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YourCall

ISSUE 02 Spring 2018

How do you know when you are pregnant? Page 4

Lee’s Stroke Story

Understanding Frequent Callers

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www.nwas.nhs.uk


Welcome to the Spring edition of Your Call

We’re anticipating a visit from the Care Quality Commission (CQC) over the next few weeks – a great time to highlight the wonderful work of our staff whose care and compassion was highlighted following the previous CQC visit. Speaking of our staff, are you following our new @TeamNWAS Instagram account yet? If not you can find out what you’ve been missing on page 9. The account aims to give you an insight into the different roles within the service, although you can get a closer look at the role of a community specialist paramedic and the Frequent Caller Team in this edition of Your Call. We also take a look at how the trial of a new scheme in Lancashire went, as we joined forces with both Lancashire Police and Lancashire Fire and Rescue.

As we look forward to lighter nights and warmer days, we can’t help but reflect on the past few months and of course, the ‘beast from the east’ which we hope is gone for good! With winter comes the busiest time of year for us – find out how we prepare and the measures we take to make sure we’re still able to give the best care to all of our patients. If you’ve ever had the symptoms of pregnancy, you might wonder how anyone could go the whole nine months without even an inkling, but this is what happened to one of our patients and it might be more common than you think! We also hear from Lee who tells his story of survival after suffering a stroke – a reminder to think FAST if you suspect you or someone else is having a stroke. We hope you enjoy this latest issue of Your Call. NWAS EDITORIAL TEAM

Our shared values

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Off-duty bravery gives family vital extra time with loved one When people sign up to work in our control room they know that they will deal with emergencies over the phone every single day but never expect that they will find themselves face to face with one. This is exactly what happened to Dispatcher, Nathan Moon. He has worked in our Broughton Emergency Operations Centre (EOC) for over six years and on 19 November 2017, whilst travelling back from a family trip to Blackpool Zoo, he came across a car that had drifted into the central reservation. Rather than just driving past, Nathan stopped to help and quickly became aware that this gentleman was having a heart attack. Nathan dialled 999 for an ambulance but minutes later the man suddenly went into cardiac arrest. Nathan said: “Although I volunteer as a community first responder as well as working as a dispatcher, I have never been in a situation like this before and my years of experience of working with patients in similar situations became vital in keeping me calm!”

of a busy motorway, continuing until the ambulance crew could take over. Nathan continued: “I realise that what I did was very dangerous but I knew I was doing the right thing, although I think if I found myself in a similar situation again I probably would think a little bit more about the risks.” Sadly, although the man’s heart did start beating again, he passed away a few days later but thanks to Nathan’s brave efforts his family got the chance to say goodbye. The family have since been in touch to thank Nathan for what he did and although it’s very sad that this man passed away, Nathan said: “It is comforting to know that he died with his loved ones surrounding him, and not on the side of the motorway surrounded by strangers.” Peter Ballan, EOC Sector Manager added: “Nathan’s extreme courage and bravery just shows what amazing people we have in this organisation – it makes me so proud.” Nathan was shortlisted to receive a bravery award at the APD Control Room Awards 2018.

Nathan was able to drag the man out of the car and began CPR all whilst on the side Newsletter

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Feature Article

How do you know when you are pregnant? Seems like an obvious question, however occasionally the answer may not be so straight forward. As we know, most women get back pain, a heightened sense of smell and they notice their body changing. For the five and a half thousand or so women who we help during their labour each year, these symptoms are very real and can’t be mistaken. For Kelly Allsebrook, mum of three from Accrington, these signs were not so apparent on 22 October 2017. As she recalls her experience she said the first she knew she was pregnant was when she called us about to give birth. “That day I had started to get quite bad stomach ache. I didn’t know what it was but it wasn’t going away.

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My other half, Chris, wanted to take me to hospital as he thought it was appendicitis but you just try and shrug it off. “I suddenly started to get extreme shooting pains and in that split second, I knew it was labour pain.” Kelly and Chris went on to ring 999 immediately when they realised what was happening and got through to Emergency Medical Dispatcher, Lauren Snook who helped the couple to deliver their baby. They were on a mobile phone and the signal went right at the moment they were about to tie the chord. They rang back and got through to another Emergency Medical Dispatcher, Claire Sixsmith, who talked them through this part of the birth until the ambulance arrived.


