Your Call - autumn edition

Welcome

to the autumn edition of Your Call

We’ve always thought of this time of year as mysterious with its changing nature of life; the nights begin to draw in, the pull of crisp air and browning leaves awaken our senses, it feels different. This year, we’ve become accustomed to different.

We’re living in a world of new and changing ‘normals’ as we hurtle towards the colder months. Amongst this uncertainty there are three things we can be sure of which will help stop the spread of coronavirus; washing our hands, wearing our masks and keeping a safe distance from others.

With mental health being an additional concern, we meet the people behind a successful initiative in Blackpool geared towards helping to treat patients with mental health conditions.

From paramedic to director - we talk to Director of Strategic Planning, Salman Desai about his career in the ambulance service and why patient care has always shaped what he does.

You may have seen them on BBC One television show Ambulance but what exactly is the role of the doctors we work with? We uncover more inside.

A Greater Manchester family share their twins’ brave brain tumour story which makes paramedic parents Gary and Claire proud.

As autumn is a time we instinctively focus on our health by boosting immunity through habits and nutrition, we look at how one #TeamNWAS member has changed her diet due to her environmental role at NWAS.

We’re inviting one reader to guest write a feature for our winter edition; it could be about a personal health journey or indeed about your experience with our service. To get in touch, email communications@nwas.nhs.uk.

Take care and stay safe.

Communications Team

Our shared values

From paramedic to executive director – Salman Desai

Executive Director of Strategy and Planning

Salman Desai looks back on his 23 years with the ambulance service and tells us what he’s learnt from his varied and exciting career.

After completing a degree in health studies and being unsure which path to take, Salman realised his heart lay in emergency care when he came across a road traffic collision involving a family friend.

Salman returned to NWAS to join the board of directors in 2015.

Looking back over his career Salman says: “The proudest moment for me is still the patient facing element. I really enjoyed being on the road but I wanted to work to improve the care we deliver for patients. Patient care continues to shape and remain at the centre of what I do today.”

Sharing the knowledge he has learnt over the years with younger colleagues, Salman says: “If you set your mind on something, nothing will get in your way but don’t underestimate the value of a trusted group of individuals who can guide you on your journey.

After completing his studies, Salman applied to become a student paramedic for Greater Manchester Ambulance Service. He then spent some time travelling around the USA and almost missed out on the spot due to his travels. Deciding to cut the trip short to follow his ambitions, in 1997 Salman joined the ambulance service and began his training at Ladybridge Hall. The same building he is based at today.

Salman spent the next seven years in patient facing roles where he has fond memories of the willingness of his colleagues to learn from each other and give the best they possibly could to their patients: “It was not just another job to them, they always had the patient in mind.”

During this time Salman also trained colleagues and other healthcare professionals in advanced life support and later went on to undertake a training role focusing on reducing drug related deaths. This work saw him speaking at conferences around the UK and even as far as Vancouver, leading him to receive an NHS Outstanding Contribution to Health award as a result of his efforts.

Over the years that followed, Salman undertook a number of managerial positions within the newly formed North West Ambulance Service, working to align the former ambulance services into one trust. He successfully secured a position on the National Breaking Through Leadership Programme before undertaking a two year secondment as Transformation Lead at a large teaching hospital in Manchester.

“What was really clear was that nobody knew what to do besides pick up the phone. For me it was that moment that I realised that I would like to work for the ambulance service.”

“Don’t be afraid to make mistakes, that’s human nature, learning from them is what’s important.”

Saying ‘I’m fine’ to the world may not be enough

One thing that hasn’t changed with the pandemic is the struggle with mental health. We’ve seen a 20.5 percent increase in mental health related calls to our 999 service from March to August this year, compared to the same period last year.

It is no coincidence that many celebrities have chosen this time to talk about their own struggles with mental health across their media platforms. From singer-songwriter Anne Marie who opened up to Mind charity about her mental health problems as a teenager, to Loose Women presenter Andrea McLean who recently talked openly about her breakdown in 2019.

