Your Call - Issue 21

YOUR CALL.

Issue 21

Corrie’s Tanisha Gorey on becoming an on-screen paramedic

Using NHS 111, an A-Z guide

nwas.nhs.uk

Emergency maternity care in the ambulance service

Welcome To the latest edition of Your Call Spring is in the air and doesn’t it feel lovely?! We hope that by the time you are reading this the sun is shining and the temperatures are on the up.

Whilst the birds may be chirping and nature seems to be sighing with relief to see the back of the colder months, it’s not a time for the ambulance service to relax and take it easy. The spring and summer months bring their own challenges for us and there are still plenty of people who need our help. This is why we’re busy preparing lots of content to support people to stay safe and healthy during the forthcoming months.

In this edition, Jo Sugden, who works in both our patient transport and emergency services, tells us about her son Frankie who has autism. She shares their story to help make sure neurodivergent children, like her son, feel part of society.

We have put an A-Z together for our NHS 111 service - explaining in more detail how it can help you. We sometimes hear feedback that there are aspects of NHS 111 that remain unknown, so we hope you find it helpful.

Are any of our readers Corrie fans? If so, you may recognise our cover star. We recently met Coronation Street actor Tanisha Gorey, who plays Asha Alahan on the ITV 1 soap. She’s put on a green uniform for the first time as her character begins life on the road as a student paramedic.

Also in this issue...

The journey of a 999 call

We take you through what happens when you dial 999 and how an ambulance may arrive at your door.

“I am deaf and wear hearing aids.”

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Doctors in the ambulance service: Dr Chan’s story

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Turning your feedback into action

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Philip is one of our many volunteers. He gives an insight into his role and shares why he thinks there is a volunteer role to suit everyone.

One of our Medical Emergency Response Incident Team’s (MERIT) founding members talks about doctors within Team NWAS, as MERIT celebrates 10 years.

You told us you had concerns about defibrillator maintenance and a lack of knowledge in this area. We look at this in detail and share our actions to help alleviate your worries.

Note: You may hear us refer to ourselves as NWAS throughout the edition, this is short for North West Ambulance Service.

This edition is packed full of articles we can’t wait for you to read. We have stories on endometriosis, how we are developing our maternity care and how we turn your feedback into action. We want to thank all of our staff, volunteers and public who have taken part and shared their stories; some are personal, some are about achievements, but all are remarkable and inspiring.

Enjoy!

Your Call magazine team @nwasofficial @NWAmbulance

Do you have a story to share with us?

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If so, please get in touch by emailing: communications@nwas.nhs.uk

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Emergency maternity care in the ambulance service Did you know we are one of four ambulance trusts to have a consultant midwife? We’re passionate about improving our service for patients who are experiencing a maternity emergency and need our care.

Susie Rhind is a paramedic based in Cumbria. She is currently working as our maternity quality and governance practitioner alongside our Consultant Midwife Stephanie Heys to review our maternity processes. With Susie and Steph’s backgrounds, training and expertise, they are making positive changes to the ways we look after parents and babies.

They have introduced many initiatives in the last couple of years to improve our maternity and newborn care. All of our ambulances now have maternity packs and special equipment which includes a thermal mattress designed to keep babies warm on the journey to hospital. We have also introduced snugglepods. These are soft, knitted pockets to provide dignity for babies who have been born too early for resuscitation, something that is a comfort for a family when travelling to hospital.

A new maternity care policy was introduced for our clinicians, which clarifies what care is expected when caring for women and newborns. Susie has also introduced a protocol for staff who handle 999 calls.

The protocol ensures all maternity calls are flagged to a senior clinician. The senior clinician will provide additional support and guidance to ambulance clinicians if needed to provide the safest care to our patients.

Susie has written a blog about her career, her training and how she has helped to develop our maternity care over the years, you can read a snippet of it here: “The birth of my daughter changed my whole perspective around the care that I provided clinically and how I viewed the world. Her shoulder became stuck during birth, and her arm sustained multiple fractures to facilitate her birth. The first time I looked at my long-awaited child, she lay lifeless in my arms.

“The team quickly whisked her away to another part of the hospital to attempt resuscitation whilst my husband and I were swallowed in the silence. I promised myself, that I would do all I could to support new parents in a similar position.