Kelly described: “I just remember being so worried thinking how far pregnant am I? Is our baby healthy? Is our baby alive? It was just astounding. “My instinct kicked in and I knew I just had to deal with it. I managed to calm down but it was so difficult as our other three kids were in the background. We had our five year old, Finlay, up and down stairs trying to see what was happening. Our eldest, nine, looked after the 11 month old downstairs for us and Finlay waited on the doorstep to show the crew his new baby sister who he named Seagull! “Through all of the panic and commotion, the ladies who took our calls kept us both calm and actually from going into shock. We could not have done it without their help and I can’t thank them enough. We now have our gorgeous Evie Grace Crowe who was unexpected but who has changed our family’s lives completely.” Newsletter

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Cryptic Pregnancies

Volunteers in the driving seat

Statistics show that approximately one in seven thousand women in the UK can have what is termed, a ‘cryptic pregnancy’ at the time of birth, whereby symptoms are so mild that the woman does not relate them to being pregnant. These symptoms can be due to pre-existing medical conditions although not knowing a pregnancy exists is rare. We spoke to Advanced Paramedic and Maternity Lead, John Henry about this very unusual case. He said: “There will almost always be recognised symptoms when a woman is pregnant, however occasionally some women will only have very mild symptoms or signs that are passed off as relating to other conditions, particularly if the woman has not accessed a health care professional. What must be remembered is that any female of childbearing age can become pregnant despite the likelihood or denial that the possibility exists. “If a woman has always suffered with abdominal conditions, symptoms such as fatigue, nausea and weight gain can easily be disregarded as relating to that condition. In fact during the first 20 weeks evidence suggests ‘cryptic pregnancy’ can occur in 1 out of every 500 pregnant women.”

Neil and Paul have been volunteer car drivers in East Lancashire for over 20 years combined and have made countless journeys to and from hospital for patients who aren’t able to get to their appointments themselves. Neil Fowler, 52, from Blackburn, says: “After sadly losing my wife I really felt like I should be giving something back to the NHS which is why I decided to sign up to become a volunteer car driver and honestly, I’ve never looked back.” Volunteers currently help us transport patients approximately 250,000 times a year, many of whom need life-saving treatment such as dialysis or cancer treatment. We are currently looking to enlist hundreds more volunteers in Lancashire, Merseyside, Greater Manchester and Cumbria. Paul Alker, 34 from Blackburn, said: “You do really get to know the patients, particularly if they’re on long term treatment. It’s lovely to be able to give them a bit of company and turn quite a daunting experience into a positive one by making sure the journey runs as smoothly as possible.” More information can be found about becoming a volunteer car driver at www.nwas.nhs.uk/volunteer.

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Call to improve wellbeing Answering emergency 999 calls and dispatching ambulances can often be a difficult and stressful job. That’s why we’ve recently teamed up with experts from the Manchester Stress Institute (MSI) to create a six week programme to improve the health and wellbeing of our hardworking colleagues in our emergency operations centres (EOCs). Nutritionist Jeanette Jackson and her team at MSI held a series of workshops at each of our three EOCs as well as our support centre in Carlisle, which focused not only on healthy eating, but also ways to improve the overall physical and mental fitness for those who chose to take part.

“My emotional health has been boosted too by learning how to deal with stressful situations. I can now think of ways to not only help myself, but also identify when colleagues may be suffering from stress too.”

One of those people is Emergency Medical Dispatcher, Daniel Kenyon. In October last year, Daniel collapsed in his home after a disc in his back erupted into his spinal cord. Following emergency surgery he was left paralysed. He had to learn to walk all over again, which – thanks to his will and determination – he did!

So with the programme now complete, will Daniel be able to keep going with his new lifestyle?