Both of their stories and experiences share a common factor - they both suffered in silence. It wasn’t until they accepted they were ill, reached out for help and began to talk about their mental health did they start to feel better. Saying ‘I’m fine’ to the world may not be enough. The take home message is to try and get help when you are strugglingit is a basic human need to help us feel connected in order to survive.

Pictures: Instagram

How to access help?

If you're concerned about yourself or a loved one, there are mental health charities, organisations and support groups that can offer expert advice.

Mind charity is a great place to start, it has lots of tips, advice and resources on its website including actions you can take from relaxation and breathing exercise tips to mindfulness, mood diaries and selfcare boxes.

You can also access an A-Z of organisations who can help you by visiting nhs.uk and typing mental health helplines in the search box.

It isn’t always easy opening up but your GP is a great place to start, he or she will be able to suggest ways to help you get through this.

Hub of Hope app - this locates where you are and advises where you can get help.

Communities in Blackpool have been feeling the benefits of a mental health partnership scheme, Psynergy, which has been running since December 2018.

Psynergy sees a senior mental health nurse from Lancashire Care NHS Foundation Trust, a police officer from the Lancashire Constabulary and senior paramedic from NWAS come together as a crew in a special vehicle to jointly attend people experiencing a mental health crisis.

The scheme helps give people the right care, advice, improves their patient experience and often helps them avoid an unnecessary hospital admission – they are not always the right place to go.

Your Call talks to Senior Paramedic Team Leader Daniel Cross to find out a bit more about the scheme which runs eight hours a day, seven days a week.

“I had often found it frustrating in the past when caring for patients in a mental health crisis as it meant taking them to a busy A&E department. Whilst this is a place of safety, it can often be the last place some of our patients wish or need to be.

“Mental health incidents can often be very difficult to risk asses and can present ambulance crews with a number challenges. Often crews can spend protracted time on scene which has a knock-on effect to our other patients who may be in, for example, cardiac arrest.

“When a patient is suffering from a mental health crisis, a lack of specifically appropriate response can lead to them feeling disenfranchised and reluctant to ask for help again when the need occurs. It can also sometimes result in disruption at A&E as people become frustrated at being ‘stuck in the system’ whilst waiting for a mental health assessment in a medical department.”

Psynergy gives the patient a rapid assessment to ensure they get the most appropriate care pathway for them. This may be advice at scene, support at home to enable the patient to remain there with the right care or it may be a referral to a service they need.

From December 2018 to July 2020, the team has handled 2,677 incidents (2,350 being mental health episodes) - only 282 of these incidents resulting in taking the patient to hospital.

“I found it frustrating when caring for patients in a mental health crisis meant taking them to a busy A&E department.”

A nurse’s mission to help cardiac arrest victims

Sue Benson a nurse and midwife from Liverpool has witnessed a lot in her 41 year career in the NHS.

Now a senior clinical call adviser for NHS 111 providing advice to patients ensuring they get the most appropriate care, it is not hard to see why caring for people is Sue’s passion.

It was only when Sue joined NHS 111 working alongside 999 ambulance colleagues that she grew more aware of how often people collapsed in the street or at home. What shocked her more is how many times she encountered the sad news that the patient didn’t make it, whether it was an adult or child.

“For someone in cardiac arrest they will die within minutes unless treated immediately with cardiopulmonary resuscitation and a life-saving defibrillator.

“Our aim was to raise £5,500 towards buying at least three life-saving defibrillators and since joining we have smashed this goal and have raised over £7,000. We have raised enough funds to purchase three public access defibrillators with cabinets with support from the Vital Signs Foundation, a local councillor, a local pub and the Oliver King Foundation a Charity based in Liverpool.

“We have also been able to purchase a further two cabinets and one of our local GP surgeries, Aintree Park Group Practice, is providing the defibrillators for these. So in all, our community will benefit from five pieces of life-saving kit – of which have saved lives already.