“She was eventually returned to me, bruised but alive and peering at me quizzically through a woollen jaunty hat. This moment was the beginning of my realisation that If I had been an ambulance clinician in that situation, dealing with that case then I would have faced a myriad of uncertainty and apprehension. It was at this point that I began to focus my own continuous professional development on maternity and newborn care. My son was born almost two years later and came into the world with a little less fanfare – making up for that point since!”

You can read Susie’s blog on how our maternity care practice has evolved at: https://www.nwas.nhs. uk/news/maternity-blog 3

The journey of a 999 call

Ever wondered what happens when you dial 999 and how an ambulance may arrive at your door?

We’re taking you through the process using a typical incident as an example so you can understand how many people can be involved in saving a life.

Photo credit: Simon Walton

“Is the patient breathing?”

A 999 call is received at 11.12 am following a motorbike accident in Cumbria.

999 calls made in the North West can be answered at any of the three emergency operations centres (EOCs) in Lancashire, Manchester, or Liverpool. The call handler, Eleanor, who is in Lancashire, goes through a list of questions with the caller to determine how seriously injured the patient is.

Fortunately, the patient is awake and breathing. The call is coded as a category 2 emergency with the description: “Trapped under car – come off motorbike.”

“I’ve got another job for you.”

As soon as the location of the incident is established and the call is categorised, it is automatically transferred to the dispatcher who looks after the area via our computer system.

Today, it’s Sairah, and she will allocate ambulances to incidents based on the order they came in and their seriousness.

So, a category 1 call will always get priority over a category 2 call.

Currently, the motorbike crash is the only job on her list; however, it still takes a couple of minutes before an ambulance crew becomes available. She sends the details of the patient over to the crew, Vanessa and Lauren, and they begin to make their way to the patient.

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Major trauma

Just across the room from Sairah’s dispatch desk at our Lancashire EOC is a team that looks after our more specialist resources. This includes our advanced paramedics, Hazardous Area Response Team, and air ambulances.

Graham and Rob control the air desk. As well as getting information from dispatchers like Sairah, they spend time going through the list of waiting incidents on our computer systems to look for any that might need a specialist response.

They have already sent a helicopter from the Blackpool airbase to the scene of the motorbike crash.

In this case, they spotted the description of the incident and the remote location and knew an air ambulance would be required. Rob listens in to the 999 call to determine whether the patient might need blood, in which case they would send another helicopter to provide extra support.

On scene

The air ambulance crew, Richard and Adam, are the first to arrive, shortly followed by the ambulance three minutes later. They assess the patient and see he has a crushed left arm, broken ribs, and low blood pressure.

They give him oxygen and pain relief. He has suspected life-threatening injuries – known as major trauma. The closest hospital with a major trauma centre is Preston.

Depending on the injuries or location, often the air ambulance crew provides enhanced care to the patient on scene and then leaves, allowing the patient to be taken to hospital in a road ambulance.

However, in this case, because of the distance to the nearest major trauma unit, the patient will be flown there in the air ambulance.

Pre-alert

Back to Graham in our emergency operations centre (EOC) – he contacts Preston Hospital to tell them to expect the incoming patient. This means a medical team from the hospital can meet the helicopter as it lands and take the patient straight to receive further treatment.

It takes 18 minutes to fly the patient to the landing pad, at which point our job is over.

That’s not all

We deal with over 3,000 incidents every day, each with different levels of complexity.

We have supervisors on hand to help staff with all eventualities, and other medical staff monitor incidents and can move patients up the priority list if needed, all to ensure we can get help to those who need it as quickly as possible.

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Corrie’s Tanisha Gorey on becoming an on-screen paramedic Coronation Street actor Tanisha Gorey, who plays Asha Alahan on the ITV 1 soap, recently put on a green uniform for the first time as her character begins life on the road as a student paramedic.

As part of her research for the role, Tanisha visited Highfield ambulance station in Bolton to meet staff, including Paramedic Bushra, to speak about their experiences of life in an ambulance. She also sat down to give us an insight into her hopes for the future and what she feels like at the beginning of this storyline.

“I am thrilled! It’s an amazing story,” Tanisha says, “I think it is great for Asha to do such an amazing job; it’s such an aspirational role.

And it’s good to show the audience that she’s aspiring to work within the NHS. I’m so pleased and looking forward to seeing where it goes.”

The next obvious question is: Does real life imitate television, and could she step into the shoes of a paramedic outside of Weatherfield?

