Your Call

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YourCall

ISSUE 03 Autumn 2018

Storming the streets with pride A nightmare with a happy ending

Liz’s story: Losing a child is unbearable

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www.nwas.nhs.uk

Welcome to the Autumn edition of Your Call

In this season’s edition of Your Call we bring to you a selection of stories that we hope you will enjoy reading; from apps and gadgets to help you feel fit, lower blood pressure, stop smoking and improve your health overall, to advice on back pain and epilepsy from our clinical team - there’s something for everyone.

As usual we feature real life stories from patients. On page four, Robert Marsden talks about surviving a cardiac arrest thanks to his neighbour, Geoff, who is a paramedic. On the subject of lives being saved, there’s great news from the British Heart Foundation who are teaming up with Microsoft and ambulance services across the country to map defibrillators which can be used to save lives in the future. Even better news comes from the government who have announced changes to the school curriculum that will see children learning life saving skills in school - it’s about time!

The tragic death of three year old Jessica Wallis is discussed by her heartbroken mum, Liz, on page 17. Jessica passed away when she got sepsis following a kidney infection.

Liz is working with us on an training video for our staff to raise awareness of the condition that kills 44,000 people every year in the UK. Celebrations for the 70th anniversary of the NHS have taken place throughout the summer.

We’ve had invitations for staff to go to various Royal events and services. Find out about a consultant paramedic’s day as a guest judge with celebrity food critics on page 14.

Elsewhere, the health regulator, Care Quality Commission, has inspected our services - we’re waiting for their report and will share their findings on our website when we have them.

Finally, we’re pleased to share with you that we’ve been filmed for BBC One’s Ambulance which is due to air in October. We’ll share more about our experiences of taking part in the next edition of Your Call.

Best wishes Communications Team communication@nwas.nhs.uk

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There’s an app for that!

From lowering blood pressure and cholesterol to tackling obesity and smoking, digital technology is transforming the way you can manage and improve your health.

Apps and other digital tools are effective ways to share your goals, get advice and support, or talk to other people who can inspire you with their experiences.

Wear it

Scan it

Many of us eat and drink too much sugar without realising it. The Change4Life Sugar Smart app lets you scan the bar code and food and drink labels to see how much total sugar they contain.

Move it

The NHS Couch to 5K plan is designed to get you off the sofa and running 5km in just 9 weeks.

Wearable devices are designed to automatically track things like your physical activity, sleep patterns, mood, and calorie intake.

These gadgets, which come in the form of wristbands, watches and earphones, can be a good option if you need a nudge and want information about your wellbeing.

Lose it

With up to 4 million downloads to date, the NHS weight loss plan has helped thousands of people with their weight loss goals. The 12-week plan is delivered through 12 fun and motivating weight loss packs, which include colourful food and activity log sheets.

Eat it

The One You Easy Meals recipes app is a great free way of helping everybody eat tasty healthier meals. Use it to search for easy calorie-counted recipes and keep track with the handy shopping list, which organises the ingredients you need by supermarket aisle.

This gradual running plan is a free and easy way of getting fitter and healthier, and has helped tens of thousands of people so far.

Flex it

The Strength and Flex plan is a five week exercise programme delivered through five podcasts. The plan is a fun way of improving your strength and flexibility, and getting you motivated to exercise regularly.

You’ll find links to the apps and trackers listed above on the NHS website - nhs.uk.

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Feature article

A midsummer’s nightmare with a happy ending A summer’s day turned into a nightmare for Robert Marsden, 43 from Freckleton, and his wife Rachel when Robert suddenly collapsed after a cardiac arrest.

Speaking about the incident Rachel said: “I didn’t know Geoff that well but we said hello in passing and I knew that he worked for the ambulance service.

Luckily, they live down the road from paramedic Geoff Hamriding and Rachel quickly ran to call him for help.

“I shot over as quickly as I could and banged on his door so hard to get him to come as soon as possible.

Geoff sprung into action and began CPR while Rachel dialled 999. Her call was answered by Emergency Medical Dispatcher, Frank Cerra, who sent Rachel to a nearby public access defibrillator.

