showcased the intolerable pressures UK ambulance staff are under and how that related to A&E closures. Given the 1400 word restriction it was a challenge to convey the current situation and paint a picture of the future in the face of organisational changes due to budget cuts. I also looked into an ambulance attendance to a 71 year-old female suffering an acute allergic reaction which threatened her breathing and requested some information from the EEAST regarding why the response took nearly an hour. I spoke with EEAST Associate Director of Communications & Engagement, Chris Hartley, and we talked about incoming changes to ambulance deployment and the impact that might have on patient care and crew morale.

Pressing Concerns

I’ve seen this morning’s Mail on Sunday and I am cautiously happy with my contribution – it has been quite heavily edited from my original submission, but I feel it still gets across much of the current issue without drowning the reader in detail. It covers information pursuant to the Mail on Sunday’s focus on A&E closures and I hope gives an idea of how close to breaking point I believe road crews are. You can read the full feature online here.

I am a little disappointed at the dilution of my concerns about the pressure of ambulance crews  – whilst some references remain, my emphasis on the levels of fatigue and the relentless conditions has been diminished in favour of the A&E closure perspective. I also hope the editor’s addition of the word “idle” in reference the sentence about crews waiting at hospitals doesn’t give the wrong impression; “…crews stand idle in corridors, their patients still on trolleys.” They’re not idle, they are still looking after the patient. The need to trim words has also made the example attendance a little hard to understand – it no longer entirely makes sense, although I think readers will still get the gist.

Sadly, for the sake of brevity, some things couldn’t make it into the final piece; including my coverage of the North Norfolk Act On Ambulance campaign, a discussion about the potential impact of dynamic deployment and rota changes and the example attendance I mentioned earlier. Perhaps they will make it into a separate story at a later point. Hayden Newton’s thoughts on overworked crews and the part the EEAST Board play in reshaping the East of England service will also have to wait for a later opportunity to to be discussed. I intend to focus on all of these issues here on The Broken Paramedic anyway, so it’s not a complete loss.

What Next?

I feel the many elements that never made it to print are key to the ongoing discussion and I’m keen for further opportunity to push related issues into the limelight. I’ll keep trying. It is my hope that this article might at least get the ball rolling on a national conversation about the perilous precipice our emergency healthcare system is teetering atop and how the general public have to play a bigger role in the future of the nation’s health in order to prevent disaster.

There is no point in foot-stamping, demanding something should be done then waiting for someone else to do it. Everybody needs to step up. This video highlights why:

Categories: Broken Paramedic

North Norfolk resident/parent of a serving paramedic · 30/09/2012 at 17:32

I am a retired resident of North Norfolk and a parent of a serving paramedic. I have been following this blog and readership comments since its inception and also the Act on Ambulance campaign. I am not a labour voter but I have signed their petition. This must never become a political issue.

After reading today’s blog entry I bought the Mail on Sunday. What a revelation it was to place the anguish of the paramedic saga alongside the problems in A & E. It’s all part of the same picture and same problem! The same curative pill helps them both.

The original concept of “Free at the point of use” was a wonderful concept at that time. It was a different world then. As a child I remember being taken to A & E on the back of a Lambretta scooter. My parents didn’t own a car and it was the only form transport available down our street. I had fractured a bone in my foot. I suppose ambulances were available to my parents but nobody locally had a telephone anyway. It was automatic that people just helped each other where possible. I wasn’t dying – only in pain – so it really wasn’t a medical emergency. Many people then were far less educated but somehow so much wiser.

In todays’ world, where most homes have 2 vehicles just outside their front door, somebody will ring 999 thereby making the ambulance service a sophisticated, highly skilled, very expensive taxi “free at the point of use”.

This is a really tragic irony – a terrible waste of financial and human resources. Thank you Mathew for highlighting it so eloquently. It is being perpetrated by all of us and I hope the message is getting through to millions. My problem is that I would still instinctively dial 999 if I saw an accident. When asked “Which service do you require?” what should my answer be?

Anonymous · 30/09/2012 at 20:57

As a retired operational supervisor in what was the South and East Wales Ambulance Trust I foresaw the demise of the Ambulance Service, as was, with the introduction of what was laughingly called 'Trust Status'.