“Honestly, I very nearly studied it at university,” Tanisha reveals.

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“When I was 18, I was looking at Open University. I am still very interested in it to the point where I could potentially train. All the gory stuff and the blood doesn’t really bother me.

Of course, I know that’s not all you have to deal with, but I think it’s something I could pursue.”

Tanisha’s first scenes on the road won’t be seen for a few weeks yet, and as for the storylines, she’s in the dark as much as the rest of us. However, she’s desperate to show off her character’s medical skills in dramatic fashion.

“I don’t have any hints. I know as much as you.

“If I could choose, though, it would be the most thrilling incident: a car falling off a bridge and someone suffering bizarre injuries that I could then treat. I think it would be really cool to show and portray that. But it is Coronation Street, so anything could happen, but I’m looking forward to it!

“I’m putting pressure on myself to make sure that I do it right and that everything is shown correctly,” she continues. “But I do understand that there are real paramedics watching Corrie, and sometimes we do get messages pointing out what would really happen. So, I want to make it as authentic as possible. That’s one of the reasons I’ve come here to get that insight, and hopefully, I can use that to have some input into my scenes.”

Raising awareness to help neurodivergent children feel part of society Jo Sugden wears many hats, as the saying goes. She is one of our patient transport service (PTS) team leaders and also occasionally picks up shifts as an emergency medical technician for our 999 service. When she is not attending to the people of the North West, she is at home caring for her son Frankie.

Frankie is 11 years old and at the age of seven, was diagnosed with autism. Autism is a lifelong developmental disability that affects how people communicate and interact with the world.

Before his official diagnosis, Jo was aware of autism so was noticing the autistic traits Frankie displayed from a young age. She said: “One of the traits was echolalia where he would repeat everything. He had speech and other communication delays, got fixated on things, and showed signs of a lack of empathy. He is very tactile and has to constantly touch things and run his fingers over objects.”

Currently, 150,000 people are on the waiting list for an autism assessment in the UK* and unfortunately, after waiting more than five years for a confirmed diagnosis, Jo can relate to the frustration many people on that list are feeling. She told us:

“It was very hard to get professional help, with resources so oversubscribed it took a long time to get him assessed. We knew that his behaviour was different but getting support with confirming what was going on for him was frustrating.”

As well as autism, Frankie was also diagnosed with behaviour disorders: attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and dyspraxia – a developmental co-ordination disorder.

Receiving Frankie’s diagnosis was a huge relief for Jo and has helped him manage his day-to-day life. She explained: “He has got an education, health and care plan so he now has one-to-one support. He also has regular consultations with the Child and Adolescent Mental Health Services (CAMHS) doctors and has support from the paediatric team at the hospital. It has also enabled him to be prescribed the correct medication to help him manage the demands of the day - which we are still working on and have a long way to go.”

Jo says life has gotten slightly easier after receiving professional help and getting their cocker spaniels Buffy, Jarvis, Indiana, and Merlin - who Jo says are excellent

therapy for Frankie and them. However, juggling her job as well as caring for their son can be a challenge for both Jo and her partner. She said: “Juggling work and home comes with great difficulty as we can get a phone call at any time during the day to collect him from school if there have been any issues with him. Now I’m not on the road as often, it’s marginally easier as I’m invariably locally based and not on emergency patient-facing jobs where it would be harder to get hold of me. Working for the ambulance service on 12-hour shifts including nights is not easy for any parent which was one of the reasons I opted to take a post with a better home/work life balance in the patient transport service. It’s not as straightforward as letting a childminder look after him - it must be us or people very close to him so it’s important as parents we are close by to deal with any emergencies.”

Jo has learnt to take it one day at a time, especially as each day can come with a different obstacle. She explained: “There are ever-changing challenges for him, we can cross one bridge then something else happens.

School is an everyday challenge because this is where he displays his most challenging behaviour. Our worry is this is going to be highlighted more when he starts secondary school in September. As he is getting older it’s hard to distinguish what parts of his behaviour are attributed to his autism or for other reasons due to developmental delay.”

Jo is hoping that by sharing Frankie’s experience, she can help raise much-needed awareness about the condition.

She added: “It’s important to raise awareness as it is part of living in an inclusive society that people with autism can comfortably live in. It’s important for neurodivergent children to feel part of society rather than be treated like they are different and cannot integrate. It’s about society accepting and understanding differences and not being exclusive or fearful of what is deemed to be ‘different’.