“I was motivated to take action in my local area after a former colleague and friend posted on Facebook last year that he had raised enough money for a second defibrillator for his local community. This made me think I need to do this as if I don’t start, who will?”

For the last 11 months Sue has been leading a group in her local community in Orrell Park - The Defibrillator Fundraising Group Walton Vale and Moss Lane - to fundraise for life saving defibrillators. They have had support from local councillors, GP surgeries, churches, pharmacists, solicitors and local shops.

“I’ve met some wonderful people on this journey who have survived because of a defibrillator and they are keen to lend their support to what we’re doing. One of these wonderful survivors, Robbie Eaves has joined our group with his daughter Katie and together we have plans to keep the fundraising going in the future.”

“The chances of survival from cardiac arrest diminish rapidly with every passing second so the sooner someone can receive treatment, the greater their chances are of leading a full and healthy life afterwards.

“Obviously coronavirus has slowed our progress but it never stopped us.

Think of the ambulance service and you will likely think of paramedics...

But we have hundreds of different roles here at NWAS – from 111 health advisors, ambulance care assistants and mental health practitioners to nurses, pharmacists and doctors.

In fact, the doctors who work with us take on a number of different roles, whether that be forming part of the Medical Emergency Response Incident Team (MERIT), volunteering with the British Association for Immediate Care (BASICS) team or attending more serious incidents on the air ambulance.

MERIT doctors are specially trained to provide advanced medical advice and practice at a range of emergency incidents. In particular, they play a huge role in our response to major, mass casualty and significant incidents.

Often, this role doesn’t involve physically attending the scene of an incident, but rather giving remote advice to the tactical health command team responsible for co-ordinating how we help patients at major incidents. As a medical advisor, the MERIT doctor is responsible for making sure patients are given the correct care for their needs and taken to the most suitable hospital to give them the best chance of recovery.

Did you Know?

If needed, a MERIT doctor may also undertake the role of a forward doctor, which would see them attending the scene of an incident so they can co-ordinate and direct clinical care to patients at a safe location such as a casualty collection point or clearing station.

Although MERIT doctors don’t necessarily work for the trust full time – with “day jobs” including GPs or consultants – the MERIT team provides a 24 hour, seven day a week capability to ensure patients are getting the very best care.

Some of our clinicians wear red epaulettes on their shoulders. This is so advanced paramedics, consultant paramedics and doctors can be easily identified in a major incident.

If you need urgent care, think 111 first

Over the coming weeks we are asking you to think about contacting 111 first before you attend your local emergency department –part of a new national programme to combat coronavirus.

When you contact 111, our highly trained call handling Team NWAS members take you through an assessment in order to get you the right care, in the right place.

We may give you advice on attending a pharmacy, your GP or out of hours GP, a district nurse, a walk-in-centre, an urgent care centre, or a local emergency department. We can even book you a direct appointment with many of these services.

If appropriate, our clinicians will give you advice on how to manage your symptoms and safely look after yourself at home, and in the most serious emergencies we can arrange an ambulance for you.

If, following the assessment, you do need to attend your local emergency department, we will be able to book you an appointment slot to attend as part of this new programme.

At the time of print, this new scheme is currently live for patients in Blackpool, Warrington and

Halton. However there is a full national roll-out planned over the next few weeks and months so it will be available in your area soon. For updates visit nwas.nhs.uk.

The emergency department appointment slots will help to reduce overcrowding making social distancing easier in hospital emergency departments, helping to reduce the risk of transmitting coronavirus.

Jackie Bell, Head of 111 at North West Ambulance Service, said: “When contacting NHS 111, you will be asked a series of questions about your symptoms to determine which local care service will be able to provide the right care for your needs. Our friendly health advisors are trained to guide people through the questions and direct you to the most appropriate service, and we have clinicians on hand to offer additional expertise and speak to you if you need further assessment.

