Your Call - Issue 9

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YourCall

ISSUE 09 Spring 2020

We hit the NTAs 2020 year of the nurse and midwife

We explore childhood anxiety www.nwas.nhs.uk

Aidan, we’re #proud of you

Welcome

Teenager Aidan Jackson from Widnes, Cheshire was just 12 years of age when he first started fundraising. Five years later, he’s raised over £50,000 for charities and good causes.

to the spring edition of Your Call

Now aged 17, Aiden has been channelling efforts over the last 18 months to raise money to place lifesaving defibrillators across Runcorn and Widnes.

He’s now on defibrillator number 14 with each one costing approximately £1,600.

A new season always brings about change and we can’t think of a better time of year than spring to try something different. Whether it’s a new hobby, learning a new skill, helping somebody in need or joining our patient and public panel, the positive affect on your mental health is immeasurable. Give it a go, we dare you!

It’s good to see so many people prioritising being kind in the face of bullying, whether it is online or face to face – we’ve all seen the tragic impact of not being kind. Inside we take inspiration from Gail in our NHS 111 team who practices a random act of kindness every shift she works on. We also talk about Jesy Nelson’s documentary Odd One Out, which explored the impact of cyberbullying and we give advice on what you can do if you’re feeling unable to cope.

We meet teenage social media fundraising phenomenon Aidan and find out what he’s been up to. We feature exclusive interviews with our Chief Nurse Angela Hansen and Deputy Chief Executive

Michael Forrest about what it means to them to lead one of the biggest ambulance services in the country.

We’re seeing an increased amount of calls to our NHS 111 service relating to Coronavirus. You can read more information on how you can play your part.

We’ve recently had a visit from the Care Quality Commission – it was a great time to show the brilliant work of our staff and the compassionate patient care we provide as well as sharing lessons learnt.

Finally, in the name of change, we’re looking for guest writers for Your Call. Whether you’re a member of the public, patient or staff member, if you have a story to share and want to get involved please email: communications@nwas.nhs.uk Enjoy!

Communications Team

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Respect and Dignity

Everyone Counts

Commitment to Quality of Care

Compassion

Aidan was diagnosed with ADHD and has Asperger’s Syndrome. More recently he’s been diagnosed with epilepsy, yet he’s never let his disability affect his fundraising. He’s raised funds through raffles, collection tubs, online donations and donations from local businesses. His many challenges have included a mile of pennies, sponsored walks, swimming the distance of the English Channel crossing in a pool, raffles, car boot sales, carol concerts in his front garden and craft stalls.

We invited Aidan to our regional office based in Speke, Liverpool and he shared with us the reason why he does it.

“The more life-saving machines available in our communities the better. I’m always asked how important community defibrillators are and each time I give the same answer – they’re extremely important as anyone can use them.

“By performing CPR and using a defibrillator, you’ll give someone the best possible chance of survival, but there isn’t always a defibrillator close enough

Our shared values Working Together for Patients

Aidan started fundraising after close friend Olivia Walker passed away in 2014. Her family set up a foundation in her memory to provide specialist medical equipment to children.

to help save the life of someone having a cardiac arrest. I hope that my fundraising means that lives will be saved.”

Dave Kitchin, Head of Service for Cheshire and Merseyside said: “When you meet somebody from our community who is so dedicated and committed to making a difference, it’s inspiring. We can’t thank Aidan enough for the work that he’s been doing in his local community and we know that the equipment has already been used and no doubt will save lives. Well done Aidan!”

Donations can be made via PayPal to caz1971@hotmail.com or www.justgiving.com/ crowdfunding/aidanjackson

Fact about Aidan At the start of 2020, Aidan was playing a game on his computer in his room against a girl in Texas, America when he had a fit and became unresponsive, unbeknown to Aidan’s parents sitting downstairs.

The girl somehow found a contact number for Cheshire police, called it, they then rang an ambulance. Aidan’s parents heard the ambulance and the crew treated Aidan with the story making global news! Aidan recently went to New York and reunited with the girl who saved his life on a television talk show!