Thankfully after four shocks from the defibrillator and ongoing CPR, Robert began breathing again and was rushed by ambulance to Blackpool Victoria Hospital, where he was given a stent procedure and allowed home just three days later.

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“It was an extremely frightening situation but Robert and I are so thankful to Geoff and the team at NWAS for saving Robert’s life. The work that they do is truly fantastic.”

Robert and his wife Rachel was able to reunite with Geoff and call handler, Frank, at Lytham Ambulance Station where they thanked the team for their actions.

Paramedic Geoff said: “I was shocked when Rachel banged on my door, it was really lucky because I had just got home from being out but I didn’t hesitate to rush and help.

“Early CPR and defibrillation is vital as every single second counts in saving a life!”

Robert and Rachel live just a stone’s throw away from the nearest public defibrillator and by dialling 999 they were able to get the access code and information from the ambulance service about how to use it.

Emergency Medical Dispatcher Frank said: “Rachel was so calm and collected on the phone, it’s an extremely traumatic experience for anybody to go through but by staying calm and listening to my instructions we were able to quickly get the defibrillator and give Robert the best possible chance.

“As a call handler, it’s very rare for me to get the chance to meet our patients. It’s amazing to see Robert so fit and well.”

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Lifesaving skills to be part of the school curriculum Lifesaving first aid is set to be part of the national school curriculum in plans announced by the Department for Education which will come into force from 2020.

The plans say that pupils should know basic treatment for common injuries, life-saving skills including how to do CPR and the purpose of defibrillators and when one might be needed.

Our Community Engagement Manager, Andrew Redgrave said: “This is excellent news for the country and will create lifesavers in the future.

“Currently, less than one in 10 people survive a cardiac arrest (out of hospital) in the UK, but evidence suggests that one in four could survive if young people were trained in CPR skills.

“In 2015, we were lucky enough to host an event at the House of Commons for all MPs, Lords and partner organisations to share our vision of educating the public about CPR and defibrillators, to ensure the UK has the best survival rates in the world for out of hospital cardiac arrests.

“Following the event, there was a parliamentary debate about the subject, the prime minister at the time sent a letter of support to our trust and the government provided funding for defibrillators for public places.”

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Defibrillator map will save lives The NHS, British Heart Foundation (BHF) and Microsoft are working together to map life-saving defibrillators so they can be made readily available for every out-ofhospital cardiac arrest in the UK. Defibrillators are small machines which can ‘shock’ a person’s heart into restarting after a cardiac arrest.

If this can be done in the first few minutes, patients have a 60-70 per cent chance of making a full recovery.

They are easy to use, easy to carry and they won’t deliver a shock unless it is required.

NWAS already holds a list of defibrillators but we estimate there are thousands that remain unknown and hidden in businesses, hotel chains, factories, shopping centres and smaller organisations such as social and sports clubs and schools.

There are over 30,000 out-of-hospital cardiac arrests every year in the UK, but less than 1 in 10 people survive.

In countries where the public are better equipped to recognise and deal with cardiac arrests, survival rates are up to three times higher.

The national defibrillator database will launch in spring 2019, but defibrillator guardians in the North West can register their lifesaving devices with us now at nwas.nhs.uk.

Body coach brunch The Body Coach, Joe Wicks, is a man on a mission to rescue people from the dieting industry.

Joe said: “I’m sick and tired of people struggline on low calorie diets... These banging sweetcorn fritters with avocado and chilli are so good - perfect for breakfast or brunch.”

Ingredients 20g plain flour Pinch of smoked paprika or chilli powder 1 medium egg 1 egg white 135g tinned sweetcorn (drained weight) 65g soy beans 40g spring onions, finely chopped Salt and pepper 1 tsp olive oil 40g avocado, sliced 40g yoghurt, such as Greek, natural, soy Small bunch of chopped coriander

Method Put the flour, smoked paprika or chilli powder, egg and egg white into a food processor then add the sweetcorn, soy beans and spring onions. Season with salt and pepper then pulse to a rough paste, leaving some pieces of sweetcorn and soy beans for texture.