“Being able to provide patients who need emergency department care with a specific timeslot to attend is a great expansion to the service we already offer and will help to keep people safe and well.”

Most of our patients and those we interact with are polite, pleasant and incredibly grateful that we are there to help them - often in some of the worst moments of their lives.

“When someone on the phone is abusive we can’t just hang up on them immediately.”

But unfortunately we have seen an alarming rise in callers who are abusive to our call handlers. The offensive comments can range from basic insults to racial abuse.

The aggression is not only verbal. NWAS took part in a recent Sky News report that showed there were nearly 1,604 physical assaults on ambulance workers across the UK recorded between January and July 2020. These figures are not even for every single ambulance service, so it is a disturbing picture.

Emergency Medical Dispatcher Imran Khan works at Broughton. He joined Team NWAS in April 2020 after working as an air steward on transatlantic flights. He has already experienced two abusive calls.

“In my previous job nobody would ever have used language like that to me, so when it happened I was quite shocked.

Vicky Blackburn is the Emergency Operations Centre’s regional planning and development manager and chairs NWAS’ ‘Violence and Aggression’ (V&A) group which looks at different ways of supporting our workforce. “Staff should never have to put up with verbal or physical abuse. It is absolutely not part of the job and we will never tolerate it. When someone on the phone is abusive we can’t just hang up on them immediately, so we have introduced a procedure whereby abusive callers are warned and asked ‘could you please stop this language/tone’ a number of times.

“If the abuse continues, the caller is transferred to a supervisor. Staff understand that anxious callers may be offensive, and are trained to deal with this. However personal insults or threats are not part of the job. Having said that, the safety of our patients is our priority and this also has to be considered at all times.”

To deal with the day to day reality our workforce face, our V&A group has introduced many improvements over the past year - staff can now log these incidents as hate crimes internally. We are also working collaboratively with our police colleagues to encourage reporting and what to expect if charges are brought. We have also been promoting the benefits and use of restorative justice.

CEO Daren Mochrie is very clear that he finds any threat to colleagues entirely unacceptable. “This should not be happening and I encourage anyone, from any part of the trust, who experiences this abhorrent type of abuse to report it immediately.

“Everything around me went really quiet, the whole room fell silent - you could have heard a pin drop. I took it personally because of the language he used, I was really surprised.

“The man’s girlfriend took hold of the phone after he’d said it, and was very apologetic. My supervisor eventually took over. I was asked if I wanted to report it to the police but I decided not to take it further.”

“A man had called and was initially fine, he was asking for an ambulance for someone else. Then all of a sudden he turned abusive and used offensive language. I just said ‘I’m not going to tolerate racial abuse.

“No-one should tolerate this type of behaviour and the trust will support all staff that highlight the issue.”

Over 150 patient transport service (PTS) colleagues, whose day to day job is to help patients get to and from non-emergency healthcare appointments, volunteered to support ambulance crews in our emergency service this year. By doing this they enabled our emergency frontline to continue to help patients with lifethreatening conditions during the pandemic.

Your Call talks to Colin Goldson, Ambulance Care Assistant who did just this. We ask Colin about his experience in our emergency service - something he didn’t think he would ever do in this capacity and a role he is still enjoying.

having a heart attack and we took him to hospital as an emergency.

Why did you volunteer to work within our emergency service?

When I found out that our emergency service needed support from us, I knew volunteering was the right thing to do. The pandemic was and still is an unprecedented situation and I knew that I wanted to help in whatever way I could.

What training did you have beforehand?

We had a three day training course which mainly looked at the equipment we would assist with and how to use it.

What does your new role entail?

I drive to non-blue light incidents and I help take basic observations on patients. I keep the ambulance stocked with all its equipment including kit required to move patients, blankets, sheets and everything else we need. I clean the vehicle after each patient.

How have you liked working on the emergency frontline?