Our son is very social and quite often people (children) do not know how to take him, this would be less of an issue if people had more of an understanding of autism.” *National Austic Society

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Getting you the right advice and treatment when you urgently need it NHS 111 A-Z guide

Our NHS 111 service is available 24 hours a day by dialling 111 or by going to 111.nhs.uk. NHS 111 is a free health care assessment service for when you need medical help or advice fast – but it’s not an emergency.

We recently held some community listening events and we heard feedback that there is still a lot unknown about the service. So, we have put together an A-Z guide about what NHS 111 can help you with.

A B C

D 8

I

Assessment service

NHS 111 is an assessment and referral service.

It will evaluate your symptoms (which involves asking certain questions for every patient) before providing the right advice, guidance, or referral onto another health or care service. We don’t have access to your full medical record so might ask questions about any existing health conditions we might need to know about.

Busy

We handle around 1.7 million NHS 111 calls every year. To help keep our lines free for those who need us, please use 111.nhs.uk – it is the same system and asks the same questions as one of our call handlers would. If the patient is aged five and under, always call 111.

Call handlers and clinicians

We have trained call handlers who manage a variety of calls and complete assessments over the telephone. These are supported by senior clinical advisors who are usually trained nurses or paramedics. They work together to provide advice or direct you to the right care.

Difficulty hearing?

You can call 18001 111 on a text phone.

Alternatively, search ‘NHS 111 British Sign Language (BSL) interpreter service’ online if you’re Deaf and want to use the phone service. We also have a large print guide, easy read guide, and audio guide on our website: nwas.nhs.uk.

Important information

E F

G H

Emergency prescription

If you get your medicine with a repeat prescription, always order and collect these ahead of time using the NHS app or through your GP surgery, allowing extra time for weekends and bank holidays. If you do run out unexpectedly, we are able to help. We’ll ask you questions, and we may refer you to a pharmacy to provide you with enough medication to last until the GP surgery re-opens.

Feedback

Feedback is key to improving our services. We host community listening events annually in each county to talk to the public about our services, including NHS 111. If you are interested in attending email: talk.tous@nwas.nhs.uk. We also ask a selection of patients to provide feedback after using NHS 111 by completing a survey. This helps us to keep on improving.

Guide

We want to guide you in the right direction to get help for your needs when using NHS 111. A better understanding of what NHS 111 can help you with will provide you with a good experience when using the service.

Helping you

Patient care and safety is our top priority. We always start the call by ruling out a life-threatening condition and then direct you to the most appropriate healthcare service to suit your needs as quickly as possible. Please bear with us whilst we ask you questions.

You can find out everything you need to know about our NHS 111 service on our website: nwas.nhs.uk.

J K L M N O P Q R

Job

When you join our NHS 111 team, you’re at the heart of something amazing. No matter what part you play, from call handler to senior clinical advisor, you’re making a real difference, every day.

We all have one thing in common. We care. Keep an eye out for our current vacancies by visiting: nwas.nhs.uk/careers.

Knowledge

We’d like to help everyone who uses NHS 111 but there are some things we’re unable to do. For example, we get asked a lot for sick notes and blood tests, but this is not something NHS 111 can provide or arrange. You need to speak to your GP or healthcare provider.

Local

We cover approximately 5,400 square miles – serving more than seven million people across the communities of Cumbria, Lancashire, Greater Manchester, Merseyside, Cheshire and Glossop (Derbyshire). We use a Directory of Services which covers the North West meaning that you will always get the best care advice and directed to other services closest to you, wherever you are situated in the North West.

S T U V

Medication enquiries

W

Nurses

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Our call handlers will need to ask you some questions before they can point you in the right direction for any medication enquiries so, please bear with them.

Nurses have been part of Team NWAS for many years now. We have nurses working as senior clinical advisors in NHS 111 supporting patients over the telephone to give them the care they need.

Online service

111.nhs.uk is there for when it is not an emergency, but you need urgent healthcare advice. It provides you with the same advice as we would give you on the telephone and if needs be, you will be called back by a clinician. If you are seeking help for a child aged five and under, always call 111.

Paramedics

We have paramedics working in our NHS 111 service too. Just like our nurses, they use their expert knowledge to help you over the phone if you need a call back from one of our senior clinical advisors.