Improving Lives

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Feature article

“Good staff care leads to good patient care” Living by the philosophy of ‘treat other people how you want to be treated’, Deputy Chief Executive Michael Forrest talks to Your Call about his priorities for the trust and his passion for supporting staff who are always at the centre of everything we do.

Michael started in human resources when he secured a trainee human resources advisor role at Tameside Council, where he stayed for almost 30 years working his way up to director level.

Ready to take on a new challenge, Michael joined the ambulance service in 2012 as the trust’s head of organisational development and a year later became the director of organisational development, before becoming the deputy chief executive in 2019. In 2018 he took up post as interim chief executive for nine months. During this time he managed a successful CQC visit and led a campaign calling for the public to ‘get behind 999’ and help stop abuse towards emergency services workers.

Michael said: “It was an extremely proud moment and a privilege for me to step up as chief of the trust. For me it is all about the staff, nothing gets done without them and my passion has always been to support our people, develop them and make sure we help them to be the very best they can be.

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“I learn from listening to staff and taking on board their experiences. This has led to the development of a number of award winning initiatives including ‘Women in Leadership’ aimed at empowering our female leaders, and ‘Invest in Yourself’ which involves dedicated web pages for staff with advice and information about being happy, fit and healthy. The pages have examples of wellbeing, podcasts and counselling information. We want to continue our focus on staff care. Good staff care leads to good patient care.”

Michael’s current priority is working together with our CEO to implement the trust’s strategy and deliver on our promise to be the best ambulance service in the UK. Looking to the future, Michael sees the trust growing and developing even further with more integration with other services and healthcare professionals including pharmacists, mental health workers and physiotherapists to help bring the right care closer to home for our patients.

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Rubbing shoulders with celebs!

Stand out from the crowd

Four lucky staff from our BBC One documentary Ambulance were invited to walk the red carpet at this year’s National Television Awards, hosted

by David Walliams.

The documentary which focused on the work of our service was nominated in the factual entertainment category. Sadly, on the day a win wasn’t meant to be.

Pop star Jesy Nelson’s Odd One Out documentary took home the award. Nevertheless, our team came home with great memories and a few star-studded selfies!

Gene Quinn, Sajid Ali, Sam Payne and Alex Lyons, who were all involved in the series, joined production company Dragonfly at the event. All dressed to impress as they rubbed shoulders with TV’s greatest.

New seasons mean new challenges. Why not join our panel members from all over the North West who are helping to shape our future? If you’re looking for a career in health care, fancy trying something new or want to give back to your community, joining our panel may just give you that edge to stand out from the crowd.

We have three levels of involvement to suit your lifestyle: Consult – you can respond to surveys, give feedback on publications, initiatives and strategies online from the comfort of your own home.

There is no need to travel anywhere.

Odd one out?

Coronavirus

Jesy Nelson’s documentary, Odd One Out, explored the impact of the cyberbullying she was victim of after she found fame with the band Little Mix on X Factor in 2011.

Her dream of becoming a pop star had come true, but a nightmare had begun. She received comments and messages from online trolls who criticised her weight and face, and cruelly told her that she did not deserve to live.

Jesy could barely watch footage or look at photos of herself from that time. They made her miserable, constantly questioning herself and struggling with her self-esteem. Eventually, she attempted to end her life.

The death of Caroline Flack, who sadly took her own life in February 2020, raised similar issues but with the media in the spotlight. Fans of the TV presenter called for a boycott of celebrity gossip magazines and, in a show of empathy, #BeKind was trending on social media.

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You will no doubt be aware of the substantial media coverage relating to COVID-19, commonly known as coronavirus.

According to the Samaritans charity, signs you may be struggling to cope include a lack of energy or feeling tired, finding it hard to concentrate, feeling restless, agitated, tearful and wanting to cry all the time, not wanting to talk to or be with people, using alcohol or drugs to cope with feelings and experiencing ‘burn out’.

When people are going through a tough time they often experience negative thoughts about themselves and feel they have no-one to turn to.

Even if you don’t have family or friends close by, you are never alone. Samaritans volunteers are available every day of the year, round the clock – call 116 123 or put your thoughts on an email to jo@samaritans.org for a response within 24 hours.