My emergency colleagues are clinically very knowledgeable and always try and help you understand what they are doing and why.

I’ve really enjoyed seeing the other side of what we do, why and how most patients end up in hospital in the first place. We attended a gentleman who had been having chest pain for ten days. He was

I got so much satisfaction helping this patient; I’d spent time with him, talked to him and calmed him down whilst the paramedic could concentrate on what he needed to do. We then met the medical team waiting for him in the hospital who took him straight into theatre for a life-saving operation.

What extra skills do you think PTS staff bring to working alongside our emergency service? As PTS crews we are masters in moving and handling patients. We also have the luxury of being able to spend a lot more time with patients who are not in need of time critical care. We spend a lot of time chatting with patients, which helps to relax them and keep them calm during stressful situations.

What have you learnt about yourself?

How patient I can be in certain situations and that I can cope working long nights. I’ve coped better than I thought I would in some stressful situations. It has opened my eyes to the range of pathways available for the benefit of the patient and I also appreciate now just how hard my emergency colleagues work and how emotionally and physically tiring and frustrating the job can be. Would you like to continue working alongside PES?

Full time, no I wouldn’t as I enjoy my PTS job too much and have done for the last 12 years. I have enjoyed this taster and will continue to help for as long as I can.

“We attended a gentleman who had been having chest pain for ten days. He was having a heart attack.”

Colin’s story

Behind the flashing blue lights and sirens

- the hidden heroes

Team NWAS members working behind the scenes have been keeping things in line long before the pandemic so that we can continue to give you the best possible care. Sam Griffiths, Clinical Hub Manager is one of these people. Sam, originally from Streatham in south-west London, has lived up north for 17 years in Rhyl, North Wales. She started her career at the ambulance service in 1999 at London Ambulance Service (LAS) as a call handler in their Emergency Operations Centre (EOC). Fast forward 21 years and Sam has worked her way to line managing clinicians based in their Clinical Hub, who assess patients with urgent and emergency conditions over the telephone, making sure they get the right care.

“The ambulance service wasn’t even on my radar when I was thinking of a career when I was younger. After university, I fell into bar work and eventually ended up as a pub landlady for a while in west London. I then became a parent and it wasn’t practical.”

remember taking an emergency call and then having to dispatch it myself. Luckily the volume of work was nothing in comparison to the volume of calls our EMDs have to deal with today. I have the utmost respect for EMDs - they are the first point of contact for the public and it can be an emotional rollercoaster on an hourly basis, with very little respite.”

Sam progressed at NWAS to the role of EOC performance manager which included working with ambulance crews, teaming up staff, making sure vehicles were safe, reporting and arranging their repairs whilst also managing staff.

“When the position of clinical hub manager came up, I went for it. I got it and it was quite a big jump which I was anxious about as I had never been a direct line manager of clinicians before.”

As an ambulance service, we’re at the heart of urgent and emergency care in the North West and the Clinical Hub is an integral part of this, so we are ready to respond to our patients’ needs.

Sam quickly progressed in LAS from call handler to dispatcher to radio operator communicating directly with crews away from their station. But when she left LAS to work for the then-Mersey Regional Ambulance Service (MRAS) Sam had to resign her position and take up a role as call handler.

Sam adds: “The role of call handler was very different in those days. We took calls and wrote the details on colour coded paper dependant on the type of call. We then handed the paper to an allocator for an ambulance to be dispatched. In EOC now we have call handlers and dispatchers, the call handlers take the incoming 999 calls whilst the dispatchers monitor resources and send ambulances to patients – it is all computer-based.

“When I learned to dispatch in MRAS, there were occasions when we were rather short staffed and I

The hub ensures that we’re providing the right response for each individual patient. This may be a referral to a GP, a trip to an urgent care centre or self-care at home. Last year, the Clinical Hub helped prevent 90,000 ambulance journeys for patients with less serious health needs as they were treated safely by other means – freeing ambulances up to attend people with life threatening conditions.