Daniel saw the MSI programme as an opportunity to continue with his recovery, to maintain his positive attitude and to learn how to cope with difficult situations. Having just joined Slimming World, he was intrigued by the nutritional aspect and while he hoped the programme would help him lose weight, he didn’t quite realise the impact it would actually have.

What did the MSI programme involve

Daniel said: “The programme has really changed my life. I have seen a huge physical change – in just four weeks I lost over a stone in weight and five inches around my abdomen and I’ve dropped down a size!

“I will definitely continue the clean and intelligent eating and will make sure that I look after my brain as well as my body!”

Jeanette and the team held a whole host of workshops across the six weeks. They included hypnotherapy for stress sessions, ways to aid sleep, mindfulness, desk exercises, yoga and how to make healthier food choices. Staff were even treated to late night live cooking demonstrations by chefs who served up Malaysian, Chinese and Italian dishes to keep the teams refuelled throughout the night! Newsletter

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Team NWAS takes to Instagram In a first for ambulance services in the UK, we have launched a new Instagram account (@TeamNWAS) which is entirely led by the different faces of our organisation. Each week somebody different takes control of the account, giving followers a behind the scenes peek into what life as an ambulance service worker is all about. We employ almost 6,000 staff in over 300 different roles across the region. From paramedics, dispatchers and ambulance care assistants to 111 health advisors and urgent care practitioners – everyone contributes in one way or another to saving lives every single day. First to take the realm was Advanced Paramedic (AP), David Blowers who has worked in the ambulance service for the past 17 years.

David said: “As an AP, there’s no such thing as a typical week! Every day can be different, whether spending the day with my team on contact shifts, attending some of the most life-threatening emergency incidents, or assisting with the dispatch of enhanced clinicians to the most serious traumas. “I was really excited to launch the account which is a great way for people to learn what really goes into an ambulance service. People sometimes think it’s all about blue lights and paramedics, but there’s so much more than that.” Since launching @TeamNWAS we’ve seen visual stories of the working lives of a great selection of NWAS staff including a resilience officer, emergency medical dispatcher, senior paramedic and communications manager.

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Feature Article

Lee’s Stroke Story Would you know what to do if you suddenly lost feeling in one side of your body? Or if all of a sudden you could no longer keep your balance? So many of us would brush it off as just a strange sensation but ignoring the signs of a stroke could have catastrophic consequences. Luckily for 39-year-old Lee Skilling, he called for help when faced with an emergency where every second counts.

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Friday 23 June 2017 started off as just a normal day for Lee. After a morning of doing the school run and attending to his chickens at the allotment, Lee decided to have a quick snooze to refresh for the rest of the day ahead. As he made his way to bed he suddenly lost all balance, repeatedly fell over and found he could no longer feel the left side of his body. It was then he knew something wasn’t right, but he had no idea just how serious it was. Lee said: “I was home alone and even though I knew something was wrong, I was completely unaware I was having a stroke. I actually rang 111 rather than 999 as I thought I would be wasting the emergency service’s time!” The 111 health advisor who took Lee’s call instantly picked up the symptoms and requested an ambulance to attend right away. Paramedic Toby arrived first to check Lee over, before a second crew turned up to take Lee to hospital.

It was at hospital that Lee discovered he had suffered a stroke and a bleed on the brain. Despite doctors believing that he wouldn’t make it at one point, Lee has made – and is continuing to make – a good recovery. He still suffers some numbness to the left side of his body, as well as some memory loss issues, but had he not called for help so quickly that day, things could have turned out a lot differently for Lee. He said: “I know I’ve been very lucky and its all down to the care I have received from the minute I called the ambulance right through to the community stroke team. When I see people and say I had a stroke last year they don’t believe me!”