As an NHS organisation, we’re following all guidance from the Department of Health, and our own policies and procedures, in terms of responding to suspected COVID-19 cases. Our 111 staff have been working hard to answer calls from worried members of the public and we would like to thank them for the reassurance and advice they are offering during this challenging time.

The symptoms of coronavirus are a cough, high temperature and shortness of breath but these symptoms do not necessarily mean you have the illness. The symptoms are similar to other illnesses that are much more common, such as cold and flu.

Co-produce – you can join in meetings or discussion groups and give your opinions, experience and expectations to help us make improvements to our services.

Influence – you can take an active role in highlevel meetings and committees to help us with decision making and discussions.

Membership is open to anyone who lives in Greater Manchester, Merseyside, Cheshire, Lancashire, Cumbria or Glossop who isn’t currently employed

by NWAS and is 16 or over. Applications are welcome from people of all backgrounds, beliefs, cultures and circumstances to ensure the panel is representative of the communities we serve.

Find out more information about the panel: www.nwas.nhs.uk/panel.

How to avoid catching or spreading coronavirus: • wash your hands with soap and water often – do this for at least 20 seconds • always wash your hands when you get home or into work • use hand sanitiser gel if soap and water are not available • cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze • put used tissues in the bin straight away and wash your hands afterwards • try to avoid close contact with people who are unwell NHS 111 has an online coronavirus service that can tell you if you need medical help and also advises you what to do - 111.nhs.uk/covid-19.

Stay informed with latest Government advice and information: www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public

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Your pharmacist has your back CORONAVIRUS: PUBLIC INFORMATION The Government and NHS are well prepared to deal with this virus.

You can help too.

The best way to protect yourself and others is: Wash your hands with soap and water, or use a sanitiser gel, regularly throughout the day.

Catch your cough or sneeze in a tissue, bin it, and wash your hands.

If you have recently arrived back from specified areas follow the returning traveller advice.

Check the list of areas and find out more at nhs.uk/coronavirus

Need a repeat prescription at the drop of a hat? Want a consultation for a minor ailment? Your pharmacist has your back!

Simply call 111 and answer a few questions.

They can make a digital referral to a convenient pharmacy, where you can go to get advice and treatment for a range of minor illnesses, or for an urgent supply of a previously prescribed medicine.

Should you need to be referred to an alternative service the pharmacist can arrange this.

Pharmacists have fantastic skills and medicine knowledge, making them the right choice for minor illnesses. These additional services help to alleviate pressure on GPs and emergency departments.

The 111 service in the North West, which we provide, refers more patients to pharmacists than anywhere else.

Health Advisor Alex Bailey said: “Having this help available for our patients means more people are getting the care they need closer to their homes and are being seen quicker.

“To access these services you have to go through a 111 assessment first so we can ensure that this is the right place for you.”

9 out of 10 people live less than a 20-minute walk away from their local pharmacy.

Your pharmacist is specially trained to spot any interactions between different types of medication, and understand the potential side effects, in order to give the best advice possible.

Did you know?

You can be seen by your pharmacist for; acne, allergic reactions, ear ache, failed contraception, headaches, limb and joint injury, pain and swelling, skin rashes, sore throats, tiredness, vomiting, wound issues and many more!

Do you follow our Instagram?

From April 2020, we’ll be handing over the reins to our people to give you an insight into what we do.

You’ll see what we get up to across our patient transport services, NHS 111, paramedic emergency services and our support services - we may even give you a sneaky peak at what we get up to when we’re not at work!

If you fancy joining our #TeamNWAS follow @nwasofficial. #YourCall

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Feature article

Chief Nurse Angela Hansen talks to Your Call about the role of nursing within the ambulance service.

2020 is the first ever global Year of the Nurse and Midwife Nurses and midwives make up the largest numbers of the NHS workforce.

They are highly skilled, multi-faceted professionals and 2020 is our time to reflect on these skills, the commitment and expert clinical care they bring, and the impact they make on the lives of so many.

Catching up with our Chief Nurse Angela Hansen, we talk all things nursing.

We’re taking strides in bringing care closer to home for our patients and one really important aspect to this is working together with other healthcare professionals, in particular nurses.