“I love my job. I have a fantastic team who work hard to provide great care for the people of the North West.

When I saw an advert in a local newspaper for 999 call handlers, I applied and the rest is history.”

“What doesn’t change is the bond you form with your team; the banter, providing a shoulder to cry on, talking about family and life’s trials and tribulations.”

Running for his twin; meet the Pullan family

Paramedics Claire and Gary Pullan met at work and got together in 2012 after Gary’s first wife died of breast cancer. They have four children between them; twins Matthew and Alex (17), Mark (14) and Samuel (12).

The past few months have been difficult for the Pullan family from Bury in Greater Manchester. Whilst we’ve all battled our way through the pandemic, the family were also hit by something else. They devastatingly found out that their son Matthew had a rare brain tumour.

Your Call speaks to Matthew about his diagnosis and to his twin brother Alex who has embarked upon a running mission to raise money for Brain Tumour Research. He is doing this to enable the charity to find a cure for brain tumours such as his brother’s, which will ultimately shorten his life.

Matthew’s story

Matthew was three when he was diagnosed for the first time with a brain tumour which was successfully removed. A few months ago he started to be aware he was falling over more and became a bit clumsy so he went to see his consultant at the Christie Hospital.

Neurologically he was fine but he was sent for a precautionary scan. That scan unfortunately showed that Matthew had a brain tumour which was reaching out towards his brain stem.

“This time it’s a different type of cancer to the first, which the experts can’t determine what it is.

“They have removed 99 per cent of it however some of the cells have spread to my brain stem which can’t be removed surgically. I am in the middle of radiotherapy and chemotherapy treatment which I am finding incredibly difficult but I know it is worth it and it will help me.

“Knowing the brain tumour will shorten my life is daunting and knowing that no one knows what the tumour is, is a bit surreal. It gives me hope knowing it isn’t a big scary tumour any more. However, I am worried and know high grade cancers aren’t good but I’m positive.”

Before Matthew was diagnosed for a second time, he loved to run with his twin, he was super fit and active and strove hard to increase his fitness levels. Now that has been taken away from him.

“Doing not a lot is tiring. I lie on a table for under two minutes and I’m tired, yes radiation is being blasted at my brain, but I don’t feel like I should be as tired as I am. Going from really fit and active to not doing a lot is destroying, but I will get out again hopefully.

“It’s amazing, having Alex run for me and live what I want to be living. I’m really proud of him and this money can be put towards helping to find a cure for this demon which has possessed me twice and will eventually be the end of me. I just want to say a big thank you for donating and prolonging my life and giving others a better chance to survive.”

Alex’s Story

“When we found out it was such a shock because no one was expecting it, not even the consultant who had sent him for a ‘precautionary’ scan after a neurological assessment that was pretty much perfect.

“It came as very bad news, when you find out something like that is happening to someone you love it’s very hard to accept it and you live in denial for many weeks, months or even years in some cases. Understanding will always be the hardest part and as a family we support each other. It’s hard, but there isn’t much we can do, we are helpless.

“It felt even more surreal as Matthew was admitted to hospital on the anniversary of our mum’s death.”

Alex has been running for Matthew whilst he can’t and ran at least 5k everyday throughout Matthew’s radiotherapy to raise money for Brain Tumour Research.

To support them and donate, please visit the Just Giving webpage and search for Alex Pullan.

“It was 44 days worth of running for me and 30 days of radiotherapy for Matthew. Both of us are runners, a hobby we have shared and we both run for the local club Radcliffe AC. I am rurring for him, while he can’t.”

Picture: left Matthew, right Alex

For the past three years we have been working on a piece of digital kit for our ambulance crews which will really help us to improve the care we give to you.

Trialling this autumn in Blackpool, our clinical teams there will be the first to move from paper based patient record forms to an electronic patient record. Dr Chris Grant, Medical Director at NWAS has led the project for the past year.