Y Z

Signposting

We will signpost you to the most appropriate care for your condition, which could be safe selfcare at home, your GP, and out of hours doctor, community nurse, local pharmacy or walk-in centre.

Transport

We get calls from patients wanting us to arrange transport to and from healthcare appointments.

This needs to be done via our patient transport service (PTS) and not NHS 111. Making a booking with our PTS is simple, free and easy and can usually be done through our booking centre number: 0800 032 3240.

Unwell

If you are feeling unwell and not sure what to do, 111.nhs.uk has the support and advice you need.

Values

Our values underpin everything we do in NHS 111 and across our services. We work together, we make sure we are at our best and we make a difference to the lives of our patients.

Wait times

If you call and there is a wait for us to answer, we will provide you with approximate wait times. If you call from a mobile telephone, you’ll have the opportunity to start providing your information via an online form, which can help to save time.

X-rays

We cannot book you in for an X-ray, but we can refer you to a service that provides X-rays if it’s appropriate.

Your NHS 111 service

This service exists for you, and when asked last year, 94% of patients said they were likely to recommend the NHS 111 service to friends or family if they needed similar advice or help.

Zest

We have a zest for exceptional patient care. We have a Patient and Public Panel which is made up of local community members who volunteer to get involved and help shape our services, including NHS 111. If you would like to join visit: nwas.nhs.uk/get-involved/volunteering.

Questions

These are an essential part of using NHS 111. We will ask you several questions about your symptoms if you call, this is so we can determine the right care advice for you.

Referrals

After an assessment, we can signpost you to get help or make an urgent referral for you if we think it is appropriate. We are unable to chase referrals that have been made by your GP or other healthcare provider.

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Raising awareness of endometriosis It is estimated that endometriosis affects 1.5 million women in the UK - a similar number of women affected by diabetes*.

It is a condition where tissue similar to the lining of the womb grows in other places, such as the ovaries and fallopian tubes. Statistically, 1 in 10 women in the UK suffer from it.

It’s a long-term condition that can be very painful and have a significant impact on a person’s life.

NHS 111 Health Advisor Alison Greenwood was diagnosed with the condition at the age of 21. She said: “I was experiencing excruciating period pains and abdominal pains during different times of the month, so I did some research myself and decided to ask my GP if it was endometriosis.”

On average it takes eight years from the onset of symptoms to get a diagnosis and although it wasn’t that long for Alison, it was still a battle to get a confirmed diagnosis. She told us:

“My symptoms were disregarded numerous times. I even attended the emergency department once as my pain was so bad but eventually, I was referred to gynaecology.

They arranged for me to have tests to find out what was going on. Following this, it was found that I did have endometriosis and I was offered diathermy - a therapeutic procedure which uses electric currents to generate heat

in layers of your skin - to remove the endometriosis from various internal organs.”

Alison thought the procedure would help end her suffering, but she wasn’t expecting the blow that came when she saw her gynaecologist again. She explained:

“I remember distinctly in this appointment that I was told that I would find it difficult to have a family due to the extensiveness of the damage caused by the endometriosis. I was devastated. To stop any more endometriosis from forming, I was put on a treatment plan of controlled drugs, some of which I had to inject into my stomach and caused menopausal symptoms which were then counteracted with hormone replacement therapy.”

“My husband and I did manage to start a family, but it has been a very bumpy ride. We had our first child in 2004 and have since had three more children. However, during that time we have had miscarriages and also an ectopic pregnancy. The ectopic pregnancy was a direct result of the endometriosis as there was a large mass that needed to be removed.”

To keep her symptoms at bay, Alison has had further treatment including more diathermy treatments and is now able to manage her pain. She explained: “After more than 20 years of having endometriosis, I have learned to cope with my symptoms, and I just manage them with pain relief.”

From personal experience, Alison now advocates for more to be done for endometriosis sufferers. She added: “I feel it is so important to raise awareness of this condition. Many women are still misdiagnosed and not listened to regarding their symptoms.

I know people who have had this condition and have faced difficulties in getting the correct support. If I could give one piece of advice to anyone with endometriosis, it’d be to push for the treatment you need - it is a condition that is very much overlooked.”

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*National Institute for Health and Care Excellence

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It’s all in the research We have an award-winning Research and Development Team focused on finding out how we can improve the care, treatment and experience of our patients.