Having set up a nursing forum and implementing a Nursing and Midwifery Strategy for 2019/20, the role of nurses across the organisation is growing. Working within NHS 111, emergency operations centres and out on the road, they bring additional knowledge and skills which complement the service and help give our patients the right care for their needs.

Joining NWAS in 2018, Angela has more than 30 years nursing experience, having worked in a number of senior positions across different areas of the profession. Angela has a passion for nursing believing that it’s the best job in the world.

“There is a big place for nurses within the ambulance service and it’s really important that they are given a voice, which is why we set up

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the nursing and midwifery forum allowing our nurses to come together, exchange ideas and get professional support from each other.

“We’ve had some huge achievements including two of our nursing staff being commended by Chief Nursing Officer (CNO) for England, Ruth May who visited us in 2019 to present two CNO Silver Awards for Excellence in Nursing.

“Aligning our nursing strategy with the national commitments, we have been able to offer additional development opportunities for NWAS and looking to the future, we are hoping to expand on this further and offer even more innovative roles within the service for nursing staff.”

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Job of dreams!

Responding to your needs

Did you know that over 400 apprentices have been employed by NWAS since we became an ‘employer provider’ in May 2017?

Becoming an employer provider means that we are now able to deliver apprenticeships directly to our staff with internal training and assessments.

With each apprenticeship lasting around 12 to 15 months and staff being guaranteed a position in the trust upon completion, 139 apprentices have now successfully finished their course.

Rotational working for paramedics is a relatively new idea and one we piloted between 2017 and 2019. ‘Rotating’ means that every few weeks, a small group of paramedics switch between settings to use their skills to care for people in a variety of ways, rather than always responding in an ambulance to emergency incidents.

Our apprentices work across our clinical services as well as our corporate services including in ICT, communications, finance, learning and development and workforce development.

Some of our apprentices share their thoughts with us.

Paramedics have a unique role that crosses over healthcare, social care and public safety. The role has developed considerably in recent decades and today, paramedics are responsible for providing patients with the right care, at the right time, in the right place, which will often involve care and support at home instead of emergency treatment and a trip to hospital. Recognising that paramedics are able to help patients in many ways sparked the idea of ‘rotational working’ in the North West.

Emergency Medical Technician Apprentice Clair Thornton joined in November 2019.

Emergency Medical Technician Apprentice Alex Dibden joined in November 2019.

Communications Apprentice Elena Winstanley joined in May 2018.

“I’m loving my role and learning all aspects of the job. The other apprentices are lovely and we get full training and support from our educators.

“I’m really enjoying the apprenticeship so far. Everyone has really bonded and become friends.

“I absolutely love my role as no two days are the same and I have learnt so much since starting. My colleagues have supported me throughout my apprenticeship which has helped me progress and has helped me develop my current skills. I would recommend an apprenticeship to anyone as you get a qualification at the end whilst gaining experience in your dream job.

“I’d say to anyone considering an apprenticeship in the ambulance service, go for it! Age doesn't matter - I’m 42 and now doing my childhood dream job. It is totally worth it and at the end of the day you are learning how to be a lifesaver.”

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“I’ve gained a better understanding of the role and have already found it really rewarding. You get lots of support from educators, get paid to learn and have a guaranteed job at the end!”

“You’re never too late to start one so apply for the one you’ve got your eye on and join the thousands of people that have benefited from this amazing scheme across the country.”

Our rotational paramedics spend some of their time working on an ambulance, some of their time in the clinical hub assessing patients with less serious conditions over the telephone, and the rest in our emergency operations centre (EOC) alongside emergency medical dispatchers (EMDs), who take 999 calls, making important clinical decisions.

All three aspects of the rotational role help to ensure patients get the right care for their needs and don’t end up going to hospital if they can get the right care in the community. It also offers staff a chance to use their skills in different settings, adding variety to their role.

Rotational Specialist Paramedic (RSP) Nicola Griffiths based at Estuary Point, Liverpool chats to Your Call about her role.

“I assess patients with urgent and emergency conditions either at home or over the telephone making sure they get the right care. When I’m in the clinical hub I work alongside other healthcare professionals including pharmacists, nurses and mental health practitioners. We’re able to access alternative primary and community care pathways to ensure patients are receiving the most appropriate care. We also have telephone contact with ambulance crews on scene to offer extra advice and help them when it comes to decision making.