Heat the oil in a frying pan over a mediumhigh heat then drop large spoonfuls of the mixture into the pan. Fry for 2 minutes on each side until golden then transfer to a serving plate. Serve with the avocado, yoghurt, coriander and a pinch more smoked paprika.

Bon appétit!

Joe’s plan aims to give people the knowledge they need to get a healthy strong body without going hungry.

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Nurse Emma on back pain Back pain is very common and is one of the top reasons people ring us on 111 and, believe it or not, 999. Often there is no need for an emergency ambulance and the pain normally improves within a few weeks or months.

Senior Clinical Advisor Emma McGoldrick explains: “Pain in the lower back is particularly common, although it can be felt anywhere along the spine – from the neck down to the hips.

“In most cases the pain isn’t caused by anything serious and will usually get better over time.”

“To relieve back pain you should stay as active as possible and try to continue your daily activities, try exercises and stretches for back pain; other activities such as walking, swimming, yoga and pilates are good. You can take anti-inflammatory painkillers, such as ibuprofen and use hot or cold compression packs for short-term relief.

“Although it can be difficult, it helps if you stay optimistic and recognise that your pain should get better, as people who manage to stay positive despite their pain tend to recover quicker.

“Back pain usually gets better on its own within a few weeks or months and you may not need to see a doctor or other healthcare professional.

“It’s a good idea to get help if the pain stops you doing your day-to-day activities, it is very severe, gets worse over time or you’re worried about the pain or are struggling to cope.

“You can see your GP, who will ask about your symptoms, examine your back, and discuss possible treatments. They may refer you to a specialist doctor or a physiotherapist for further help.

“Often it’s not possible to identify the cause of back pain. It’s very rarely caused by anything serious.

“You should contact your GP or NHS 111 if you have back pain and numbness or tingling around your genitals or buttocks, difficulty peeing, loss of bladder or bowel control, chest pain, a high temperature, unexplained weight loss, a swelling or a deformity in your back or if it started after a serious accident, such as after a car accident.

“These problems could be a sign of something more serious and need to be checked urgently.”

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Feature article

Proud staff storm the streets The LGBT+ community comes together across the North West every summer to celebrate Pride and this year we’ve had fun flying the rainbow flag at events in Manchester, Liverpool, Blackpool and Chester.

A year later, marchers gathered in New York to celebrate ‘Christopher Street Liberation Day’, (refering to the address of the Stonewall Inn), which along with parallel events in other cities, marked the anniversary of a watershed moment in the history of LGBT+ rights.

Today’s Pride celebrations are a far cry from those that took place at the beginning of pride’s history, where parades were more like marches without the glitter, music and dancing that we see at modern celebrations.

An annual tradition was born and these days more and more cities across the globe stage their own carnivals and street parades to celebrate gay, lesbian and trans culture.

Pride’s history begins in the USA, where a month of activities take place each year remember the Stonewall Riots that broke out in New York City, in 1969, following a police raid of one of the city’s most popular gay pubs, prompting the regulars to fight back in protest.

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NWAS staff from the LGBT+ community and beyond take part in the North West’s Pride events.

As an employer that values diversity that’s something we’re super proud of.

This year, in the run up to Manchester Pride, we were honoured to host the National Ambulance Service LGBT Network’s third annual conference in Manchester.

Almost 200 people from the UK’s ambulance services joined together to hear from keynote speakers about leadership, there were also mental health, trans and cultural change workshops.

The conference provided professional development and insights into areas of learning for LGBT+ people working in ambulance services and about LGBT+ patients which is not typically provided elsewhere.

There have been huge strides in getting rights and fairer representation for LGBT+ people and Pride plays an important role in providing a platform from which the community can speak out against discrimination and prejudice. But there’s work to be done; more than 70 countries around the world continue to enforce homophobic legislation.

In NWAS, 244 people have declared their sexual orientation as lesbian, gay or bisexual (around 4%), a further 20% have not declared.

Our strong LGBT network supports us on our equality and inclusion work. Over the last 12 months this has included a Procedure for supporting trans staff and an LGBT history event.

