Working Together Winter 2018

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SCAS LEADING THE WAY IN APPROACHING MENTAL HEALTH Winter Twenty Eighteen

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CQC Report – ‘Good’ an even better 10

Over 5,000 trained on Restart A Heart Day 14

Ambies 22

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nd getting

CFR App 32

WW1 Commemorations 52

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SCAS LEADING THE WAY IN APPROACHING MENTAL HEALTH POSITIVELY AND PROACTIVELY It’s well known that working within healthcare whilst often intensely rewarding, can be incredibly stressful.

Programmes like ‘999 What's Your Emergency?’ have started to highlight the demands that ambulance crews face, but what is less well recognised is how challenging it can be to work within a telephone triage environment.

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“If we want our workforce to care – about the work they do, about the people they serve and about their colleagues, then we must care for them. Genuinely care for them, in a way that is tangible and that permeates the bones of the organisation.

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Staff within NHS 111 and ambulance control rooms have to be ready to deal safely and effectively with any eventuality and have to master the art of quickly building a picture in their head about something they can’t see on the other end of the phone. If all callers were calm, coherent and patient, this process of picture building would be difficult enough, but often this isn’t the case, with many calls being highly emotionally charged.

What’s more, these services are in high demand and the stakes are high.

Switching off for a few moments can mean missing vital information, which really can mean the difference between life and death. And this degree of mental agility and mental effort is needed from the beginning of a shift right through to the very end, because every single call matters and the diversity of presentations is limitless. Added to this there is often little time to process their thoughts between calls and seldom any knowledge of what happened to callers, which calls handlers report heightens the ‘emotional turbulence’ associated with the role. So, it’s not surprising that research by mental health charity MIND found that call handlers sometimes felt overwhelmed and ill-equipped to carry out their role and that this can impact their own wellbeing.

MIND’s research found that call handlers often felt ill-prepared in dealing with callers experiencing mental health problems, describing this as one of the biggest challenges of the role. Call handlers sometimes have to stay on the line with callers experiencing suicidal thoughts or feelings for long periods of time, while waiting for a frontline response to arrive, and the research found that staff worried about making things worse by saying the wrong thing.

It’s clear to see then that mental health is a really big deal within NHS 111 and 999,

so it’s fantastic to be able to report how SCAS is investing culturally and financially in this vital area. Over recent months, the Trust has commissioned a series of training programmes through Red Lotus Consulting, which have included Mental Health First Aid (MHFA) Training, Mental Health Champions in Telephone Triage Course and Compassion@Work Training. Red Lotus Consulting’s founder Claire Hunter, a nurse by background, is recognised as a leader in the field of telephone triage and understands the complexity, pressures and competing demands of working within the public sector. Claire and her whole team are deeply committed to educating and caring for the staff who are paid to care for others.

Claire explains the reasons why: “If we want our workforce to care – about the work they do, about the people they serve and about their colleagues, then we must care for them. Genuinely care for them, in a way that is tangible and that permeates the bones of the organisation.

We need to care about people in their best and worst moments, when they excel and when they make a mistake, when they’re nice to be around and when they’re at their grumpiest worst. This is how we build a genuinely compassionate workforce, that is loyal, committed and that will go the extra mile when needed.

A commitment to wellbeing doesn’t have to cost the earth, but it does have to be led by a senior team who are passionate and committed. I’m so delighted to be working with the SCAS team on their wellbeing agenda, because they really are taking it seriously. It’s so easy to adopt a tick box approach, by training a few mental health first aiders here and there, but this is seldom enough.

It needs to become part of the fabric of the organisation and this is where SCAS’ holistic approach is to be commended.”

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One of the strands of SCAS’ wellbeing strategy has been to ensure mental health has parity with physical health and so MHFA training has been an important part of the Trust’s approach.

However, as well as equipping staff with the skills needed to support each other through MHFA, SCAS has also focused on delivering a better service to patients with mental ill-health by putting 34 staff through the Mental Health Champions in Telephone Triage Course. The focus of this programme is to equip telephone triage staff with the knowledge and attitudes to be able to respond to callers and patients with mental health issues in a skilled, compassionate and non-judgemental way.

Here’s what a few SCAS staff had to say about the experience: “Having completed the course I now feel more confident in helping patients that are going through a crisis. I’m hoping they’ll feel better supported and know we’re here to help them.”

“The facilitator was exceptional. Clearly very knowledgeable, engaging and clearly had a passion for the subject matter.”

“Claire ensured all students took an active part. A very interesting day that highlights the issues around mental health and encourages you to be confident in raising this sensitive subject.

It certainly leaves you wanting to do more!”

“The facilitator was brilliant. I thoroughly enjoyed the course and have not stopped talking about it since.”

SCAS has also trained 32 staff through the innovative Compassion@Work Course, which focuses on the human side of managing or supporting a team, where wellbeing is taken seriously and is as important as ‘getting the work done’.

This course introduces delegates to the principles of managing their teams with compassion and high levels of emotional

intelligence, in order to start creating the conditions for a highly engaged and loyal workforce.

Here’s what one participant had to say about the experience: “I now feel I have a better understanding of the impacts of suffering at work and the impact it can have on you and your colleagues, and how we can apply the NEED chain of compassion. Julie, the facilitator was very engaging and it was helpful that the facilitator had the same background as the students and could relate that to the training.”

The next stage is for SCAS to work with Red Lotus Consulting in piloting an innovative programme called Compassion@Work Circles. This framework designed for public sector workers, will be rolled out across SCAS NHS 111 and 999 clinical coordination centre (CCC) staff in 2019. Compassion@ Work Circles are groups of staff who come together to reflect in a structured and consistent way, on challenging client interactions or cases that ‘remain with them’. The aim is to offer a safe, skilfully facilitated environment in which to share stories and offer emotional/practical support to one another.

Compassion@Work circles are based on the premise that allowing staff to articulate difficult situations using a structured method can help them grow and move on. Facilitators are trained in the ‘ALLOW’ process and methodology which combines reflection with mindfulness techniques. This commonsense, easy to remember process can be applied in both one-to-one and group settings to help people process a situation, grow and move on. The sharing of difficult experiences helps normalise the challenges of work, for all present within a ‘circle’ – not just the person discussing their story. This shared experience helps build bridges and create

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strong, supportive bonds between staff.

The shared problem solving also helps staff process and move on from a difficult experience with a mindset of learning, rather than with regret, shame, sadness or resentment. This process of ‘letting go’ supports people to continue doing their job in a caring and compassionate way, rather than developing what’s known as ‘compassion fatigue’.

Debbie Diffey, Clinical Assurance & Training Manager EOC who has been instrumental in developing SCAS’ wellbeing approach says: “It can be really difficult to get good student engagement and facilitator expertise when delivering mental health sessions. I am really pleased to be working with Claire and her team who have delivered engaging and innovative sessions. I am delighted with the staff feedback from those who have already attended training and the enthusiasm they have shown. I look forward to working with the Red Lotus team this year on the Compassion@Work circles and hope this will assist us in maintaining and supporting the workforce in the CCCs. I really hope we can continue to offer more staff the Mental Health Champions Training this year that has been so enthusiastically received by a number of CCC staff.”

If you would like to find out more contact Debbie at debbie.diffey@scas.nhs.uk or Red Lotus Consulting at hello@redlotusconsulting.co.uk

Winter 2018

CONTINUING IMPROVEMENTS FOUND IN SCAS’ EMERGENCY SERVICES

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In early November, the second and final Care Quality Commission (CQC) inspection report into SCAS was published. The Trust was delighted to retain its ‘Good’ rating in the latest inspection which highlighted the improvements that continue to be made across the organisation’s emergency and urgent care service, resilience and emergency operations centres.

CQC inspectors visited SCAS in July and August and rated the Trust as ‘Good’ for the overall quality of its services, as well as ‘Good’ for being safe, effective, responsive to people’s needs and a wellled organisation.

Will Hancock, Chief Executive at South Central Ambulance Service NHS Foundation Trust, said: “At a time when pressure on all our services continues to rise, I would like to thank all our staff and volunteers for their commitment, dedication and hard work that have been recognised in this latest CQC inspection. Since the last inspection in 2016, inspectors have recognised the improvements made to services, the success we have had in recruiting more staff despite considerable challenges and it is particularly pleasing that staff told the CQC they felt supported, valued and respected. Today’s publication recognises that we consistently deliver safe, patientcentred care across all of our services.

I am proud to lead an organisation with such a culture of continuous improvement, and one where delivering the very best care for every patient is at the heart of what every one of my colleagues does day in, day out.”

The inspectors found that: èè Staff across the Trust cared for patients with a great deal of compassion, treating them with dignity and respect èè Response rates to 999 calls had improved and SCAS was achieving results above the average across all English ambulance trusts èè The Trust’s strategy, vision and values underpinned a culture which was patient-centred èè Managers at all levels had the right skills and abilities to run the service and provide high-quality, sustainable care èè Staff felt respected, supported and valued, as well as positive and proud about working for the Trust and their team

It was particularly pleasing to see that the 36 CQC recommendations from the 2016 inspection had been reduced to just one in the latest report. Inspectors also noted the success SCAS has achieved through joint working with a wide range of partners.

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Professor Helen Young, Executive Director of Patient Care and Service Transformation, said: “I am delighted that the CQC reports confirm that we are making great progress on our journey of continuous improvement. It was particularly pleasing to see that the inspectors identified a number of areas of outstanding practice, such as our pioneering Falls and Frailty Service partnerships that help keep frail and elderly patients out of hospital, and the well-established ‘Bright Ideas’ scheme. Under the scheme, innovations such as our Trauma App and Clinical Pathways App have helped deliver real benefits to our staff, our patients’ experiences and clinical outcomes.”

A copy of the full report on SCAS’ emergency and urgent care service, resilience and emergency operations centres can be found here:

èèhttps://www.cqc.org.uk/ provider/RYE

The report into SCAS’ NHS 111 service – which also confirmed it had improved since 2016 to be now rated ‘Good’ across all categories – was published in September and can be downloaded here:

èèhttps://www.cqc.org.uk/ location/RYEA3

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Winter 2018

INTERNATIONA RESTART A HEART DAY 20

On Tuesday, 16 October, SCAS staff, volunteers and p once again took part in International Restart a Hea

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The event is a designated annual day of action with the aim to teach vital life-saving cardiopulmonary resuscitation (CPR) skills to as many people as possible.

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This year’s event was the first time it had gone global, with support from resuscitation councils covering North, Central and South America, South Africa, Asia, New Zealand as well as the European resuscitation councils that had historically marked the day of action.

Under the guidance of Nic Morecroft, Head of Operations – Community Engagement and Training at SCAS, this year’s Restart a Heart Day was the most successful one to date in the South Central region. Over 50 schools took part on the day – from north Oxfordshire to the Hampshire coast – and 8,170 people were trained in life-saving CPR; a 44% increase on the 2017 event.

in Caversham on the evening of 22 March. Gary had been suffering the symptoms of a heart attack and both he, and initially Helen, had been on the phone to Emergency Call Taker, Sian Faulkner. Recognising the seriousness of the symptoms being described, Sian along with Control Shift Officer, Phil Worrall, quickly arranged for help to come straight to the couple’s home.

Lou Edwards and Tanya Cantrell, military co-responders based at MOD Corsham, were the first to arrive “A huge thank you to everyone who with Gary and Helen, and they were turned out to take part in teaching CPR soon backed up by an ambulance to school and college children in various with Clinical Mentor Felicity Luptonlocations across our four counties. The Smith, Emergency Care Assistant Alex aim of the international event was to Pullan, and Student Paramedic Richard train 200,000 young people globally this Baxendale on board. year and with your help we exceeded this figure. I was also particularly Tanya adds: “Lou and I were dispatched pleased that we so dramatically and the information we were given increased the number of young people was that our patient was experiencing trained in our region compared to last chest pains. We carried out some initial year. Well done everyone and I look observations on Gary and were even forward to seeing you all again next joking with him as he was afraid he year!” wasn’t going to get his bacon roll for dinner!”

The training sessions at many of the region’s schools were featured in local “Talking with Gary and Helen”, says press and radio station bulletins, and Lou, “we noted the history of his BBC South TV came along to Highdown chest pains which Gary told us he had School & Sixth Form Centre in Reading, been suffering the day before as well.

Berkshire, for a very special re-union.

We were still chatting with them both Gary and Helen Weller arrived at the and recording observations when the school in the morning to meet the team ambulance team arrived and we began that saved Gary’s life when he went our handover to Felicity, Alex and into cardiac arrest at home Richard.

Nic Morecroft said:

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Felicity picks up what happened next.

“We had begun some additional observations using the equipment that we brought with us, such as an ECG to check Gary’s heart rate, as well as giving Gary some pain relief. This had been going on for only 5-10 minutes after we got there when Gary suddenly went into cardiac arrest.”

With a confirmed cardiac arrest, Team Leader, Jack Phillips-Lord, was then also despatched by the emergency control room team.

“The crew requested the LUCAS device – a really useful piece of equipment as it then continues CPR on the patient which frees up the staff to continue other life-saving treatment”, says Jack. “It also makes it easier and safer to transport the patient to hospital as the device can continue delivering CPR on a patient as they are being taken to the emergency department under blue lights.”

Helen said: “I’ve never seen such a brilliantly co-ordinated team. Everyone sprang into action and they fought for eight minutes when Gary had no pulse and got him back. It was the longest eight minutes of my life. I was in such a state of shock but they were all amazing.

We both really wanted to meet up with everyone again to say thank you personally. I made a cake for the guys – it’s not much of a swap for my husband!

But without their brilliant actions Gary wouldn’t be here today.”

Tanya was particularly praised by colleague, Lou, for how well she also looked after Helen. “In my view, that was probably the hardest part of the job that night. Seeing a loved one like that is traumatic and Tanya’s management of Helen’s emotions and needs, along with the compassion she showed, was something that you cannot train for and will only get through life skills.”

Jack was dispatched from Maidenhead, where he had been attending a previous incident, and when he arrived the team had already achieved a ROSC (Return of Spontaneous Circulation) and Gary was already in the ambulance. He handed the ambulance crew the LUCAS device in case he went into cardiac arrest again, and followed the ambulance to hospital for additional support. Gary spent five weeks in the Intensive Care Unit at the Royal Berkshire Hospital in Reading and doesn’t remember anything from around a week before his collapse, nor his initial weeks in hospital.

“The first thing I remember”, adds Gary, “is hearing Helen’s voice saying ‘squeeze my hand’. I could hear her in the distance and tried to do it, but couldn’t initially – it took me ages to finally do it. As I got better I wanted to do as much for myself as I could, but it was a struggle. Once I was out of ICU I couldn’t walk at first as my muscle strength had all gone, and there was one day when I decided I wanted to have a shower and got Helen absolutely soaked! After getting back home, I’ve recovered more quickly and I’m even able to do a bit of gym work now. I’m not 100% where I was before it happened but I’m just very pleased to be here still. It’s amazing what the guys in the ambulance service do.”

After an emotional re-union with the SCAS team, Gary and Helen joined them in the school’s assembly hall and Helen got some hands-on CPR training

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from Felicity. The couple were both very keen to raise awareness not just of the importance of how everyone should learn these life-saving skills, but Helen in particular wanted to feel confident she would know what to do if something similar happened in the future.

Lou adds: “Meeting Gary again, along with the rest of the SCAS team, was emotional and demonstrating CPR to the students at Highdown on the same day reinforced the message that these skills are vital and save lives. Over the ten years the MOD Corsham Military Responders have worked with SCAS, we have built up a trusted and wellrehearsed response and Gary’s recovery is testament to that.”

It was an equally rewarding experience for the SCAS staff. Student Paramedic

Richard said: “This was a great learning experience for me, being able to use the skills I have learnt in university and out in practice and to be able to make a life changing situation. This was a great outcome for everyone that was involved and this was a very rewarding job. It was a great reward to be able to meet Gary and Helen after the incident and for Gary to relay what happened and what part of the process he remembers. As a whole team we were very pleased with the outstanding recovery that Gary had made after his cardiac arrest. For me it’s the job I love doing and I am so pleased I can make a difference in patient care.”

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And Felicity added: “It was really great to be able to meet up with Gary and Helen after the incident, as this rarely happens. We were all particularly pleased to see what a good recovery Gary had made after his cardiac arrest, as this is even more of a rarity. For me, it is a clear demonstration of why I choose to do what I do, and the difference it can make.”

As they say their goodbyes, Helen tells the team that she and Gary wake up every morning and appreciate having another day together.

“We try to do something every day – a small pleasure – because we really know how lucky we are.”

“Though I never did get my bacon roll!” adds Gary with a smile.

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Winter 2018

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SCAS HONOURS ITS OUTSTANDING STAFF AND VOLUNTEERS The annual staff and volunteer awards, known as the Ambies, were held by South Central Ambulance Service NHS Foundation Trust (SCAS) at Old Thorns Hotel in Liphook, Hampshire, on Friday 30 November 2018. The Ambies showcase those members of staff and volunteers who epitomise the Trust’s values of teamwork, innovation, professionalism and care.

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This prestigious black tie event is made possible thanks to the generous contribution of a number of sponsors, including Zoll, Terrafix, SSG UK Specialist Ambulance Service, Ortivus, J. Tomlinson, Hexagon and Conduit Global.

It was an evening to remember for all those shortlisted for an award and particularly for Clinical Operations Manager for East Berkshire and South Buckinghamshire, Neil Durrant, who went home with an unprecedented three awards!

Neil, who is based at the Trust’s Wexham Resource Centre, won two individual awards – 999 Person of the Year and the People’s Pride Award – and is also part of the Senior Operations Team that won the Team of the Year – Operations Award.

in the North East with his no nonsense approach, encouraging us to work together, take some ownership for our teams, to achieve a common goal and this is evident in our performance, sickness levels and staff survey results.”

Neil’s nomination for the 999 Person of the Year Award was by the entire leadership team in his operational area, and the small section of it below sums up exactly why he won both his individual awards:

The Senior Operations Team, based across the four counties of SCAS’ emergency 999 operations, received six nominations for the Team of the Year – Operations Award, one of which included:

“While being clear in the direction he gives and the standards he expects, the results are encouraged constructively rather than dictated to us. He has a natural ability to predict, understand and overcome issues that affect the Service; his common sense and experience make him not only a skilled clinician, but also a fantastic line manager. He has created an enthusiastic, passionate, engaged team

“Many of the team have individual stories of how they have gone above and beyond to support the delivery of patient care in the most challenging circumstances through winter pressures, snow, world cups and heatwaves. Whilst the Senior Operations Team is not always immediately visible their hard work and commitment supports the wider organisation in striving towards our vision.”

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Philip Smith, Human Resources Manager, based in Newbury, won the Support Person of the Year Award, with his nominator writing:

affords the individual a much greater understanding of the clinical detail and, thus, empowering them in their role and instilling confidence.”

“In the last year Philip has been the driving force behind the commercial transformation programme, he has ensured the whole programme has been done with consistency, to policy and that all staff, managers and unions have felt support and confident along every step.

He has supported numerous one-toone meetings through some emotional times, written hundreds of letters to staff updating on progress and their own roles, and supported interviews.”

Andrew Gordon, Ambulance Care Assistant based at Eastleigh for the non-emergency patient transport service, won the Commercial Services Operational Person of the Year Award.

His nomination included:

Clinical Shift Manager, Sharron Mackenzie, based at SCAS’ Clinical Co-ordination Centre in Otterbourne, won the 111 Person of the Year Award. Sharron received two nominations for the award, one of which included the following: “Clinically, I've not met someone with the level of expertise and knowledge that Sharron possesses. When asking her for advice Sharron will deliver the advice needed but will then go above and beyond to ensure that one understands the advice that she has given with a clinical explanation that is tailored to the individual that she is speaking with. This

“The level of compassion and dedication to his patients is second to none and is a well-respected and liked member of the team. On multiple occasions, I have heard of incidents where Andy has gone the extra mile for patients with his kind nature and a drive to ensure the patients receive the best level of care. He always has a smile on his face and is always in the crew room telling everyone how much he loves his job and how proud he is to be part of SCAS. It is very refreshing to hear.”

Clinical Mentor, David Emery, based at SCAS’ North Harbour Resource Centre in Portsmouth, won the Educator of the Year Award. He was nominated for being: “An outstanding Clinical Mentor – with a proactive and positive stance in monitoring and developing his students and existing staff. Continually strives

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All the winners received their awards from Olympian, Roger Black MBE.

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for clinical excellence with a strong ability to identify student/staff needs, ensuring those who have the fortunate opportunity to be able to work with him, develop and are able to surpass their original goals.�

Michele Foote, Control Duty Manager based at SCAS’ Clinical Co-ordination Centre (CCC) in Otterbourne, won the CCC 999 Person of the Year Award. Michele was nominated for the award twice, with one nominee writing:

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“Her role involves managing emergency call takers, dispatchers/ assistants and shift officers. She believes that a well organised and happy team leads to the best patient care possible. Although the role is obviously managerial there are so many ways to manage, Michele's approach is to lead by example, always a smile on her face and her boundless energy and enthusiasm rivals the Duracell bunny! Michele makes everyone in the team feel important, whatever part they play, nurturing the enthusiasm of new staff and tapping into the experience of well-established staff.”

Community First Responder in Hayling Island, Richard Coates, won the Volunteer of the Year Award. His nomination included: “Firstly, he gives many hours doing overnight and day shifts to fill any gaps within our rota, and can always be called upon to assist when two persons are required, in a fall incident for example. He regularly does much more than the required minimum of 20 hours per month and more often in the region of 30-40 hours a week. He works tirelessly to provide feedback to SCAS to help improve the quality of care to patients. Richard does this without looking for any credit or recognition, but only to serve his community.”

Collected on Richard's behalf by N Patient Transport Service Call Handler, Carol Stuart, based at SCAS’ Bicester Headquarters, won the Commercial Services Clinical Coordination Centre Person of the Year Award. Carol received two nominations for the award, one of which included the following: “Carol’s dedication helping others shines like a beacon; Carol not only helps others but ensures her own call handling standards are met. Carol has got a great sense of humour and can lighten the mood in minutes. Carol is what a Call Handler should be: understanding, reliable and a good listener.”

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Terry Court, Military Co-Responder Team Leader based at RAF Brize Norton, won the Governors’ Ambassador Award. His nomination included: “During the last six years Terry has mentored many people, and currently leads a team of 20 Co-Responders.

Terry works on average four shifts per month (on top of working full-time within the RAF and having family time with his nearest and dearest), he actively participates at lots of the

Co-Responder events and families days too. Terry’s manager told me that ‘the team at Brize would not be as successful as they are without Terry’, this speaks volumes and really shows his passion and contribution to SCAS.”

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Chief Executive, Will Hancock The Ambies is always a special event and a highlight in our calendar. It was a great way to finish a very special year for the NHS in celebrating its 70th anniversary and remind ourselves – not that we need much reminding – of the truly incredible people who make the NHS the envy of the world. Congratulations to all our winners and those shortlisted; with people of this calibre working in it, the future of the NHS is in good hands.

The Medicines and Research Team, based across SCAS sites, won the Team of the Year – Support Award. In the nomination, the team was commended for: “In 2017-18 the Medicines and Research Team completed recruitment to the largest cardiac arrest trial in Europe. Although five ambulance services were involved SCAS contributed 30% of the data cementing our reputation as a research-capable organisation. The Trust is now recognised on the national stage as being research active. As a result we have been invited to speak on the subject of of pre-hospital research at a variety of forums.”

The Thames Valley Patient Transport Service Team won the Partners and Stakeholders Award for Innovation. The team was nominated for a project that it ran in partnership with Wexham Park Hospital, East Berkshire CCG, Thames Valley Commissioners and SCAS’ own Business Intelligence Team to improve on the day patient discharges.

“Due to the success of the pilot it has continued as business as usual and SCAS has now been requested by commissioners to do the same exercise for Oxford University Hospitals (OUH) and then following that go live next will be Buckinghamshire Healthcare Trust. We believe this innovation is a first for PTS nationally and are extremely proud of the results. This innovation has significantly improved patient experience, improved system flow across East Berks, improved KPI performance and showed that when NHS organisations do work together great results can be achieved in the interest of all our patients.”

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A FASTER, FIRST RESPONSE At the beginning of October, SCAS was delighted to announce the launch of a new partnership with Vodafone UK that would help get the Trust’s community first responders and co-responders to emergency incidents more quickly.

The new scheme enabled over 400 mobile devices with 4G connectivity to be distributed to SCAS’ responders.

The devices also came with a bespoke app, First Response, developed in partnership with CommonTime, which facilitates simple and reliable communication between the responder and the Clinical Coordination Centre.

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Community First Responders (CFRs) when providing on-call cover for lifethreatening emergencies in their community, would previously use a pager to alert them to a nearby incident, a SatNav to find the patient’s home and a mobile phone to make any calls.

Nic Morecroft, Head of Community Engagement and Training, said: “Vodafone UK was already a provider to the Trust, so we asked them to provide a solution that could help establish and maintain communications with our responders, as well as reducing the number of devices required to attend an emergency.”

The new solution provides the responder with a dedicated phone so that they can use the First Response app installed on it to register themselves via a unique PIN to SCAS’ Clinical Coordination Centre as logged on and available to respond.

Dispatchers can now see at a glance, which responder is nearest and available when an emergency 999 call comes in, and so send a push notification to the nearest responder via the smartphone or tablet app. They can also track where the responder is and will know when they have arrived by the patient’s side.

Ian Knight, CEO of CommonTime, added: “We are privileged to be working with SCAS to help them improve response times and efficiency for this critical service. Our experience in developing bespoke mobile applications has served us well and allowed us to develop the unique solution with SCAS required to ensure CFRs were able to continue to deliver lifesaving first aid effectively. We look forward to working with both SCAS and Vodafone UK to identify future enhancements and other areas where we can work together to aid these essential volunteers.”

Peter Cooper, CFR who responds for Aylesbury North said: “The amount of work I have to do as a receiver is very small. I simply accept the job via the app, the maps are loaded automatically and that means my on-site time is so much quicker. The new app has been transformational because it really means I can do the job of looking after the patient; that is what’s really important.”

Anne Sheehan, Enterprise Director from Vodafone UK said: “We are delighted to be working with South Central Ambulance Service to help improve response times for this critical service, and ultimately patient care. We will be working together to identify other areas where we can use the power of technology to bring benefits to both CFRs and patients.”

Nic Morecroft, added: “The excellent relationship that has developed between SCAS, Vodafone and CommonTime is now so strong that we can share openly information about its ongoing development for the future.”

The next phase in this innovation is to build a patient report form within the device, so responders can hold key information regarding the patient (that can be securely managed, protecting patient information), which can then be transferred directly to SCAS. The initiative is just one of a number of projects that the Trust has developed, recognising the huge opportunity that digital technology offers to improve patient care.

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On 13 December, Amanda Cundy, Co Responder Training and Liaison Officer (Armed Forces) and Military Champion at SCAS, along with some of our amazing Military Co Responders, attended the 10th Annual Military Awards, affectionately known as The Millies.

served with refreshments and had an opportunity to mix with the other nominees for all of the awards before a large group photo was taken.

Portsmouth A&E pair help provide international medical relief From thousands of entries, SCAS’ Military Co Responders were shortlisted in the Hero At Home (Unit) category. The team’s nomination highlighted how they had attended 5,626 incidents and undertaken an impressive 2,496 volunteering shifts between September 2016 and August 2017. This included being part of the emergency team at the scene of four cardiac arrest incidents where the patient had started breathing by the time they arrived at hospital. And all this was achieved on top of their day jobs in the Armed Forces.

Speaking about the team’s nomination and attendance at the awards, Amanda said: “The enthusiasm, dedication and professionalism shown by every team member of the Military Co Responders is exceptional. I’m sure everyone knows how very proud I am to work with this group of people. They were nominated for ‘The Millies – Heroes At Home Award’ by one of their own who has recently left the Royal Air Force to take up life in the civilian world, WO Jim Underhill.

As this is a national award, to be in the top three nominations was an amazing achievement for everyone and they should be very proud. We had an amazing day. Firstly, visiting Number 10 Downing Street for a reception with Gavin Williamson, the Secretary of State for Defence. We were

The evening event was very glamourous; the Banqueting Hall in Whitehall is an impressive building and that, coupled with the celebrities who joined us for the evening, made it a night to remember. Just being a part of an event that celebrates such brave and heroic men and women, not just in their primary roles, but here at home in their local communities, was a truly humbling experience.”

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CALL HANDLER EMILY’S SPECIAL DELIVERY

Winter 2018

Becky Taylor from Faringdon in Oxfordshire, who was pregnant with her second child, was woken up in the early hours of 6 June when it became apparent that the baby was on its way.

“We couldn’t have got through it without her!”.

“At around 2am my waters broke and I woke up my husband, Phil. I told him to call the Great Western Hospital in Swindon and let them know we were going to be coming in as that’s where we had planned to have the baby.”

However, with Phil on the phone to the maternity ward it soon became apparent from the answers he was providing that the labour was progressing much more quickly than expected; the hospital told the couple it was unlikely that they were going to get there in time so they

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suggested calling for an ambulance.

Just before 3.30am, Emergency Call Taker, Emily Wade, picked up Phil’s 999 call in the Bicester Clinical Coordination Centre.

Becky said: “Emily was absolutely amazing – a few minutes into the call she told us the ambulance had been sent but the nearest available one that had been sent was coming from some distance away from our home. She was able to keep us both calm and was constantly giving us instruction and asking us questions.

She made sure she knew what was happening at all times and when it became clear the baby was going to arrive before the ambulance, she then instructed Phil on how to deliver him safely. We couldn’t have got through it without her!”

Baby Sebastian arrived about ten minutes before the ambulance crew, Elliott Chilingirian and Greig Wyllie.

Phil adds, “Elliot and Grieg were equally wonderful – they were so reassuring and friendly. I’m a fire fighter and we obviously have some medical training – but it certainly doesn’t cover delivering babies!

Becky still needed to go to hospital so the guys looked after her and Sebastian really well and took them both to the Great Western. We couldn’t have asked for better care.”

The family, including older brother Oliver, wanted to meet up with Emily in person, and again with Elliott and Greig, to say thank you for all their help. On 26 October, they visited SCAS’ Kidlington Resource Centre and whilst unfortunately Grieg was unable to be stood down from his shift that day, Elliott was able to take a short break and Emily was not on duty and they were both

delighted to be able to meet the family.

Becky was able to tell them both that her stay in hospital was for around 36 hours and that the surgery that it was initially thought she might need, turned out not to be required in the end. Baby Sebastian was made a suitable fuss off, very much enjoying his cuddles with the SCAS team and five-year-old Oliver was thrilled to be shown round an ambulance and be able to turn on the blue lights!

Winter 2018

LAUNCH OF WINDSOR SAFETY HUB On 19 October, a new service – the Windsor Safety Hub – was opened to provide additional support at night for vulnerable people in and around the town centre.

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The Windsor Safety Hub is a partnership between SCAS, Thames Valley Police, the Royal Borough of Windsor and Maidenhead and the Windsor Street Angels. It is based at Windsor Baptist Church on Victoria Street and is open every Friday and Saturday night from 10pm to 3am. Over the festive period, additional services ran on Christmas Eve and New Year’s Eve. The Hub, which enhances the support that was already being provided by the Windsor Street Angels, provides respite, refuge, support or first aid to any person requiring it.

Neil Durrant, Clinical Operations Manager for East Berkshire and South Buckinghamshire at SCAS, said: “The ability to see, treat and discharge or refer patients to non-A&E services enables us to reduce the impact of the night time economy on local health services. As well as those affected by drugs and alcohol, or the victims of assaults, the Hub staff have also been able to assess a number of the town’s rough sleepers. Working in conjunction with the local drug and alcohol teams, primary care services and mental health team, we are now able to take a preventative approach to managing chronic underlying conditions within the rough sleeping community, reducing the impact this has on 999 services during the peak winter months.”

Inspector Louise Warbrick, from the Windsor Neighbourhood team, said:

“This is a great example of how multi-agency partners are working together to improve night time safety for the local community and visitors to Windsor. By combining resources all under one roof, we can ensure that those in need receive help while reducing demand for emergency services during peak periods.”

Windsor Street Angels Co-ordinator, Police Community Support Officer David Bullock, said: “The new Safety Hub complements our wonderful team of patrolling volunteers so that we can help even more vulnerable people. The team provides a range of support from supplying water and blankets through to administering first aid or simply allowing people to talk about their problems.”

Almost two-thirds of the patients seen at the Safety Hub since opening have been treated by the team without the need for an ambulance to be dispatched.

Winter 2017 2018

It’s the most, busiest time of the year

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The festive season is always a busy time for SCAS and this year proved no different, with the seven days from 24-30 December being the busiest week of 2018 for both our 999 and NHS 111 services.

From Christmas Eve to New Year’s Day, the NHS 111 team helped 38,899 patients and the 999 team came to the aid of 11,692 patients.

The 999 team achieved all the national response time targets as well as call answering targets, and handover times at hospitals within the South Central region were also shorter this festive period.

was less than a fifth of the level it was at over the same period in 2017.

Our Patient Transport Service (PTS) team faced significant challenges this festive season with an increase in demand (both planned and unplanned), with clinics and hospitals trying to get more people to have had their appointments as well as more patients discharged from hospital in time for Christmas.

PTS teams on the road and in the Contact Centre went above and beyond on numerous occasions to get people home for Christmas, as well as ensure those patients who need regular treatment – such as dialysis for renal patients – were able to make their appointments.

Over in the NHS 111 team there was a 30% improvement in the speed with which calls from patients were In Sussex, Nick Highfield and Brian answered and the call abandonment rate Owen (08:00-14:00) and Clare Davis and Richard Alder (14:00-20:00) volunteered to work from the PTS base at Hellingly on Christmas Day; a great example of the dedicated staff we are lucky enough to have on our PTS team.

Winter 2018

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Thank you to all our staff and volunteers for their efforts over the festive period

Winter 2018

CHIEF CONSTABLE COMMENDATIONS FOR SCAS STAFF

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Winter 2018

A number of SCAS staff have recently received commendations from Thames Valley Police. The recognition was given for two similar incidents earlier this year, firstly over the M40 in Oxfordshire and then in the centre of Reading.

Darren Weston, Assistant Private Provider Manager (Seconded) “On the 11 January 2018, I was part of a multi-agency response to an incident that closed the M40 in both directions. On my arrival, Thames Valley Police had road closures in place and were trying to negotiate with a young teenage female who was standing on the wrong side of the barriers on a bridge over the motorway.

Having attended multiple incidents similar to this, I had a real concern that the young lady was troubled in terms of her mental health and showed a real intent to jump. I suggested that we review a plan whether she had consumed alcohol or taken drugs prior to this event as I was concerned that she could become impaired if any substances she had consumed had yet to take effect.

It was soon established that she was on medication that could

cause drowsiness. There was a real feeling that she would jump from the bridge, or accidentally fall as temperatures were near freezing and the road surfaces and pavements were slippery. As the incident went on it became clear that the patient was becoming disengaged with the blue light agencies and I, together with the other bronze officers at the scene, devised a plan if this occurred.

I relocated the ambulance crew at the scene to the carriageway below; they were out of sight of the patient but would be with her in seconds if she jumped or fell. Because of our escalating concern towards the

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patient, it was decided that blue light personnel would make an assertive attempt to grab her. This occurred swiftly and thankfully without injury to her or anyone else.

The young lady was checked over in the ambulance as she was very cold, and then transported to a place of safety by the SCAS crew accompanied by TVP officers.

It was very humbling to receive the Chief Constable’s Commendation for an incident where all the agencies involved were recognised for their effective, collaborative working in such challenging conditions.

The commendation mentioned the

effective scene management I was able to provide, but this was just one part of the SCAS response that day. Equally as important were the team in the clinical co-ordination centre who initially responded to the emergency, as well as the ambulance crew with me on the day who ultimately handled and cared for the patient with great compassion and dignity.�

Darren received the commendation from Chief Constable Francis Habgood at a special event held at Holdsworth Hall on 21 November 2018.

Winter 2018

Three members of staff from Reading Ambulance Station received Thames Valley Police Commendations after they successfully intervened and brought a positive resolution for a patient who was threatening to jump from an overbridge in the centre of Reading.

Pat Harris (Team Leader), Lydia Kerr (Paramedic) and Rob White (Emergency Care Assistant) were called to the incident, a report of a male patient experiencing a mental health crisis, who was sat on the wrong side of an overbridge 30-40ft above a very busy dual carriageway. The patient was clearly intent on his actions, was distressed and the crew managed to gain his confidence, by communicating with him and providing support to him, along with officers from Thames Valley Police.

Sadly, despite all their efforts, the patient went to jump from the bridge, but the team reacted with haste and managed to grab the patient, preventing him from harming himself and others on the carriageway and he was pulled back to safety and detained under the Mental Health Act by our police colleagues.

Pat and Lydia were able to attend the commendation ceremony at Reading Police Station on 3 October, presented by the Area Commander Superintendent Stan Gilmour, however Rob was taking some well-deserved leave and was unable to attend the award presentation in person.

Recognising the importance of this award, Head of Operations for West Berkshire, Kirsten Willis, asked SCAS Chief Executive Will Hancock to present Rob’s award on his return to work.

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Will attended Reading Ambulance Station on the 17 October, which was Rob’s first day back, to surprise him with the formal presentation of his commendation. A small celebration was held and Rob was able to receive his commendation along with his colleagues who had attended the official presentation coming in off duty to support him.

Winter 2018

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SCAS REMEMBERS THEM

Winter 2018

As part of South Central Ambulance Service NHS Foundation Trust’s (SCAS) commemorations for the centenary of the end of the First World War, the Trust applied a poppy sticker to 100 of its emergency 999 and patient transport service ambulances.

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The first sticker was applied to a brand new vehicle at our South Central Fleet Services base in Milton Park, Abingdon, on Wednesday 6 November, at an event attended by a selection of SCAS staff who are military veterans or active reservists, along with some of our military co-responder partners.

Assistant Director of Operations at SCAS and Army Reservist, Paul Jefferies, said: “I was delighted that staff across our organisation were able to use these vehicles to help commemorate a landmark occasion that touched the lives of so many people in our region. Feedback from those staff who have been fortunate enough to be allocated a poppy branded vehicle has been overwhelmingly positive with many staff commenting that they felt extremely proud to be using these vehicles.

“The spirit of unselfish service that was epitomised 100 years ago is alive and well in the South Central region today, as evidenced by the excellent care and dedication given by our own staff and volunteers. We are extremely proud of our commitment to those members of our team who are military veterans or serving reservists, as well as incredibly thankful for the excellent support we get from our volunteer military co-responders.”

The poppy stickers remained on the 100 vehicles for the whole of November.

On Sunday 11 November, SCAS staff and volunteers took part in remembrance parades and events across the South Central region.

We were particularly proud that Reading Paramedic, Stephen Jackson, was invited to attend the official commemorations at the Cenotaph in central London on Remembrance Sunday. Prior to qualifying as a paramedic, Stephen was a Naval Submariner.

Winter 2018

At 11:00 hours on Remembrance Sunday – and where operationally possible – staff and volunteers on duty fell silent to remember the fallen. In particular our thoughts turned to the 6,873 members of the Royal Army Medical Corps who died performing their duties unarmed in the First World War. Seven members of the RAMC were awarded the Victoria Cross in that conflict.

Some of those brave medics were amongst those buried at Tyne Cot Cemetery in Belgium. This was where Team Leader Babs Mudge, Clinical Mentor Kelly Brunton, Associate Ambulance Practitioner Luke Mortimer (all from our Wexham base) and Technician Sean Mudge (Bracknell) visited on Thursday 8 November to lay a wreath on behalf of everyone at South Central Ambulance Service.

“It was a beautiful Autumn day and the British and Commonwealth soldiers lie in a very peaceful location on a hill overlooking Ypres. A situation that couldn’t have been more different during the Battle of Passchendale on the same spot in 1917 that claimed so many of their lives.

Everyone found it a moving experience; not just because of the scale – Tyne Cot is largest Commonwealth War Graves Commission cemetery in the world and the resting place of nearly 12,000 men – but also because so many of the soldiers lie in unmarked graves. We were also struck by just how young the vast majority of those who have been identified were.”

Babs Mudge

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PETER AND FAMILY THANK SCAS TEAM FOR SPECIAL CHRISTMAS

On Tuesday, 18 December, Gosport resident Peter Knight and his family made a very special pre-Christmas visit to SCAS’ North Harbour Resource Centre in Portsmouth. One of Peter’s daughters, Kristen Stone, had got in touch with SCAS through social media to say thank you to the team that saved her Dad’s life when he went into cardiac arrest at home on 19 November.

Winter 2018

Back row (L-to-R): Max, Katie, Kristen, Vicki Soris, Dawn, Janet & Nathan Front row (L-to-R): Chantelle, Lauren Stone, Baby Mila-Mae, Peter & Monica

Kristen was delighted with the offer of the family being able to give their thanks to the whole team in person.

“I remember being sat on the settee that evening”, says Peter, “and the next thing I remember is waking up in the ambulance!”

Peter, a chef, had gone to work early that day as normal and after coming home, he had put the tumble dryer on, sat down on the settee with a cup of tea and began to feel unwell. Thinking it was indigestion, he decided a lie down would probably be the best medicine and so he went upstairs.

Peter’s partner, Monica Stone, recalls what happened next.

“I had stayed on the settee and was playing Candy Crush”, says Monica. “Peter is never ill, famously never having been to the doctor for over 20 years, and he’s a bit of a joker. So when he came downstairs

and joked around a little about still not being well, that’s all I thought it was – but then things took a rapid turn for the worse.”

Peter collapsed on the sofa in the living room and Monica immediately dialled 999.

Her call was answered in SCAS’ Clinical Coordination Centre by Emergency Call Taker, Dawn Robinson, who assured Monica that help was being sent immediately by Emergency Dispatcher Chantelle Lomas and her Assistant Dispatcher, Max Daniels-Byng. Dawn also then talked Monica through carrying out CPR on Peter whilst the ambulance crewed by Katie Candlish and Nathan Mather made their way to the family home.

Katie and Nathan arrived in under four minutes, followed three minutes later

by Janet Woodland in a rapid response vehicle.

Luckily, Peter’s daughters and partner, Monica, have been making sure he has been doing exactly that.

Monica adds: “I don’t know how you got there so quickly. I was numb that day; all I remember is Dawn’s voice. I was grateful for her help and just did exactly what she told me. The hardest part was getting Peter on the floor – he was such a weight! I never thought I would ever have to call 999.”

She tells the team: “You really don’t get enough appreciation for all that you do. You were like angels that came from nowhere.

I cannot praise you enough; I thought Peter had gone.”

Katie adds, “Monica was doing everything perfectly when we got there. I’m sure the minutes must have felt like hours to her, but her actions definitely saved Peter’s life. Those minutes of CPR were vital and when we took over, we gave Peter one shock from our defibrillator and that restarted his heart.”

With Janet’s help, Peter was loaded on to the ambulance for the journey to the Queen Alexandra Hospital and was handed over to the PPCI Catheter Lab where he had a stent fitted. He only needed a three day stay in hospital and, apart from having cold feet now, feels ‘as right as rain’.

“I’ve stopped smoking now obviously”, says Peter, “and cut out the sweets!

The hardest part for me was resting and taking things slowly; I’ve a very active job in the catering trade and sitting still is not easy!”

“So this afternoon me and my family met the ambulance service that saved my Dad’s life when he had a heart attack a few weeks back. So overwhelmed meeting these truly amazing people who go to work every morning selflessly for every one of us with rarely little appreciation. I for one can’t fault our NHS and without them our Christmas as a family could have been so different. From the bottom of my heart thank you to the response team who talked my Mum through giving CPR, the paramedics and ambulance crew that treated him and brought him back to us, right through to the cardiac ward at the Queen Alexandra Hospital. It really does make you realise how important family is and I for one will be holding them just that little bit closer this Christmas... thank you so much.”

Kristen Stone

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Winter 2018

Community round-up

Our charity team, staff, community first responders, volunteers and supporters work tirelessly all year round raising much needed funds for the South Central Ambulance Charity and other causes, as well as develop and strengthen the Trust’s relationship with the local communities we serve.

Here’s a small selection of what they have been up to between October and December 2018.

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Charity Fun Day and Annual Members Meeting On Saturday 6 October SCAS held its Annual Members Meeting alongside a Charity Fun Day at the Asda Superstore in High Wycombe, Buckinghamshire. Activities on the day included a charity raffle, blood pressure tests, emergency vehicles and CPR demonstrations. In the community space, people attending had the opportunity to hear about the Trust’s activities over the last year, as well as review the Trust’s Annual Report and Accounts.

Pete’s 100k Gridiron Challenge Pete Marriott and his son, Peter, took on the 100K Gridiron Cycle Challenge in October to raise funds for the SCA Charity. The event was held on 14 October; the day that Storm Callum swept across Hampshire! As a result, only 285 of the registered 1,000 entrants turned up. The biblical weather conditions didn’t deter Pete and Peter though, and they completed the challenge raising £200.

Winter 2018

World Aids Day SCAS staff across the organisation ‘Rocked the Ribbon’ in support of World Aids Day on 1 December. The Trust is part of the National Ambulance LGBT Network and in the Network’s first joint venture it worked closely with the National AIDS Trust to produce a new resource pack for ambulance staff to coincide with World Aids Day. The resource pack can be downloaded here: www.scas.nhs.uk/news/ campaigns/world-aids-day/

CALA Homes Supports Windsor First Responders Local award-winning housebuilders, CALA Homes, donated £1,700 to Windsor’s Community First Responders to install a state-of-the-art Terrafix communication and tracking system in the Scheme’s first response car. The new device provides access to the mapping database currently used by other emergency services.

Nick Twine, Managing Director for CALA Homes (Thames) said: “We are delighted to have been able to support the Windsor Community First Responders as part of the 2018 Community Bursary scheme. Community is firmly placed at the centre of our ethos, and the first response volunteers perfectly mirror this with the incredible work they do, potentially saving lives. Therefore we are thrilled to provide the funding to enable them to purchase and install their system, which will hopefully result in much more effective communication between them and the emergency services.”

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999 Ted Joins Christmas Lights Switch On On 1 December, SCAS Mascot, 999 Ted, was part of the SCAS Team that supported the Christmas Light Switch On in Bicester, home of our Trust HQ. Information was given out to all those in the town centre about the Trust, its career opportunities, the launch of the new SCAS Youth website and the work of the Charity. A tombola raised over £300 too!

Red Bag Scheme Launched in West Hampshire SCAS staff joined Eastleigh MP Mims Davies and colleagues from NHS West Hampshire Clinical Commissioning Group, University Hospital Southampton NHS Foundation Trust, Southern Health NHS Foundation Trust and local care homes to launch a new, nationally recognised Red Bag Scheme in Hampshire. The bags are designed to carry people’s health information, care plan and medication, as well as personal items such as glasses, slippers and dentures so they don’t get lost if they go into hospital.

Winter 2018

Children in Need Staff in SCAS’ Southern and Northern Houses raised nearly £400 for Children in Need in November. The funds were raised by a ‘silly headwear at work’ day and a raffle. Well done everyone!

Milton Keynes Tri-Service Hub Takes Shape In December, Director of Finance, Charles Porter, Head of Estates, Paul Cross, Head of Operations, Mark Begley, and Clinical Operations Manager, Steve Winfield, had a guided tour around the MK Tri-Services Hub that is currently under construction. The impressive, state-of-the-art building is beginning to take shape just off the A5 and, once completed in early 2020, will be the base for local ambulance, police and fire service teams.

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Royal Wedding – Take Two! SCAS staff and volunteers were once again on duty in Windsor on 12 October to look after the thousands of well-wishers who descended on the town to see the wedding of James Brooksbank and Princess Eugenie.

Sussex PTS Team Visit Conquest Hospital PTS Team Leaders Matt Atkins and Dale Glazier, along with Locality Manager, Ian Thomson, visited Conquest Hospital in October to demonstrate the latest equipment that is now available to Sussex PTS to help patients get to and from hospital. This is part of a regular

Winter 2018

series of engagement events with local partners in Sussex in order that they can get the best out of the local PTS team, as well as help local hospitals understand the best way to book and use the service.

Karen Cycles India Karen Pieroni, who works for SCAS’ NHS 111 service in Northern House, cycled 450km across India from Agra, the home of the Taj Mahal, to Jaipur in Rajasthan. She was part of a ladies only group and completed the effort in an impressive five days! The 96 women in the team raised an amazing £362,592 with the money being split between breast cancer, Jo’s Cancer Trust and cervical cancer charities. Well done, Karen!

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Winter 2018 Autumn 2018

How are we doing?

Ambulance Response Programme

Apr-Dec 2018 What does it mean?

Category 1

Category 3

Life-threatening calls. Responded to in an average (mean) of seven minutes and at least nine out of ten times within 15 minutes (90th percentile).

Urgent calls. Responded to at least nine out of ten times within 120 minutes. You may be treated by ambulance staff at the scene.

Category 2

Category 4

Emergency calls. Responded to in an average (mean) of 18 minutes and at least nine out of ten times within 40 minutes (90th percentile).

Less urgent calls. Responded to at least nine out of ten times within 180 minutes. You may be given advice over the phone or referred to another service, such as a GP or pharmacist.

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Category 1

Category 2

06:58

15:48

90th Percentile

90th Percentile

12:42

31:34

Category 3

Category 4

Mean

Incidents 20,344

90th Percentile

1:56:15

Incidents 115,220

Target achieved

Mean

Incidents 169,764

90th Percentile

2:47:14

Incidents 9,583

Target missed

Winter 2018

Winter Twenty Eighteen Please send articles, or ideas to communications@scas.nhs.uk along with any photos or images.

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Copy deadline for the next issue of Working Together is 22 March 2019

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