“When I’m in EOC, I focus on giving support to our EMDs to ensure we’re getting the best care and advice to our patients as quick as we can. When I work on the road, I’ll either be out in an ambulance or on a rapid response vehicle helping patients or making referrals into other community resources.”

What’s your favourite part of your job?

“My favourite part of this role is the variety it brings. I personally feel this helps keep me motivated and interested, improving job satisfaction and quality patient care. I still really enjoy working as a frontline paramedic and wasn’t ready to leave that role all together.

Rotational working allows me to continue with this, however makes my role more sustainable in the long run. I certainly enjoy having a break from working outdoors in cold, wet weather at 3am in the morning!

“It’s also a great way to enhance my skills in assessment and treatment, I’m learning new things to further develop my clinical knowledge and I’m challenging myself with something new!” #YourCall

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Heaven isn’t ready for him yet!

When a cardiac arrest occurs, every second counts, as 69 year old Tony Mckean from Liverpool knows only too well.

Last summer Tony was skipping at a church fair to amuse the local children, but it was far from fun when his heart stopped beating properly and he collapsed.

With no signs of life, a 999 call was made and the church’s trainee priest, Mario - who was on a sixweek visit from Malta - did CPR on Tony until the ambulance crew arrived.

A bystander doing CPR is essential as it keeps oxygenated blood pumping around the body’s vital organs to limit damage to them should the person recover.

Around 1 in 10 people survive an out of hospital cardiac arrest but where members of the public step-in and successfully resuscitate a patient before the ambulance arrives, three quarters of people survive and are discharged from hospital.

Get protected against measles

Tony was shocked with a defibrillator and taken to the Royal Liverpool Hospital where he spent a few days in a coma being looked after by the intensive

The Measles, Mumps and Rubella (MMR) vaccination is the safest and most effective way to protect you and your family against these diseases. Full protection requires two doses.

care team. He was later transferred to Broadgreen Hospital where he had an internal defibrillator fitted.

Now back home, Tony feels fit and well – in fact he’s keeping busy with volunteering and walking up to 20,000 steps a day!

Tony said: “A massive thank you to the paramedics Gerard Hughes and Darragh Carrighan who saved my life along with Mario who I’d like to see in a higher post – how about Archbishop!”

With members of the public able to make a real difference to the lives of people in their communities, we have launched our new ‘CardiacSmart’ accreditation scheme to celebrate and recognise those who actively help to increase survival rates from cardiac arrest. Find out more at nwas.nhs.uk/cardiacsmart.

For anyone not fully immunised, a catch-up vaccination is available.

Do you need that journey?

Ask the reception team for more information.

Did you know we take patients on a whopping 1.6 million non-emergency journeys across Cumbria, Greater Manchester, Lancashire and Merseyside each year?

Seven percent of these journeys are wasted as we’re not finding out about changes in people’s circumstance whether it’s due to the journey no longer being required, the patient being too poorly to travel or an appointment being changed.

www.nhs.uk/MMR

We’ve teamed up with Healthier Lancashire and South Cumbria Network (a network of local NHS organisations and councils who have teamed up to improve health and care in their local areas) to try and create awareness around this. Our new advice poster is being shared with hospitals across the North West. © Crown copyright 2019

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Rachel Keith, Nurse

We’re asking you or your friends and family who use our service, if you no longer need the journey for whatever reason, that’s okay, just please let us know as soon as possible so we can send the ambulance to somebody else. #YourCall

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Feature article

“It was only when I reached my 40s I got a clinical diagnosis of depression and anxiety. Looking back, my disorder has taken away things in life I won’t get back – I’d always wanted to be a nurse.

If I’d had the help back then that’s available now, I maybe could have had the career I’d always wanted.”

Maggie now uses her experience to help other people and shares her story with service users at the Recovery Academy, a project set up by Manchester Mental Health NHS Foundation Trust which provides a range of free educational courses and resources to help people with mental health and substance misuse issues.

Expert view

Bridie Gallagher, Clinical Psychologist from Manchester Mental Health NHS Foundation Trust works with young people in the specialist Child and Adolescent Mental Health Service.