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Emergency services join up to create super team People ringing 999 in East Lancashire and asking for the help they require have been finding themselves getting a response from all three emergency services at once. This is because we’ve teamed up with Lancashire Fire and Rescue and Lancashire Police to create a multi-agency vehicle meaning that all three services can work closely together. The eight week trial, which ran between December and February on particularly busy evenings, mainly at weekends, comprised of a senior paramedic, a police sergeant and a watch manager and responded to 999 calls from all three services. Dave Suart, Operations Manager, who oversees the project from an ambulance prospective said: “For us, the idea of the collaboration is not only to work together with our emergency services colleagues but

if a patient is able to be treated at scene and doesn’t need to go to hospital, it reduces the need for an ambulance to attend, freeing up vital resources. “So far we’ve been really happy with the success of the scheme and hope to run it again on key dates throughout the year.” 90% of incidents attended by the multiagency vehicle were able to be resolved at scene without the need for hospital transportation. The typical incidents that the multi-agency vehicle has attended include assaults, road traffic collisions, mental health incidents and house fires.

Cultivating care for children

If you have children, the chances are your number one priority is their health and safety and, should they ever need medical help, you want the best possible care to be given by those charged with helping them. That’s why we are constantly looking at ways we can improve the way we assess, care for and treat children. The paediatric patient priority group (PPG), which is led by Advanced Ambulance Practitioner, Chris Preston, has a number of projects being undertaken by a dedicated team of clinicians. Each project focuses on a

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The role of specialist paramedics in the community We might cover the entire North West but being a pivotal part of the different communities within the region is something we’re extremely passionate about. That’s where our community specialist paramedics (CSP) come in.

Often referred to as the go-to people for all things NWAS in the community, our CSPs take on a whole host of responsibilities to ensure that the best care is provided to each and every patient. They develop ties with local community groups, provide education and knowledge about the service, build relationships with community nursing teams and GPs, implement community care plans for our most vulnerable patients, look at how to wisely spend money for patients with commissioning groups and offer support and advice to crews. All that on top of responding to our patients can make for a very busy job! Kieran Potts is relatively new to the position – being appointed as CSP for West Lancashire at the beginning of February – but he’s already seen the impact the role can have both on the community and the service.

different aspect of paediatric care, working with partners from outside of our organisation. Chris said: “I am extremely proud to be leading the paediatric work within the trust. Each project carried out by the PPG aims to develop the ways we look after children who need our help – making sure they get the most appropriate care for their needs.” As well as the PPG, paediatric care is also a focus of our Transforming Patient Care programme. In particular, we want to reduce the amount of children being transported to the emergency department and are looking at safe and sustainable ways in which we can do this.

Kieran said: “The clinical freedom and the ability to have a real impact on change is like no role I have had. In other roles I’d say I was reasonably experienced in attending meetings and planning my time – but nothing could fully prepare me for the diversity and challenge of the CSP role! “I love seeing patients and I enjoy using my local contacts and relationships to provide safer care closer to home, but for me the most rewarding part of the role is when you have a discussion with someone who might not have understood the role of an ambulance crew before, and they start to understand just how much our crews actually can do, and that they do this every day.” If you want to find out more about Kieran’s role as a CSP, you can follow him on Twitter - @NWAMB_Kieran

What are the projects of the PPG?

Vickie Mounsey (Paramedic) is looking at the role of fluids in diabetic ketoacidosis (a dangerous complication of diabetes which happens when the body starts running out of insulin). Martin Rolls is researching the use of a paediatric early warning score, otherwise known as POPS. This will help our clinicians assess children and look at alternatives to taking them to the emergency department. Paddy Ennis is currently studying an Advanced Paediatric Practice MSc. His project considers the use of rigid collars on children with suspected neck or spinal injuries. Jeff Hetherington is working with the Sepsis Team at Alder Hey Hospital to develop a paediatric and neonatal sepsis screening tool. Newsletter

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Would you know what to do in the event of a stroke? Did you know that there are more than 100,000 strokes in the UK every year? It is the fourth largest cause of death in the UK, every year killing twice as many women as breast cancer and killing more men than prostate and testicular cancer combined.

What is a stroke?

A stroke is an attack on the brain which is caused by a disturbance of the blood supply to the brain.

Who’s most at risk?