Research Lead and Consultant Paramedic Steve Bell, Research Manager Sandra Igbodo, research paramedics Adam Wright and Michelle Waddington, and Research Support Officer Jesse Oliver are all part of the team and work closely together.

Through their work, they host research trials with clinicians, staff and patients that range from simple surveys and looking at new treatment processes, to developing a better understanding of pre-hospital care.

Most of their studies are supported by The National Institute for Health and Care Research (NIHR).

Research Paramedic Adam Wright explains why this work is so important: “Our research uses evidencebased practice which means we combine clinical expertise, patient values, and the best available research evidence when making decisions for patient care. We help to improve treatments, reduce costs and minimise complications. Without it, our practices could stagnate and there’s a risk we could be offering outdated care to patients.

“Part of my role involves raising the profile of our research department with staff across NWAS and demonstrating

how integral pre-hospital research is to the paramedic profession.

“The studies that we promote examine staff opinions or wellbeing and can ultimately improve the day-to-day working life of clinical staff.”

The team is currently looking into improving cardiac arrest outcomes with the national PARAMEDIC-3 project.

This study builds on the knowledge from previous trials which showed that the faster adrenaline is given to a patient in cardiac arrest, the better the neurological outcome for that patient. The trial has now progressed and is currently looking at the quickest way to give adrenaline to a patient, whether that is injecting directly into the vein or bone.

So far NWAS paramedics have enrolled 325 patients into the study, contributing to the nationwide target of 15,000 patients.

The team is also working on the SPEEDY study, which looks at the effect of transporting stroke patients directly to Royal Preston Hospital for thrombectomy. This is a special procedure that removes clots blocking large blood vessels in the brain. Ordinarily, stroke patients are taken to a local hyper acute stroke unit, but this procedure is only available in a minority of specialist centres, meaning these patients undergo an additional journey that delays the thrombectomy by at least 90 minutes and reduces its benefit.

It is hoped the trial will demonstrate that direct access to specialised thrombectomy centres has a big impact on the outcome and recovery of the patient. The trial started in June 2023 and since then, our clinicians have made over 100 calls to the stroke team at Royal Preston Hospital to discuss if their patient is suitable for the procedure.

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Our Research and Development Team was recognised for its work in October last year when it won the Special Award for Exceptional Experience at the Greater Manchester Health and Care Research Awards.

“I am Deaf and wear hearing aids - it doesn’t stop me from volunteering at all.”

When retired Paediatric Nurse Philip Hudnott isn’t looking after his two-year-old grandson, he spends his time volunteering for NHS and Care Volunteer Responders*. Philip helps to supply our ambulance crews with hot drinks and snacks whilst they wait to hand over patients at hospital emergency departments.

Philip is just one of the many volunteers we have and is sharing insight into the role and how accessible the service is for disabled people like him.

Philip was born Deaf. He said: “I was born with otosclerosis, a disorder in which a tiny bone inside your ear fuses with other parts of the ear and stops you from being able to hear properly. When I was a teenager, I had surgery which corrected a lot of my hearing loss. In the early part of my nursing career, my deafness did not have too much of an impact but as time progressed it became more difficult to undertake tasks.”

Philip’s hearing progressively got worse and at the age of 55, he decided to take early retirement. With a lot of spare time on his hands, Philp started to investigate volunteering to fill some of his time.

Not wanting to leave the healthcare profession completely behind, he took a role as an ambulance welfare volunteer. Philip feels his 35 years of experience as a nurse helps him with his volunteering role. He explained:

“Having spent my entire career working in healthcare, I feel like I understand some of what the crews experience which helps me to know when to approach them and when not to.

“I love being able to meet and interact with new people and knowing that my work is appreciated by the crews. The ability to make a difference to their shift when they may be working non-stop by offering them a drink, snack and chat can be very rewarding and the feedback is always positive.”

Through his experience of volunteering through the NHS scheme, Philip encourages other people with disabilities to consider it as an option. He adds: “I am Deaf and wear hearing aids, and it doesn’t stop me from volunteering at all. I can select the type of volunteering I do, so as well as the ambulance staff support roles, I also undertake vaccination steward roles and medication collection roles.

“To anyone that is Deaf, or has any other disability, I would always say give volunteering a try. Reach out to the organisers and discuss your needs. You will get lots of support to find a role that is suited to you, and it will boost your confidence to achieve something that you may have thought was not achievable.”