In time, this will enable us to connect with the wider health system digitally – something we haven’t had before - giving us a more intelligent picture of healthcare needs.

Once we have put this system through copious tests, we will make sure the rest of crews in the North West are using these by next year.

It’s been some years in development – but Dr Grant explains that it is a bespoke system built and tailored specifically to the complex needs of one of the biggest ambulance trusts in the country.

“We did not want to buy an off the shelf solution, because that simply would not have worked.

“It is one of the biggest innovations to the way we work that NWAS has ever undertaken, so there are bound to be some teething problems.

Going electronic means crews will be able to view patient records to help them make clinical decisions. They can input patient information to the device which will talk to the receiving location during the journey. Patients’ data is encrypted meaning it is completely safe and secure.

“But we are 90% there with it, and look forward to sharing more details with our partners as it is road tested thoroughly.”

“It’s more significant to us than any new drug or new clinical kit. It will genuinely transform how we deliver, monitor and improve clinical care.”

“It’s more significant than any new drug or new clinical kit.”

began to stare and talk and I just burst into tears.”

When 28-year-old Abi Shaw experienced sight loss which began during pregnancy, she thought her dreams of working for the ambulance service were over. Fast forward seven years and Abi now works in our Manchester Emergency Operations Centre as an emergency medical dispatcher, all with the help of her trusty Guide Dog, Rachel. Always being very active and a keen driver, Abi began experiencing headaches during her pregnancy and after months of agonising waits, tests and appointments she was advised that her eyesight was deteriorating and she had very little peripheral vision.

As her eyesight deteriorated further during her second pregnancy, Abi was registered partially sighted meaning that she had to face her toughest obstacle to date, giving up her driving licence.

The months that followed were extremely difficult for Abi as she adjusted to life with limited vision: “I began white cane training around my local estate. Everyone began to stare and talk and I just burst into tears, I couldn’t cope with it and suffered with severe depression.

After months of assessments and training, Guide Dog Rachel came bounding into Abi’s life in January 2020 and she has never looked back. In March she was over the moon to have been offered a position at the ambulance service.

“Everyone was so helpful and understanding, Rachel is absolutely spoilt here at NWAS. She gets so excited when she sees me getting my uniform ready for work. I am just so happy at how everyone has welcomed us onto the team.

“I have break buddies to help with making hot food and one of my lovely colleagues kindly gives us a lift saving me a two hour pubic transport journey. I do love my work family!”

“We moved house and I began my cane training again, much to the joy of my son who thought the cane was a toy sword! I did struggle with the cane, especially while pushing the pram, so my trainer told me I would be better with a guide dog.”

“After two years I thought, you know what I’m not going to let this defeat me.”

“Everyone

“My environmental job role impacts what I eat”

According to researchers from the University of Oxford and the University of Minnesota eating a vegan diet could be the biggest way to reduce your environmental impact on the earth. They say cutting meat and dairy products from your diet could reduce an individual's carbon footprint from food by up to 73 per cent.

Your Call talks to Team NWAS’ Environmental Sustainability Officer Karen Aguilera whose environmental beliefs have led her to change to a plant-based diet.*

What is the best bit of your job?

I‘m involved in a range of unusual projects from improving biodiversity to reducing waste and designing and delivering the world’s first ambulance specific carbon literacy training.

I’ve always been environmentally conscious and as the NHS produces five per cent of the UK’s carbon emissions, it’s a huge challenge to be a part of. NWAS is leading the way on sustainable development which is important as it encourages others to catch up and join us on our journey to net

When did you start your vegan journey? It’s taken a few years to go fully plant-based. Initially I focussed on removing meat. I started with removing red meat a few years ago, then white meat a year ago and have been gradually switching out dairy and eggs for plant based alternatives over the first six months of 2020.