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G’day mate, ambulance service

“The whole operation was very slick and professional, even though I didn’t know the postcode for my friend’s address. I was really impressed both by the response of the operators here and by the ambulance service over in Melbourne.

On Saturday 2 June, Luke McManus from Manchester made a particularly unusual 999 call…

“When the ambulance arrived at my friend’s house, nobody else was aware that anything was amiss. My friend’s wife and two kids were asleep in a different part of the house, they heard nothing, and it was around 1am local time there.

“During the course of a telephone conversation with my friend in Australia, I heard what I presumed to be an epileptic fit. He was verbally unresponsive.

“I had no means of contacting anybody close enough to help and I was the only person who was aware that anything was wrong.

“I remembered reading a news story some months earlier in which a UK 999 response centre was able to relay a message to counterparts abroad in an emergency situation.

“I phoned 999, figuring that if you couldn’t alert Melbourne directly you would probably know how I could get a message through to them.

“I need not have worried – the operators seemed able to liaise with colleagues in Melbourne as easily as if they were in Liverpool.

“He was found unconscious and cold outside with head injury. During the episode, he had fallen onto a stone surface and cut his head.

“The ambulance crew called me directly from Australia to ask me for details of what I had heard over the phone when the emergency arose.

“My friend is recovering now. He tells me that he has no memory of anything which happened between speaking normally with me on the phone and waking up in A&E. “We would like to pass on our sincere thanks. I could never have imagined that I would ever be involved in alerting an ambulance crew to an emergency on the other side of the world!”

What is epilepsy?

Your Call spoke to Advanced Paramedic Jon Strivens about the common condition that affects the brain and causes frequent seizures.

A seizure happens when there is a sudden burst of intense electrical activity in the brain. This causes a temporary disruption to the way the brain normally works and has a wide range of symptoms.

Jon said: “Epilepsy can start at any age, but usually starts either in childhood or in people over 60. It’s often lifelong, but can sometimes get slowly better over time.

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Chefs celebrate NHS

The BBC’s Great British Menu returned to screens this summer with more top class cookery and even better judging in the form of our very own Dan Smith, Consultant Paramedic, who appeared in an episode that aired on Friday 7 September 2018!

This series is celebrating the 70th anniversary of the NHS, with chefs cooking celebratory and heartfelt dishes in tribute to the heroic staff in the service. In charge of picking the perfect four course menu are judges Andi Oliver, Oliver Peyton OBE and Matthew Fort.

The series will end with a banquet at the Great Hall of Britain’s oldest hospital – St Bartholomew’s in the City of London. The competing chefs will be tasked with producing a four-course menu that celebrates the National Health Service, with the

Dan (second from left) with the judges banquet attended by a cast of NHS heroes from around the country.

Each week, the three expert judges are joined by a special guest to decide the winners of the regional heats. Dan was invited to take part as he was one of the first paramedics on scene at the Manchester Arean bombing.

Other guest judges include Jenny Turner, Britain’s longest serving nurse, Aneira Thomas, the first baby born on the NHS and Dr Rangan Chatterjee from BBC’s Doctor in the House.

This year for the first time ever one outstanding chef will be crowned the champion of champions when banquet diners vote on their favourite dish in the final episode.

“Seizures can affect people in different ways, depending on which part of the brain is involved.

“Sometimes the person might pass out and not remember what happened.

“Possible symptoms include uncontrollable jerking and shaking – called a fit, losing awareness and staring blankly into space, becoming stiff , strange sensations such as a rising feeling in the tummy, unusual smells or tastes, a tingling feeling in the arms or legs and collapsing.

“Call 999 for an ambulance if someone is having a seizure for the first time, has a seizure that lasts more than five minutes, has lots of seizures in a row, has breathing problems or has seriously injured themselves.

“Epilepsy is usually a lifelong condition, but most people with it are able to have normal lives if their seizures are well controlled.”

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If you could see flu germs, you’d see how quickly they spread.