If you are interested in becoming a volunteer like Philip, take a look at the volunteer opportunities available on our website at: nwas.nhs.uk, or through the NHS and Care Volunteer Responders. *Did you know our North West Ambulance Service Charity funds initiatives like these and funded some of the welfare vans during the pandemic? Find out more: nwas.nhs.uk/get-involved/donate.

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Doctors in the ambulance service This year marks the 10th anniversary of our Medical Emergency Response Incident Team (MERIT). We took some time to speak to one of MERIT’s founding members, Dr. Kung-Kim “K-K.” Chan.

MERIT is a team of doctors working within NWAS to support us with clinical decision-making during largescale incidents involving lots of casualties. They work on an on-call basis, available 24/7 to support when needed with incidents across the region.

Bringing together a range of specialties, each MERIT doctor offers expert knowledge and experience in their practice areas. The team provides medical advice on scene and helps us get the right care to patients who need us in difficult circumstances involving lots of casualties.

A GP of over 30 years, Dr Chan specialises in prehospital emergency care. Alongside his work as a GP, he has held senior positions in St John Ambulance and the British Association for Immediate Care (BASICS).

Through BASICS he trains other doctors and healthcare 14

professionals in caring for patients in an emergency before they get to hospital.

Dr Chan initially volunteered for NWAS as a doctor responding to emergencies across the region, and when MERIT was formed in 2014, he became one of the founding members.

Speaking about MERIT, Dr Chan says: “NWAS has a unique approach to MERIT within the ambulance sector.

By working within the ambulance service itself, rather than through external agencies, we’re able to work under the same rules and regulations as other NWAS employees. We attend regular training sessions, including live exercises, which help us to continuously adapt and improve.

“MERIT began as a small team of doctors which has evolved over the years. We support with complex incidents such as chemical releases and work together with other emergency services to provide a joined-up response. Our contribution helps to minimise disruption to business as usual during large scale incidents to make sure that the emergency resources we have available are effectively allocated to those who need them.”

Turning your feedback into action Our annual public community listening events came to a close recently for the 2023/24 financial year – thank you to every one of you who took the time to join us.

Our listening events are vital as they give us a chance to get valuable feedback from members of the public within each of the counties we serve. We act on this and it helps us make important improvements to our services.

From the latest round of events, a frequent theme identified was around lack of knowledge and concerns for defibrillator maintenance.

Community public access defibrillators (cPADs) are defibrillators available to members of the public to use if someone has a cardiac arrest. They are available 24 hours a day and are often located in buildings that are permanently open, such as hotels, or in special cabinets on the outside of buildings.

cPADs are usually funded and taken care of by community groups or individuals, using the new online national defib network, The Circuit. The guardians of the defibrillator maintain this record within The Circuit which then updates our control room systems. In an emergency, the cabinet is accessed via a code given to the person who rings 999. New national guidance on all defibrillator cabinets is that they should be unlocked – this is expected to come into effect by the end of 2024.

Businesses and organisations can also buy an automated external defibrillator (AED) which can also be used for the public during an emergency. The responsibility of

registration, maintenance and replacement of that AED is down to the individual and or business, working hand in hand with our community resuscitation team, British Heart Foundation (BHF), or the organisation the guardian has worked with to install it.

When any defibrillator has been used, it is taken offline

by The Circuit. The guardian is notified and advised to check it and replace any consumables, including pads, so that it can be made available again. There was a concern raised in our listening events that failure to do this could mean a defib was out of action for some time.

We have been in touch with BHF to discuss if there are ways we could encourage companies or groups to have spare replacement parts available. This will help to keep these valuable pieces of equipment in operation for the community and prevent them from being out of operation for considerable periods.

Community Resuscitation Manager Shaun Sproule said: “Defibrillators are exceptional pieces of equipment that can improve the chances of survival during a cardiac arrest. We would like as many public areas as possible, communities and workplaces to have accessible defibrillators. Our community resuscitation team is happy to provide advice and training on basic life support and how to use a defibrillator.”

If you want more information about defibrillators or if you would like to arrange basic life support training for your colleagues, or community group, please get in touch by email: talk.tous@nwas.nhs.uk.

Did you know?

In the UK, around 60,000 people have an out-of-hospital cardiac arrest every year.

Less than 1 in 10 people survive a cardiac arrest.

Defibrillation within five minutes can result in survival rates as high as 70%.

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