“I was living in a scary film” For Maggie, 63, her crippling anxiety started when she was five years old and has stayed with her throughout adult life. Your Call explores childhood anxiety, a debilitating disorder.

It's normal for children to feel worried or anxious from time to time, such as when they're starting school or nursery, or moving to a new area. But for some children, anxiety affects their behaviour and thoughts every day, interfering with their school, home and social life. Most anxiety disorders in childhood do not persist (anxiety is common in childhood) but most adults with clinical anxiety started to have problems in childhood. Teenagers with an anxiety disorder are more likely to develop clinical depression, misuse drugs and feel suicidal.

Last year our service responded to 72,407 patients with mental health-related conditions across the North West that included suicidal thoughts, self-harmed, overdosed and misused drugs.

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Maggie’s story

“My mum had learning disabilities and suffered anxiety and depression from a trauma that happened in her childhood. She leaned on me at an early age and I knew she was different to other mums as she would always cry and tell me she didn’t know how she was going to get through the day.

“When children feel scared they will do pretty much anything to not feel those awful anxious feelings in their bodies. Avoidance works well in the short term and they feel better, but then they never get to find out that the feared thing was not that scary and they could have coped with it just fine. Gently encouraging children to face their fears is a really helpful response.

“The main protective factor for good mental wellbeing is the presence of a consistent caring adult who listens and understands. This can protect a child who has an anxious temperament or who has to cope with trauma and adversity.

“This is why services often offer support to families instead or as well as the child or young person.

Professionals know that the family are best placed to offer the support and maintain positive change.

When children learn to manage their fears and worries early in life this sets them up to be able to cope with anything life throws at them.”

Symptoms of anxiety in children • finding it hard to concentrate • not sleeping, or waking in the night with bad dreams • refusing to go to school or do activities they usually enjoy • not eating properly • quickly getting angry or irritable, and being out of control during outbursts • constantly worrying or having negative thoughts • feeling tense and fidgety, or using the toilet often • often crying • being clingy • complaining of tummy aches and feeling unwell

Getting help • Start with an appointment with your GP who may refer your child to the local child and adolescent mental health service (CAMHS).

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If your child doesn't want to see a doctor, they may be able to get help directly from a local youth counselling service. For more information, visit youthaccess.org.uk.

• There are lots of great resources available by visiting: youngminds.org.uk.

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Books on prescription: “How to parent an anxious or depressed child” Sam CartwrightHatton or Overcoming Your Child’s Fears and Worries” Cathy Cresswell and Lucy Willetts.

“I developed anxiety worrying about my mum constantly and the things she would say to me.

My anxiety escalated into social anxiety and I couldn’t get out the door. I became paralysed with fear and I couldn’t function and do everyday things like go to school and it didn’t leave me.

My mum continued to suffer which only prolonged my suffering. I remember being ten years old and I couldn’t open my eyes - I was petrified of the world around me. I felt like I was living in a scary film that I couldn’t escape from and nobody around me understood.

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An act of kindness Gail Southern Health Advisor at our NHS 111 service enjoys baking for her colleagues and brings in sweet treats nearly every shift that she works.

Gail, whose colleagues love her, has worked at NHS 111 since it started in 2013. Prior to this she worked at NHS Direct, starting in 2001 as a health information officer.

Gail said: “I have always baked. My mum used to bake when I was little so the tradition continued when I had my son, George, who is now 16.

People aged 65 and older have the highest risk of falling; around a third of people aged 65 and over, and around half of people aged 80 and over, fall at least once a year. Unaddressed fall hazards in the home are estimated to cost the NHS in England £435 million – a staggering amount.

“I love to bake, I don’t find it difficult, I just add it into my day. A little kindness goes a long way, you never know what a person is going through and sometimes a nice gesture is all they need, so I hope I can make someone’s day a little better with a piece of cake.”

Last year we attended to 91,285 patients who had fallen. While many of these are simply one off accidents, there are lots of people out there who are more vulnerable and susceptible to falling.

This could result in life changing consequences which is why it’s really important that we do all we can to help reduce the risk of further falls.