There are a number of factors which could put people more at risk of having a stroke: • Age • High blood pressure • Diabetes • Smoking • Overweight • Poor diet or lack of exercise • Heavy drinking 14

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What are the signs? Learn to Act FAST:

Face – has their face fallen on one side? If you’re unsure ask them to smile or look in the mirror if you suspect you’re having a stroke. Arms – ask them to lift both arms. Can they keep them there? Speech – Listen out for slurred speech Time – time is critical in the event of a stroke. If you see any single one of these signs, call 999 immediately. The quicker you act, the better the chance of recovery.

Are there any other signs? • • • •

Sudden loss of vision or blurred vision Sudden weakness of numbness in one side of your body Sudden memory loss Sudden dizziness, unsteadiness or a sudden fall


Beast from the East

Operations Manager, Nick Griggs, managed to find the funny side to the horrendous weather!

From November to March it seemed as though you couldn’t go anywhere without hearing about the NHS winter crisis – it was constantly featured on news programmes, in newspapers and online.

This year was certainly one of our busiest yet with a 14% rise in incidents in December compared to the year before. The week in between Christmas and New Year was particularly busy with over 5,000 calls every day.

Of course with each winter we have an idea of what we should expect which is why this year we started planning for the season earlier than ever before. Thanks to previous years we were able to see which days tend to be the busiest so we could increase cover on our rotas, we put paramedics in our control centres so patients could benefit from senior clinical advice earlier and, once winter hit us, we used our patient transport service to help with discharged patients to make room in hospitals for new ones – we certainly made the most of our resources!

As January came and went, we couldn’t help but think we had seen off the worst of the winter pressures until the ‘Beast from the East’ paid us a visit, bringing with it some of the highest volumes of calls we have ever seen. As always, our fantastic staff showed their professionalism, resilience and positivity throughout and we saw so many examples of staff going that extra mile for their patients. Hopefully we’re out of the worst of it (for now), although it won’t be too long before we’re planning for the next one!

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Feature Article

Understanding frequent callers Currently within the North West, there are 1,581 people that regularly call 999, with Greater Manchester having the highest number. Paramedic, Angela McNally sees firsthand the people who make these calls and why they do it which is why the Frequent Caller Team was established – with Angela at the helm.

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There is a notion and belief that all people who frequently call 999 are delinquents, trouble makers and hooligans. But that is far from the truth a lot of the time, says Angela. There are so many reasons why they make the calls. It could be due to their satisfaction and experience, their unrealistic expectations or because they are at risk, vulnerable or accessing the incorrect healthcare for their need.


Loneliness Angela said: “They contact 999 for some form of human contact which could be their only contact with the outside world. This then becomes a regular pattern which brings a great strain on the service and one that we can’t sustain. “Our intervention is very powerful as we work with the appropriate person to understand what the patient’s needs are and explore what help is available for them in the community. We encourage them to re-engage in the community support which helps to boost their confidence and help with their social isolation and loneliness.”

Mental Health

The right help at the right time

Angela’s team takes a holistic approach to identify unmet care needs which include looking for pattern to the calls, staging interventions that follow and gaining consent from the person to share information with other health care providers to make sure the best possible care is given. Angela explains that there is one thing that massively helps in this situation: “Visiting the patient in their home environment is helpful to have that eye on approach to their living environment that cannot be picked up over the phone, and these visits work well when attending with other professionals needed to support.”

One in four of us will experience poor mental health in our lives. “We have a lot of people that frequently ring us with poor mental health. “When people’s lives are falling apart in front of them and in times of crisis, they may not get the help and support that they need. To the person calling, 999 may seem their only option. We know that actually this might not always be the best option for them and there are other services more appropriate for these people to get help.” The Frequent Caller Team is an example of collaboration with other services and Angela is full of praise for her team. “They are brilliant and we work with other services to ensure these patients can access vital information and can provide the most appropriate support.”