Cold and flu germs can live on some surfaces for hours. To protect yourself and others this winter, always carry tissues with you and use them to catch your cough or sneeze. Bin the tissue, and to kill the germs, wash your hands with soap and water, or use a sanitiser gel. This is the best way to help slow the spread of flu.

For more information visit www.nhs.uk/staywell Catch it. Bin it. Kill it.

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Caring for patients with Michelle Urgent care practitioners are new to our ambulance service. The role was launched in June as part of our Transforming Patient Care programme, recognising that many patients who call 999 don’t need emergency hospital treatment but would benefit from care and support at home.

After giving him some paracetamol, getting him near a cold fan and increasing his intake of water, his temperature came down to a safe level of 37.4°C within 40 minutes. Following our visit he took himself to a walk-in centre where it was discovered he had a throat infection and was prescribed antibiotics.

Practitioners split their time between working on the Clinical Hub providing support to patients over the telephone (known as hear and treat) and on the road in a vehicle equipped to support patients on scene (known as see and treat).

“A face-to-face assessment like this allows us to reinforce advice that would be given over the phone. This is a great example of how see

We asked Michelle, pictured with Clinical Hub colleage Tim, to tell us about the ‘see and treat’ aspect of her role.

A typical day:

“There is no typical day! I love being out on the See and Treat vehicle attending to patients. Staff in our Emergency Operations Centres identify non-emergency calls suitable for assessment, and these are the ones we go out to.

“A common misconception about Urgent Care Practitioners is that we mainly go to falls but this isn’t the case, we go to a wide variety of jobs where the patient most likely doesn’t need to go to hospital.”

Can you give us an example of how your role has helped a patient?

“One memorable job was when I went out to see a man with a very high temperature of 39.4°C. When I arrived and assessed him I discovered that he hadn’t taken any paracetamol yet.

and treat works to free up ambulances to go to genuine emergencies.”

Favourite part of your job?

“My favourite part of being an Urgent Care Practitioner is helping patients get the right care closer to home. Prior to joining the ambulance service I was a district nursing sister so it’s great to actually see patients face to face! It gives me the opportunity to utilise my previous knowledge and skills to enhance the patients’ experience and reinforce the availability of alternative and more appropriate services closer to the patients’ home.”

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y l u r t s i d l i h c a “The loss of unbearable”

Feature article

Liz Wallis talks about the heartbreak of losing her three-year-old daughter, Jessica, to sepsis.

My week began like any other week. I worked from Monday to Wednesday and looked forward to spending the end of the week with my two children, Jessica, aged 3 and Poppy, seven months.

I rang 111 and asked for advice. They told me to make an appointment when my GP surgery opened. Jess was diagnosed as having an upset tummy. I was told to go home, to use Calpol to control her temperature but other than that there was nothing to worry about.

As the day went on Jess did not get any better. The sickness turned to diarrohea. She didn’t want to be cuddled or even touched.

Thursday was lovely - Jess spent most of the day in the garden with her Great Grandad building a wall round the patio.

The doctor asked me to get a sample of urine from her but I couldn’t because she wasn’t able to produce any.

I was surprised on Friday when early in the morning Jess woke up screaming with a high temperature. She came into our bed and asked for a drink of milk. As soon as she drank it she was very sick.

She was getting worse and looked blue around the mouth, she had no energy, was very lethargic, and just kept lying on the floor so I rang the GP again and saw him at 3.30 pm.

Once again the doctor told me not to worry, but Jess got worse. She was very sleepy and her eyes were rolling. Now I was extremely worried. I rang an ambulance. She wanted me to carry her to the ambulance so I did. She was laid down in the ambulance with all the monitors on her.

The thing that stands out to me at this point was that they were trying to get blood out of her and they couldn’t do it. I insisted they kept trying. Looking back on it, I think her body was shutting down at that point.

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All the way there the paramedics were really nice. They said this happens and we’ll get sorted when we get there. They put my mind at rest a little bit.

When we saw her next she had developed a rash and her little body was beginning to swell with the amount of fluids they had pumped into her.

At hospital Jess wouldn’t allow the staff to do the usual routine observations so she was put into a cubicle. She was deteriorating in front of our eyes and I went and asked for a doctor to come and examine her.

