Stakeholder Newsletter - 22/09/2020

Welcome to the latest edition of the Scottish Ambulance Service’s Stakeholder Briefing. This briefing contains an overview of the latest news from the service. Please contact us if you have any comments or suggestions.

Stonehaven rail crash

At the height of summer our crews in the north of Scotland were called upon to help with the aftermath of the tragic derailment in Stonehaven, just south of Aberdeen. Very sadly, three people on the train that day lost their lives and our sympathies are with the families of the deceased.  A further six were injured.

Emergency ambulance crews, our Special Operations Response Team, Patient Transport crews and the SCOTSTAR team and managers all attended the incident co-ordinated by ambulance control, and conducted a multi-agency response, alongside colleagues in the Police, the Scottish Fire and Rescue Service, Network Rail, the Coastguard and the Scottish Charity Air Ambulance.

Our teams were there not only to treat the injured at the scene, but to transport them to nearby hospitals and to provide medical backup for colleagues in other agencies conducting the retrieval and rescue of passengers.
The swift, professional response from our staff in such a stressful, challenging situation ensured that those patients who needed our help were treated with the highest quality of care at the scene and transferred to nearby hospitals.
Pandemic overview

In our last Stakeholder Newsletter, we provided an update on our role in dealing with the Covid-19. Since then our role has expanded as the pandemic continues to dominate our schedules and planning.

Throughout the spring and summer, our staff have been on the frontline of Scotland’s response, from being first on scene to many emergency calls from patients with the condition, to ensuring continuity of service for other patients who need our help with non-covid related conditions.

Our Patient Transport Service, which ensures sick patients are able to travel to and attend hospital and GP appointments, has also adapted to ensure our services remain available to those who need us alongside protecting them from any potential cross-infection.

On 31 August we took over the operation of Scotland’s Mobile Testing Units (more information on that is provided below) and during the pandemic we have developed new ways of working at pace.
Our frontline staff have continued to do us proud by working under difficult circumstances which requires them to don personal protective equipment (PPE) to help patients.

We have been innovative in our response to the challenges and continue to  look at new ways of working that can further improve patient care. We have, for example, introduced video triaging for certain categories of patients which has involved highly trained and experienced Advanced Paramedics and Nurses assessing some patients virtually.

Meanwhile, many of our support staff continue to work from home, using Microsoft Teams to conduct our regular meetings and we have focused our attention on ensuring all staff get the help they need.

Finally, as we enter the cold, dark months, we are about to launch our annual flu campaign, in which we will be encouraging all staff to be vaccinated. The winter months typically see a surge in calls as the regular flu virus takes hold, but this year we are gearing ourselves up for dealing with that alongside Covid-19 calls.

Mobile Testing Units

On the 31 August the Scottish Ambulance Service took over responsibility for conducting coronavirus tests on the public at Mobile Testing Units from the British Army.

Mobile Testing Units operate across 18 locations in Scotland, providing patients with a service to ensure patients in urban, rural and remote areas have easy access to a test.

Around 470 temporary additional staff have been recruited so that we can support the Scottish Government’s Test and Protect programme.

The units, which complement the static drive-through testing centres and the testing being carried out in hospitals and care homes, ensure that testing is as accessible as possible for all communities.

Our remit is of a clinical nature with our staff administering the tests on site. Wider issues such as appointments, scheduling, locations of centres, demand or the timing of test results are managed and overseen by NHS National Services Scotland, alongside the UK and Scottish Governments.

Advanced Triage

In April, the Scottish Ambulance Service introduced the Advanced Practitioner remote consultation model which has involved highly trained and experienced Advanced Paramedics and Nurses assessing patients virtually to ensure they received the most appropriate care promptly. Since launching, our Advanced Practitioners (APs) have triaged more than 27,000 patients – approximately 10% of 999 calls – and resulted in around 17,000 patients avoiding unnecessary transfer to emergency departments. About 10,000 of these patients required transfer to hospital.

The Scottish Ambulance Service’s primary response is to save lives and attend emergency calls involving life threatening conditions and incidents. However, a growing number of 999 calls to the service involve urgent but not life threatening situations. This new model is in the best interests of patients and ensures we get the right treatment and care for patients in the right place at the right time.

The process involves the APs having a discussion with patients over the phone or through a video consultation. APs are able to access a number of options to ensure patients get the most appropriate support, which could include providing self-care advice, referral to a GP or NHS service or dispatching one of our APs in cars. Whilst some patients will still require an ambulance and taken to hospital, many can be more appropriately managed within their own home or community with the right support. We will always continue to send an ambulance to those patient who require one.

At present, we have 80 APs operating at various locations across the country. Recent staff and patient surveys have shown very positive feedback and we are currently working on establishing the model as a permanent operation.
Earlier this year, the BBC spent a day at Dunfermline Ambulance Station observing the APs during a shift. You can read more here: https://www.bbc.co.uk/news/uk-scotland-53681625

Paramedic training

Education a new generation of paramedics is vital for us to boost our capacity and as we move towards the time of year colleges and university courses are restarting, it is worth highlighting the changes to paramedic education that are happening.

You may recall that earlier this year five Scottish universities were awarded contracts to carry out paramedic education after having their degree programmes approved and validated by the Health and Care Professions Council.
Glasgow Caledonian, Stirling, