Your Call Magazine Winter 2018

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YourCall

ISSUE 04: Winter 2018

BBC Ambulance documentary takes viewers on emotional rollercoaster Plea to people who waste ambulance time

Enough is enough #GetBehind999

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www.nwas.nhs.uk

Welcome to the Winter edition of Your Call

Blimey! We can’t believe it’s this time of year already and our final edition of Your Call for 2018. We would like to wish all of our readers a very merry Christmas and a happy new year.

To end 2018 on a high, we received number of awards for our volunteer recruitment and winter public engagement campaigns (excellent news for our team - see photo of shiny awards above!) and staff health and wellbeing initiatives.

2018 has been another memorable year for us; we saw our Chief Executive Derek Cartwright take his retirement after 30 years’ service, celebrated 70 years of the NHS, underwent a testing CQC inspection, launched our charity and let the cameras join us for the BBC Ambulance documentary.

We look forward to 2019, with some exciting appointments in our senior team, and of course we will bring you more of the stories behind the headlines in Your Call. If you have any comments to make about the magazine, or have a story to contribute, please get in touch at communications@nwas.nhs.uk.

We have also introduced a number of new initiatives to support patients to receive the right care closer to home to help reduce avoidable hospital attendances and admissions, which are already proving successful.

Finally, it is the busiest time of the year for our service and our dedicated frontline colleagues work ever so hard whilst the rest of us get to spend time with our families, so please make the right call - for life threatening emergencies it’s 999, but for anything else please think about where else you can get help.

We were also delighted to learn that the Department for Education plans to make lifesaving first aid part of the national school curriculum from 2020, as noted in a previous edition of Your Call.

Best wishes Communications Team communication@nwas.nhs.uk

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Outstanding work by ambulance crews helps us achieve ‘good’ rating North West Ambulance Service was rated ‘good’ following the latest Care Quality Commission (CQC) inspection in Summer, during which inspectors found caring and respectful frontline ambulance staff, holding the hands of patients who were scared and acting with compassion.

Outstanding practice was noted by CQC where community specialists worked as members of teams with community and mental health nurses, teachers and in care homes on preventative measures aimed at reducing the number of admittances to emergency departments.

In our emergency operations centres, CQC found staff showed compassion, kindness and respect towards callers and patients, including those in mental health crisis.

All ambulance staff said they were proud of their profession and CQC said this was reflected in them providing good quality care.

Alongside ratings for our core functions, CQC asked ‘is the service well-led, safe, effective, caring and responsive?’ NWAS was rated ‘good’ in all areas.

Interim Chief Executive, Michael Forrest, said: “We are delighted with a ‘good’ rating from the Care Quality Commission which we feel reflects the way we deliver services for patients and values the dedication of our hardworking staff who work under ever increasing demand.

“CQC said that our staff are proud to work for the organisation, and we’re extremely proud of them too! We are thrilled CQC noticed the high levels of care by our frontline staff, where patients were treated with respect and compassion.

“There’s still a lot of work to do to achieve our aim of becoming the best ambulance service in the country, but this rating assures us, and the people we serve in the North West, that we’re heading in the right direction.”

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Feature article Article

Crews become stars of BBC Ambulance documentary

Episode one of the award winning BBC documentary ‘Ambulance’ introduced us to real-life couple Andrea and Glynn Hardy who met and fell in love while working together as paramedics.

The case particularly resonates with Andrea, who tells the camera about the tragic loss of her mother when she was just 19.

Andrea spent the most-part of her career working as a sales manager. Following a bad day at work, she was told something that stuck with her – ‘It’s not a matter of life or death’.

“My mother was 38 when she came down with a sudden headache,” she says. “She died from a brain hemorrhage six hours later. I just wish that my mum had got to be an old lady and that we could have had the worries about nursing homes.”

“I just thought, what if I could do a job where it was actually a matter of life or death,” Andrea said.

And so, at the age of 38, and with two young children, Andrea quit her job and went back to university, where she trained to become a paramedic.

Four years later, she began working for North West Ambulance Service and met her husband Glynn.

It’s some people’s worst nightmare, but Andrea says she loves working alongside her husband. “It’s good fun. We’re essentially getting paid to spend the day together,” she said.

The show saw Andrea and Glynn deal with a particularly difficult job - a 78-year-old woman thought to be suffering from sepsis. She refused to go to hospital, despite them both insisting she needed to go.

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Suffering her own tragedy made it easier to deal with patients and grieving relatives, Andrea says. “When you are dealing with grief of other people, you know exactly what it feels like for that person.

“You never get used to breaking bad news.

Every case is upsetting in a different way, but life experience is the most important thing you share with people.”

As the programmes continued, we saw advanced paramedic Luke steal the show when he responded to a child initially thought to be in cardiac arrest (thankfully this was not the case), and then go on to deliver a baby at home!

Luke can be seen in the shows introduction shouting for towels and blankets to wrap the baby in. He later reveals he’s going to be a dad very soon.

“Being a parent is one of the scariest things I can think of doing to be honest and I know there’s a lot of things that can go wrong,” said Luke. “I’m going to become a dad in the near future because my girlfriend’s imminently going to pop out a baby. And so with that there’s a lot of pressure on me to do a good job with my child and I want to, I need to do a good job.”

“Our normal life stopped at that point and it’s almost like a new existence takes over. I’m back at work now and we are trying to get back to some semblance of normality, but nothing will be the same again.

“I think about Emma every day.”

Mr Galton says the family took the difficult decision to allow Emma’s death to be featured in the documentary because they hope it will encourage the debate about tougher sentences for killer drivers.

He said: “For a long time the view in this country has been that other crimes of death are treated more seriously than if someone kills someone with a car.

“It’s treated almost as if it is something we cannot do anything about.

A stark contrast in episode four saw air ambulance crew, paramedics and passers-by trying their best to save the live of 24 year old Emma Galton who was the victim of a hit and run. Tragically there was nothing they could to and Emma passed away at the scene of the incident, from which the driver had fled.

Speaking about the harrowing incident, Emma’s dad David Galton told the Manchester Evening News how watching the documentary brought back the ‘horror’ of his daughter’s death.

“But a car is potentially just as dangerous as a gun. The end result of being hit by a car can be just as lethal.

“The man who killed Emma had no intention to get behind the wheel and kill somebody.

Her death was the result of his selfishness and recklessness, but he has to take responsibility for that.

“Penalties for death by dangerous driving should be tougher and I think it’s important that incidents like this get publicity.”

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Puzzle-solving ‘doesn’t slow down mental decline in older people’ “Crosswords do not prevent dementia but can make your brain sharper to start off with,” reported the Mail Online.

This study was able to take account of the effects of childhood intelligence, as everyone in the study had taken an intelligence test aged 11.

The question of whether doing puzzles and problem-solving activities can stave off mental decline in older age is often debated.

It’s still possible that those who enjoy crosswords and puzzles tend to naturally have a higher mental ability to start with. Or it could be that doing these activities over many years from an early age can help sharpen minds.

A study of 498 people born in Scotland in 1936 found people who enjoyed intellectually stimulating tasks had better mental functioning at around age 64 than less intellectually active people, but that their rate of mental decline from that point was the same.

A possible message to take from this research is: if you enjoy regularly exercising your brain in this way, don’t leave it until retirement age before you start. It could be that the earlier you do this, the better.

‘Thanks for blocking me in a**ehole’

An angry driver left a message for an ambulance crew that blocked her in as they fought to save a life. She called 999 to complain and then left a message scrawled on a piece of paper.

It said: “Thanks for blocking me in a***hole. Just took me 20 mins to try and shunt out of drive along pavement.

So inconsiderate.. whole road empty and block driveway.

Your an a***hole and I’m going to be late for work thanks to you d***head.”

Our crews really don’t want to get in anyone’s way but unfortunately sometimes they do have to and they shouldn’t be subjected to abuse. So please be patient with us and just think, if it could be one of your loved ones we were called out to help.

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Plea to people who waste time - call 999 to cancel ambulance

Over one million pounds of public money is wasted every month when ambulance crews in the North West are called out but find nobody to treat.

Every month there are 1,181 ambulance responses to locations where no patients are found which costs the NHS £171k a month. A further 6,207 responses are made to people who refuse care and treatment from paramedics when they arrive on scene, at a cost of £900k a month.

The cost of wasted ambulance journeys is £12,855,120 a year.

This could have funded 92 brand new emergency ambulances, the salaries and staffing costs for 286 paramedics or 390 emergency medical technicians, 1,071 high spec monitoring devices for heart rate, blood pressure, oxygen levels and defibrillate patients in cardiac arrest, 2,571,024 blankets to keep patients warm or 1,071 ambulance stretchers!

Director of Operations, Ged Blezard said: “There are many reasons why people may not be there when our crews arrive; sometimes they decide to go to hospital with a family member, or get treatment elsewhere, but don’t let us know. This could be down to unrealistic expectations of how quickly ambulances respond, or because we are simply that busy that they, unfortunately, have to wait longer for a response than we would like.

“It is really important that if people no longer need us they call 999 to cancel so that we can get to the next patient quickly and don’t waste time trying to find people who don’t need or want our help.”

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Think you need urgent medical help right now?

There is now a fast and even more convenient way of getting help for your urgent medical concerns.

NHS 111 online is available across most of the country.

To get help, simply go to the website - 111.nhs.uk - enter your age, sex, postcode and main symptom and then answer a series of questions about your health problem.

You can find out how to get the right healthcare in your area, including whether you need to see a GP or seek urgent care, get advice on self-care and in most areas, get a call back from a nurse, doctor or other trained health professional if you need it.

Whatever the need is, no matter how you access the service, NHS 111 will ensure that you get the right care, from the right person, as quickly as possible. So, if you think you need urgent non-life-threatening medical help go online at 111.nhs.uk or call NHS 111.

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Its important to have difficult conversations Starting a conversation with someone about their mental health can often seem daunting, but it is in fact the most important thing you can do to help someone get onto the road to recovery.

During the winter months, especially in the run up to the festive period, mental health issues can be intensified because people feel extra pressure to be happy as everywhere they look this is what they see portrayed in the media, adverts and shops. For others, the long winter nights often lead to ‘winter blues’ with extended feelings of loneliness. Therefore, it’s even more important at this time of year we reach out to people we think might be suffering.

A lot of us are afraid to start these discussions due to fear of the unknown which often holds us back. The key is starting the conversation and being a gentle listener, in fact sometimes people who think they have the answers to someone’s problem are less helpful.

You don’t need to be an expert to talk about mental health.

Have a think about where a good time and place would be to have a conversation, think about where the other person would feel most comfortable. Ask gentle questions and listen closely, asking questions means you leave the other person in control to find their own answers.

It’s important to know that sometimes there are no immediate answers but reassuring them that you are available anytime they need someone to listen.

Don’t forget to ask how the person is feeling about their deepest emotions, fear, anxiety, anger and so on, which usually leads to much needed relief.

Check that they know where to get help, but be careful not to pressure them into anything - they need to feel ready within themselves to do this.

NWAS Mental Health Practitioner Tich Chininga shares his top tips for starting a conversation about mental health…

“In my role I offer advice to people who may be experiencing mental health problems to make sure they get the right help, whether that’s an ambulance response or support in the community.

“Here’s my best advice for starting what may at first seem like a difficult conversation.

“People often want to talk but need someone to initiate the conversation. Open questions are best, such as ‘what happened?’, ‘what has worked in the past?’ and ‘what works better for you?’.

“Focus on their feelings rather than trying to solve the problem, this will be more helpful and supportive.

“Respect their words. We often feel an urge to want to fix a person’s problems, or give them advice, but it’s important to let them make their own choices.”

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h g u o n e s i h g u Eno

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North West Ambulance Service is asking the public to #GetBehind999 and condemn acts of violence and aggression against all emergency service staff.

Out of the 1,249 incidents of violence and aggression against ambulance staff in the north west reported: • • • • • •

47 of these were sexual assaults 94 involved a blade 32 were racial abuse 26 involved a stick or a club 12 were incidents of religious abuse 466 were physical assaults

Just before Christmas last year, Senior Paramedic Andrew was called to help a man bleeding in the street in Lancashire. Although Andrew was there to help, the situation very quickly turned ugly when the man lashed out and began throwing punches and spitting blood.

Andrew said: “Adrenaline was pumping and all I could think to do was continue to help this patient despite the injuries. It was only afterwards that I realised that I how badly I’d been injured in the attack and sought hospital treatment. I was immobilised due to fears of a spinal injury. It was an extremely traumatic experience” Manchester based Paramedic Amanda was subject to an unprovoked attack when she offered an upset patient a friendly hand to hold. The man took Amanda’s hand and then laughed, pulled her on top of him, threatened to kill her and attempted to use her pen as a weapon to hurt her, leaving her with injuries to her wrist, chest and stomach.

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“This was an extremely frightening experience for me,” said Amanda. “Nobody should ever be treated in that way, especially someone who is only there to help.”

Attacker Paulius Zacharovas later pleaded guilty at Manchester and Salford Magistrates Court to a charge of assault with battery. He was sentenced to eight months in prison and ordered to pay fines of £150.

And it’s not just physical abuse that our staff deal with. Emergency Medical Dispatcher Wendy, based in Liverpool, took a 999 call about a woman in labour.

Normally a call for a birth would be exciting for our control centre staff, who are able to provide instructions on how to deliver the baby in the event of its arrival before the ambulance crew, but this particular experience couldn’t be more different.

The family of the woman in labour said they wouldn’t deliver the baby and repeatedly shouted ‘just get here’ and ‘hurry up’.

Wendy, with the support of her supervisor, explained she was trying to help as she didn’t know when the ambulance would arrive.

Wendy said: “I was physically shaking because of the abuse and my concern for the patient and her baby.

“The patient’s father came on the line… He made threats to harm us if we didn’t get the ambulance there immediately.

“We were then warned by the attending paramedic that the patient’s father had jumped out of a car with several men, stating he was on the way to our call centre to ‘sort out’ the supervisor.

At the launch of the #GetBehind999 campaign representatives from the police and fire services were there to support and highlight that abuse of those working in all the emergency services is completely unacceptable.

Since the campaign launched over a thousand people have so far signed the pledge to show their support and you can too by going to nwas.nhs.uk/stop-abuse.

“We could see the car going up and down the street outside. My supervisor and I were traumatised by this, it was terrifying.”

Recently, the introduction of the Assaults on Emergency Workers (Offences) Act 2018 came into force which doubles the maximum sentence from six to 12 months in prison for assaulting an emergency worker.

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Man reunited with lifesavers A Manchester man who made a remarkable recovery after having a cardiac arrest, met up with the ambulance team who saved his life.

Avoid Christmas weight gain

On 9 November, Ray Portlock, 51, from Newall Green had just picked up his son from school after bumping his head, when he suddenly collapsed and stopped breathing.

Son, Bradley, thought Daddy was being silly but thankfully father in law, Shaun, who had just arrived at the home, quickly rang for an ambulance. The emergency medical dispatcher instructed life-saving CPR which Shaun performed for six minutes before the ambulance arrived.

Ray, his wife Kat, two children Bradley and Jade, aged nine, made a special visit to Sharston ambulance station with their family on Wednesday 12 December where they presented the ambulance crew with treats as a thank you for all their efforts in saving Ray’s life.

Ray said: “I remember experiencing some chest pain but didn’t want to make a fuss and then the next thing I remember I was on the floor with all the paramedics around me.

“I really cannot thank everyone enough, I owe these people everything.”

“Regular weighing at home and simple tips to curb excess eating and drinking can prevent people from piling on the pounds at Christmas,” reported ITV News.

Researchers say most people put on a small amount of weight each year, and that much of this weight gain happens over the Christmas holiday period.

The British Dietary Association says some people may consume around 6,000 calories on Christmas Day alone, 3 times the recommended daily amount.

Because the weight tends not to be lost after Christmas, over time it could contribute towards the obesity epidemic.

In one trial, researchers offered weightcontrol tips in a leaflet to 136 people, along with advice to weigh themselves every day. Results showed these people lost weight and the other group gained weight.

While Christmas is a traditional time for indulgence and feasting, the study shows it’s possible to restrict weight gain, and even lose some excess weight, with a few simple tips.

Life as an ambulance mechanic Behind every high performance vehicle is a team of skilled machanics - think Lewis Hamilton and his Mercedes team! Well, our fleet of ambulances has a very special team too...

Our vehicles work hard – really hard! They can travel hundreds of miles every single day and in rural places like South Cumbria, emergency ambulances can clock up to 10,000 miles in just five weeks. This amount of travel means it’s vital they get the TLC they need to keep on the road, and it’s down to our super skilled fleet team to make that happen.

Darrel Ainscough is one of our fleet mechanics.

Starting as an apprentice ten years ago, he’s worked his way to become a fully qualified mechanic as well as standing in as acting supervisor when needed.

Based at Broughton workshop, Darrel is part of a team of ten who look after emergency ambulances, rapid response vehicles, patient transport service ambulances, HART and driver training vehicles across Lancashire and South Cumbria – from Sedbergh down to Chorley.

“We’re always busy in the workshops, whether we’re out responding to a breakdown, servicing one of the vehicles or picking one up for a quick fix. After all, without working ambulances we wouldn’t be much use as an ambulance service!”

“A typical service of an emergency ambulance takes around two to three days. That includes all the usual engine and under-the-bonnet checks as well as making sure all the equipment in the back of the ambulance is in top condition. And of course we need to check that the emergency lighting and sirens all work properly too.

“For the sake of our patients we have to make sure everything – absolutely everything – works.”

“We look after the crews too! 12 hours is a long day so we need to make sure the cab is comfortable with working windows, radio and comfy seats. And of course we give the vehicles a good wash as well. We are North West Ambulance Service after all – they’ve got to look clean and respectful!”

“My favourite part of the job has to be meeting all the different people that work for the trust in all the different sectors. I also love the right laugh we have at work – we certainly try our best at keeping our up our morale!”

1 in 3 adults over 65 will fall

Older people are more likely to have a fall because they may have balance problems and muscle weakness, poor vision, a long-term health condition, such as heart disease, dementia or low blood pressure (hypotension), which can lead to dizziness and a brief loss of consciousness.

Anyone can have a fall, but older people are more vulnerable and likely to fall, especially if they have a long-term health condition.

What to do if you fall

Falls are a common, but often overlooked, cause of injury. Around one in three adults over 65 who live at home will have at least one fall a year, and about half of these will have more frequent falls.

If you have a fall, it's important to keep calm. If you're not hurt and you feel strong enough to get up, don't do it too quickly. Roll on to your hands and knees and look for a stable piece of furniture, such as a chair or bed. Hold on to the furniture with both hands to support yourself and, when you feel ready, slowly get up. Sit down and rest for a while before carrying on with your daily activities.

Most falls do not result in serious injury. But there's always a risk that a fall could lead to broken bones, and it can cause the person to lose confidence, become withdrawn, and feel as if they have lost their independence.

What causes a fall?

The natural ageing process means that older people have an increased risk of having a fall.

In the UK, falls are the most common cause of injury related deaths in people over the age of 75.

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When to call 999 If you're hurt or unable to get up, try to get someone's attention by calling out for help, banging on the wall or floor, or using a aid call button (if you have one).

If possible, crawl to a telephone and dial 999 to ask for the ambulance service.

Hangover cures are generally a myth

Five ways to avoid a hangover 1. Don’t drink more than you know your body can cope with. If you’re not sure how much that is, be careful.

Splitting headaches, sickness, dizziness, dehydration: anyone who’s ever drunk too much knows the consequences.

Hangover cures are generally a myth. There are no cures, but there are things you can do to avoid one and, if you do have one, ease any discomfort.

If you wake up the next morning feeling terrible, you probably didn’t follow our advice!

Dealing with a hangover involves rehydrating the body to help it deal with the painful symptoms and the best time to rehydrate is before going to sleep after a drinking session.

Painkillers can help with headaches and muscle cramps.

Sugary foods may help you feel less trembly. In some cases, an antacid may be needed to settle your stomach first.

Bouillon soup, a thin vegetable-based broth, is a good source of vitamins and minerals, which can top up depleted resources. Its main advantage is it’s easy for a fragile stomach to digest.

2. Don’t drink on an empty stomach. Before you go out, have a meal that includes carbohydrates (such as pasta or rice) or fats. The food will help slow down the body’s absorption of alcohol.

3. Don’t drink dark-coloured drinks if you’ve found you’re sensitive to them. They contain natural chemicals called congeners, which irritate blood vessels and tissue in the brain and can make a hangover worse.

4. Drink water or non-fizzy soft drinks in between each alcoholic drink. Carbonated (fizzy) drinks speed up the absorption of alcohol into your system.

5. Drink a pint or so of water before you go to sleep. Keep a glass of water by the bed to sip if you wake up during the night.

You can replace lost fluids by drinking bland liquids that are easy on the digestive system, such as water, soda water and isotonic drinks.

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North West Ambulance Charity NWAS has officially launched its charity, which will raise money to support emergency service staff and local communities.

The charity funds lifesaving equipment, education programmes and other projects to benefit the health, wellbeing and safety of patients, staff and the wider community.

A charitable fund was established in 2008 to allow legacy gifts and generous donations from the public, businesses and grant funders to be used effectively to support the work of the service. In the last year, the charity has funded the installation of more than 100 defibrillators in public places.

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The charitable fund has now been developed into the new North West Ambulance Charity, and publicly launched with fresh branding, charity mascot Pandamedic, and a JustGiving page justgiving.com/nwambulance.

A big thank you to everyone who has already donated and with more support the charity can continue to fund lifesaving defibrillators and other initiatives such as schools education programmes, additional equipment and clinical training aids.

Charity funds will also contribute to extra health and wellbeing schemes supporting ambulance staff who work hard all year-round to be there for North West residents at their time of need.

Feel good food The cold, dark night mean we could all benefit from a few tips to help improve our moods. And anything that involves food is a winner - surely!

According to some nutritionists, your diet can have a dramatic effect on your mood. Why not try these feel good foods to help lift your spirits?

Walnuts

Packed with omega-3 fats, antioxidants, magnesium, potassium, B vitamins and essential amino acid tryptophan, which are all thought to help improve mood, they make a great snack.

Dried apricots

Sweet and gooey it’s difficult to believe they’re good for you. They contain feel good B vitamins, magnesium, potassium, antioxidants, and tryptophan.

Bananas

Bananaman’s snack of choice is full of potassium, which helps maintain a healthy nervous system and the body’s acid-alkali balance.

Oatcakes

Salmon

Many oily fish and shellfish make a good protein base for a meal. They contain omega-3 fats – essential fatty acids which cannot be made in the body but are vital for good emotional and mental health. They keep your brain cells, nerve fibres and neurotransmitters ticking along nicely.

Avocados

Slice it for a salad, mush it up with garlic and lemon to make guacamole, or mix it into a fruit salad. The mood-lifters are the B vitamins, antioxidants and tryptophan it contains. It also has manganese, thought to help prevent epileptic fits and ease PMS.

Pumpkin seeds

Great with boiled eggs instead of soldiers!

As well as containing B vitamins, magnesium, manganese and potassium, they help you feel fuller longer.

Along with omega-3, B vitamins, potassium and tryptophan they’re bursting with zinc.

Low levels of zinc are associated with anxiety and depression. Other zinc-rich foods include sunflower seeds, brazil nuts, oysters and whole grains.

Green salad

Baked potatoes

While the thought of salad may not fill you with happiness, experiment by adding different fruit, vegetables and sauces until you find some options you like. Watermelon, pear and apple are surprisingly nice mixed into a green salad.

Pineapples

As well as tasting of summer, pineapples contain a significant amount of feel-good chemical serotonin.

You can’t beat carbohydrates for comfort food and potatoes are packed full of serotonin – team them with beans or oily fish and you’ll have a happy plate!

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#TeamNWAS

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

Special Christmas visitors These three little elves crept their way into our ambulance station in Bolton to present our staff with some special Christmas gifts. Cousins, Lilliarna, aged nine and Luca and Ashton, aged eight from Radcliffe wanted to give something back after their mum and aunt had needed our assistance.

Working together to support patients In the Fylde, a team made up of a paramedic, a police officer and a mental health crisis nurse work together on a single resource with the aim to give patients who may require specialist assistance the right care, in a timely manner and away from hospital wherever possible. This new multi-agency approach allows us to offer swift support to people with a mental health need by delivering care within the community whilst freeing up vital ambulance, police and A&E resources.

Festive fun in Wigan To add a bit of Christmas cheer to staff working over Christmas, Senior Paramedic, Jimmy Curry has transformed the lockers at Wigan station into an extra special advent calendar.

Staff could buy a raffle ticket and each day one lucky person’s name gets pulled out of Jimmy’s Christmas hamper sack and takes home the goodies! There are also special hamper packs for those working on the special days over Christmas so nobody will go without a treat if they are working.

A great idea to give road staff an added little morale boost this year!

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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