The next day, Saturday, Jess was put onto ECMO to give her heart and lungs a rest and allow her to get the most from the antibiotics. Sunday was quiet and seemed a bit more positive. However, after a brain scan on the Monday we were told that there was nothing more that could be done for Jess.

She was very dehydrated and immediately was given fluids and antibiotics. She was still speaking to us but most definitely was not our usual Jess.

The paediatric consultant came to see Jess and immediately said: “I don’t know how I’m going to turn this around”.

Lots of tests were done… Jess had Sepsis, cause unknown. I was shocked. I thought she would go to hospital, get some fluids and be going home. Instead she was taken to resus and put on a ventilator and arrangements were made for her to go to the Children’s hospital.

Jessica said ‘Mummy I’ve had enough. Give me a kiss.’

She suffered a cardiac arrest in front of us whilst being prepared for the journey and it took many hours for the team to stabilise her.

At the children’s hospital Jess went into the Paediatric Intensive Care Unit where she was put onto full life support.

She was gone.

When the life support machine got turned off she died within a minute. I didn’t go back in the room after that but my husband went back in and dressed her.

All this happened to what had been a healthy little girl from Friday to Monday.

Tissue sampling eventually showed Jess had had had a kidney infection. She had never complained until that Friday morning. A simple kidney infection which, if it had been treated appropriately, could have saved her life.

Jess had a fast heartbeat, her skin was bluish, she was very lethargic, and she had not been able to pass urine all day.

The symptoms were there but no one recognised them as being important.

I wish I had known then what I know now.

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“NHS should prescribe dogs to keep over-65s fit” That was the headline in a recent newspaper article, prompted by the results of a new study with the rather unsurprising finding that older adults who own dogs walk more than those who don’t.

The study included around 80 adults with an average age of 70 from three regions in the UK, half of whom owned dogs. They wore activity monitors for three one-week periods spread over the course of a year.

Dog owners walked around 22 minutes longer each day and were more likely to meet physical activity recommendations of 150 minutes of exercise a week.

It seems plausible that owning a dog directly causes people to go out and walk when they wouldn’t otherwise do so.

But you can’t rule out the possibility that people who lead more active lifestyles – and so would be active anyway – are more likely to have a dog. Similarly, people with chronic health conditions may be less likely to care for dogs.

Although the Mail’s coverage was accurate, the suggestion that the NHS should prescribe dogs to older people perhaps oversteps the mark.

Of course, not everyone wants or can have a dog. But that doesn’t mean you can’t fit exercise into your life – you just need to stick to a routine.

Current public health guidelines recommend taking at least 150 minutes of moderate aerobic activity like cycling or fast walking every week, and strength exercises on two or more days a week.

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#TeamNWAS

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

Celebrating NHS 70 We firmly believe that any good celebration must include cake, so to celebrate 70 years of our extraordinary NHS on 5 July, we gave our staff a treat for all their hard work and dedication with some birthday cake. The sponge and buttercream cupcake was design by a member of staff and funded by our charity. Staff tweeted their appreciation using #HaveYourCakeAndTreatIt - check out the photos online. #NWASinBurnley We hosted our Annual General Meeting and Health Fair at Turf Moor Stadium; home of Burnley Football Club on 13 September. It was great to showcase our work and that of partner organisations to stakeholders and local people including 100 school children who were delighted to see our mascot, Pandamedic, flexing his moves in the Yoga zone!

Councillor Charlie Briggs, the Mayor of Burnley, came down to talk to everyone exhibiting and BBC Radio Lancashire broadcast live from the fun filled event throughout the morning.

Behind the scenes in the emergency operations centres Throughout August our social media featured various people working within our emergency operations centres; from 999 call handlers to mental health practitioners and pharmacists giving advice over the phone, the #IAmNWAS campaign gave followers a unique look into the amazing work of the teams that answer around 5,000 emergency calls every single day!

Keep an eye on our social channels over the next couple of months as we’ll be asking for your support to stop abuse of ambulance crews.

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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