“I think (I say think because I do not eat cake) the favourite is lemon drizzle, but I also make mini victoria sandwiches which seem to go down very well!”

One scheme that is going from strength to strength to try and tackle this is our joint Falls Response Service in which dedicated falls response cars provide specialist emergency support to people aged 65 and over who have fallen at home or in residential or nursing care.

Gail wanted to share her lemon drizzle recipe to share the love:

Lemon Drizzle Cake Ingredients Cake:

6oz butter 6oz sugar 8oz self-raising flour 2 eggs Zest of 2 lemons Lemon and sugar topping: Juice 2 lemons 2-3 oz of sugar

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“Getting help to people who fall at home”

Method

Mix all the ingredients in a large bowl, add a little milk if too dry. Pour into lined baking tin, you can use a small roasting tin and bake on gas 4 or 160 fan for approximately 45 minutes until golden.

Meanwhile juice the lemons, if you roll them first with your hand on a chopping board you will get more juice. Pour the juice into a jug or cup and add the sugar.

Take the cake out of the oven and when it’s still hot, pour the lemon and sugar mixture over the cake and leave to cool.

Currently operating in East Lancashire, Liverpool, St Helens and Southport, the service is a partnership between NWAS, hospital trusts or CCGs in the respective areas. It sees the collaboration of a paramedic and an occupational therapist who respond to non-life threatening 999 calls for falls so that patients can be treated at home without having to go to hospital or can be referred to an appropriate community service.

“In January this year, 82% per cent of the patients we treated remained at home many of which were referred onwards to community teams and specialist nursing teams.

“Taking people who have fallen to hospital isn’t always the right place for them to go so we’re getting people who fall the help they need at home to prevent them falling again.”

Across the North West there’s a considerable number of schemes that our clinicians can refer patients to who have fallen, providing they have given consent, that aim to help patients who are at risk of falls. All of our frontline staff are educated in the importance of this long term to maintain their patients’ health and wellbeing.

The East Lancashire and Blackburn with Darwen service in partnership with East Lancashire Hospitals NHS Trust has been running the longest and has just celebrated its fifth birthday.

Paramedic Gail Smith who has worked on the car from the beginning says: “We give each patient a medical assessment and an occupational therapy assessment so we see what factors have contributed to their fall both in terms of their health, activities of daily living and their home surroundings.

Love for the falls team from colleagues.

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#TeamNWAS

Our social media accounts are bursting with news. Follow North West Ambulance Service on Facebook, Twitter, Instagram and YouTube.

Top Gear triumph

Cheshire-based paramedics Christopher Evans and Dave Stubbs and Senior Paramedic Team Leader Steph Smith, recently featured on the BBC Two programme Top Gear as part of a special emergency services episode. They represented the ambulance service as part of a ‘blues and twos challenge’ fighting it out in a series of driving contests in a bid to be crowned the winners against teams representing the fire and police. They won, congratulations!

Happily ever after storybook

We’ve been educating children on when they should call 999 through our Happily Ever After storybook. Stories such as Snow White and the Seven Dwarfs have been given a modern twist in the book, written by Mathew Owen and illustrated by Emmeline Pidgen, which is available to primary school children across the region.

By educating children early on, we hope they'll gain the knowledge they need to act responsibly and with due care should they find themselves in an emergency at any point throughout their lives. Visit nwas.nhs.uk to access the book and lesson plans for teachers.

Breaking barriers

We’re all about promoting and developing a diverse and inclusive environment for our colleagues and patients and so we’ve signed up to the national NHS Rainbow Badge Scheme.

This is a key commitment of our LGBT Network and we aim to actively break down barriers for people who identify as LGBT+ and demonstrate that we are inclusive of all identities, regardless of how people identify themselves.

A thank you means so much

So many grateful patients and families from all over the North West who had their life saved by one of our ambulance crews contacted us to be a part of our #ThankYouNWAS campaign.

Your stories helped us to show appreciation to our colleagues as well as highlight real life examples of people who have received life-saving intervention. This positively reinforced our message that the ambulance service is here for emergencies – so thank you!

If you want to thank our staff in our Patient Transport or NHS 111 services, please email: communications@nwas.nhs.uk.

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