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Dorene’s Story Dorene Fowden is a lovely lady who lives alone in her own home. The 77 year old’s frequent calls have massively reduced since coming into contact with the Frequent Caller Team. Dorene rang 999 a whopping 145 times in 2016 – that’s more than once every three days. She rarely needed to attend the accident and emergency department. When cases like this come to the attention of the Frequent Caller Team, they first of all need to establish why a person is turning to the emergency services, before finding a sustainable solution. In Dorene’s case, it transpired that she couldn’t cope with her feelings of loneliness, anxiety and feeling so low. Ringing 999 was simply her way of speaking to someone who cared. Unfortunately, this could stop others from getting the help they need which is why the team needed to come up with a way to significantly reduce the number of times Dorene calls 999. They tried a number of ways but they found the best outcome came through a trial of weekly calls to Dorene made by Specialist Paramedic, Kate Gardner. Through this they discovered Dorene responds well to compassion based support and being offered the time to vent her distress and worries. Her 999 calls reduced dramatically. Finding out why Dorene has been making so many calls, and figuring out how her calls can be reduced has given the team the tools they need to help reduce Dorene’s calls for good.

Ambulance technician performs with singing superstars Michael Ball & Alfie Boe A Liverpool ambulance crew member with a secret talent took centre stage during ITV’s ‘A Night for Emergency Services’ where he sang alongside superstars Michael Ball and Alfie Boe. The emergency medical technician based at Anfield, who went viral on Facebook last year after being filmed singing classical music outside an ambulance, was surprised by Diversity dancer, Ashley Banjo during his shift and was asked to take part in the special variety show celebrating our emergency services. Lewis Quinn, 38, from Liverpool fell in love with classical music at the age of 16, he has sung in opera performances in the past but never on this scale. Lewis said: “It was such a fantastic experience, everyone treated me lovely and I was even chauffeured around in a Mercedes! It was a totally different world to me.” Lewis’ usual day consists of attending emergencies and treating poorly people but the flashing lights from the stage were a little bit different to the blue lights and sirens he is used to. Lewis’ sector manager, who also happens to be his brother, Gene Quinn said: “We’re all so proud of Lewis, he has a fantastic voice and it was amazing to see him on the big stage!”

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It’s nice to be nice We see plenty of headlines in the press when things don’t go so well for our patients - they might not agree with the treatment they received or perhaps they felt they were waiting too long for an ambulance – you’d be forgiven for thinking that everyone feels this way. Of course we need to know when things don’t go right, but let’s put that into context. In 2017 we received 2,345 complaints. Yes that seems like a big number but considering we attended over a million incidents in the same year; it really is just a small proportion – 0.22% to be exact! So what about the other 99.78%? Did you know that last year we received 1,740 letters and emails of thanks from patients and their families? Some of them thanking the ‘heroes’ that saved

their loved one’s life; some for talking a new mum through child-birth; some for being that familiar face on the way to their weekly hospital appointment; and others for simply being there in the most traumatic times. Over the past few months we’ve also been inundated with the kindest acts of generosity from members of the public – you might have seen some of them on Facebook and Twitter. We had the kind stranger who paid for an EMT1’s fuel, home-made cakes and hampers delivered to stations and even a store manager from Tesco paying for a basket-full of shopping for one of our amazing staff! We might “just be doing our jobs” but it really does mean the world when people take the time to say thank you.

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Our contributors Here’s a few words from our contributors and their thoughts on Spring and their optimism of better weather!

Christina Burke I love the lighter nights as we get into spring and summer. I feel like winter has lasted forever this year and I can’t wait for the warmer weather so I can get out in my garden. Life’s just better when it’s sunny!

Alice Rawsthorne Spring to me means one step closer to summer! Everything’s starting to look a little brighter, the grass a little greener and blossom on the trees – it just puts everyone in a good mood.

Fiona Bateson Let’s face it, spring is the new summer! I really enjoyed the three days that summer lasted for this April – I relaxed in the garden whilst admiring the blue sky. I think my dog Chester appreciates the light nights too as he gets to go for more walkies!

Karen Fitzhenry Spring has been a long time coming this year. When you feel the warmth on your back just that little bit more, the flowers, the lighter nights – what isn’t to love about the spring?

Get in touch Trust Headquarters Ladybridge Hall, Chorley New Road, Bolton, BL1 5DD Tel: 0345 112 0 999 (local rate) Email: nwasenquiries@nwas.nhs.uk Website: www.nwas.nhs.uk

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