Why have you opted for a plant-based diet? I’ve wanted to tackle my diet for a long time as I believe agriculture has a lot to answer for when it comes to carbon emissions. Most animal products (meat, dairy, eggs) having at least double, but in many cases up to 20 times the carbon footprint of

For every kilogram of beef produced, around 60 kilograms of carbon is released into our atmosphere, this accelerates climate change which in turn has impacts on air quality, water availability and land degradation - three things that humans depend on for survival.

By eating only plant based food, a single person can save on average 800kg of carbon every yearfour times the impact of recycling or eight times the impact of using LED lighting at home!

What type of foods do you eat?

I eat a lot of lentils, beans, tofu and chickpeas, in addition to vegetables, fruit, nuts and grains

(cous cous, bulgar wheat, pearl barley, spelt). I usually eat wholefoods rather than processed but I do enjoy the Heck beetroot burgers when I don’t really want to cook!

Is your diet restrictive?

At first I found it really difficult but I was still thinking in the same way as when I still ate eggs, meat and dairy. Once I understood the requirements of eating a healthy plant based diet, I found it much easier and now find it liberating. I try a wider variety of foods that I wouldn’t have previously tried and it’s rare that I eat something that I don’t enjoy.

What effects has it has on your health and wellbeing?

From a health perspective I was already physically fit but I have much more energy and rarely feel bloated or ‘heavy.’ From a wellbeing perspective, I no longer feel guilty that I’m making a significant contribution to climate change and deforestation. With more and more research linking the consumption of animal products to preventable diseases, I also know that I’m now doing as much as possible to stay healthy for longer.

Do you have any tips for people considering going vegan?

Make the change gradually; change one item at a time rather than trying to do it all at once.

Start with the higher impact items like beef and lamb and then move on to pork and poultry, followed by dairy and eggs. It allows you tackle the biggest polluters first without feeling too restricted.

Remember to include all food groups google the ‘Eat Well Guide’ online. It’s not as simple as just dropping meat and dairy from your diet, you need to replace the protein with plant based sources (lentils, beans, pulses, tofu, seeds or even ‘fake’ meats).

Find a plant milk you like, in terms of environmental impacts, oat and rice milks have the lowest impacts followed by soya, hazelnut (almond milk isn’t very environmentally friendly). Be kind to yourself, it’s easy to slip up and think it’s too hard as there are a lot of products you would assume are vegan friendly but they may contain animal products. Some cereals contain beef gelatine but this is also true of the opposite, some products are accidentally vegan like oreos, most flavours of Bisto granules and most types of bread and pasta.

Instagram is also great source of inspiration!

*Please consult your GP or dietician before changing your diet as this may not be suitable for everybody.

Butterbean and corn quinoa

Ingredients

2 tbsp sunflower oil

1 medium onion, finely chopped

1 red bell pepper, finely chopped

1 stalk of celery, finely chopped

2 tsp smoked paprika (can use chilli powder if you like it spicy)

1 tsp garlic powder or 3 cloves garlic

¼ tsp salt

¼ tsp black pepper

2 cups vegetable/vegan stock

1 cup frozen corn

1 cup quinoa, rinsed

1 can (240g) butter beans (you can use other beans if you prefer)

1/3 cup chopped coriander

Method

1. In a large pan heat oil over a medium to high heat. Add onion, red pepper, celery, garlic and seasonings; cook and stir for 5-7 mins until vegetables are tender.

2. Stir in the stock and corn; bring to the boil.

3. Stir in the rinsed quinoa*, reduce heat and simmer for 12-15 mins.

4. Once the liquid is almost absorbed add the butter beans and stir to bring them up to temperature.

5. Add the chopped coriander and stir.

6. Serve on its own or place on a bed of fresh baby spinach and top with sautéed red cabbage.

*Top tip for rinsing the quinoa, place quinoa into a jug, add cold water and stir. Place a coffee filter into a funnel over a jug and pour the water and quinoa into it, the water will drain off without losing any quinoa