The Ambulance Service was now to be run as a "business".

The Chief Ambulance Officer role was replaced by a Chief Executive Officer. Managers of all shapes and sizes suddenly appeared, many of whom had previously been uniformed officers.

M&S suits for the men and 'Power dressing' for the ladies were in abundance with a new fashion of wearing braces and highly coloured ties. Even hair gel was occasionally worn by those that had some hair left.

More importantly, of the ten Ambulances under my supervision, the newest was seven years old. On the day that the new "Trust" Board introduced themselves at our our main station they parked up five brand new Land Rover Discovery vehicles, which were apparently leased by the "Trust".

I asked the CEO why they had such exotic vehicles and was told that they were needed in case a major incident occurred "off-road". I honestly could not fathom out how a 'Business Development Manager' could be of use at any incident, off-road or otherwise.

I politely pointed out that we, as a Service, did not have any Four Wheel Drive Ambulances and was then told that we had a V8 Land Rover available to tow any Ambulances that were stuck. Anyway, the Managers who drove these expensive vehicles also "towed" privately. i.e. Horse boxes and Caravans etc.

At the same time, our mechanics were cannibalising scrap vehicles in order to keep our aged fleet on the road.

From that day, the Service as we had known it disappeared. 'Cost savings' and 'good housekeeping' were the watch words for operational matters. Crew numbers were reduced, vehicle and equipment availability was reduced. Crews' morale sank, Union Reps. were taken off operations and allowed to wear suits whilst carrying out 'Union' duties. Shifts were changed with no consideration for crews' views, in fact some shifts currently end at 2 in the morning.

Orcon Standards were revised downwards and subsequently abandoned and the current situation is that a 999 call is now a very different thing from my day.

Services constantly harp on about inappropriate calls for ingrowing toe nails and cut fingers in order to justify their lack of service but never mention the angulated fracture left waiting for 45 minutes on a soccer field or the old lady with a fractured neck of femur who can't be adequately dealt with by a single manned paramedic vehicle having to wait for almost an hour before an actual Ambulance arrives.

The Service has gone to the dogs just for the sake of a bit of money and for these so-called managers to justify their positions.

Anonymous · 03/10/2012 at 13:39

As parents of a Paramedic, the article succinctly expresses the declining ability provide adequate patient care and the effect this is having on the dedicated staff manning our ambulances
You can stretch a resource so far, then ultimately it fails completely, with the inevitable tragedy.
The CEO should wake up to reality and listen to his staff- perhaps for the first time.

Anonymous · 08/10/2012 at 10:22

I fail to understand why so many people in the East of England gripe about not getting an ambulance i.e. "a Vehicle capable of conveying a sick or injured person to or from a place of treatment" After all the whole region was given the opportunity during the consultation on the Bradley Report Proposals were they not?. This report accepted by the last Government makes it abundantly clear that "Ambulance Services" are to be disbanded and replaced by "A Emergency Medical Service" i.e. an outdated Ambulance Service, that will run cars, responders, volunteers, helicopters, Doctors on call, 112, 999, and 111 calls, NHS Direct and even the midwifery service, all part of the greater plan to increase activity so that the chiefs can obtain greater responsibility and greater salaries, and bigger pensions, together with the feeble excuse that it is in the interests of saving money, which it has been proven it will not and never will.
After fifty years in the industry, I can only now assume that like neighborhood watch, all rural places (and soon the towns) should now prepare to club together obtain a stretcher litter, situate it at the end of the street, and be prepared to take their own to hospital if they can find one that will accept someone with serious injuries within an hour’s travel, because the Ambulance Service as we have all known it and come to expect will soon disappear (read the report). The common get out by all Existing ambulance Trusts is "that they have had the busiest, busiest, busiest, day ever and hundreds of 999 calls’s all taking priority over the next call? Who said so, The Trust, why because could be charged with corporate manslaughter if they had a vehicle available and did not send it? Has anyone ever checked to see where all these ambulance are at the time of call?
A further question is “How often is there a clinical requirement for a helicopter? And taking into consideration the flying to, landing, stabilization, takeoff, flying from, landing, and conveying again to the hospital, what happened to the golden hour were a patient is in need of a surgeon?

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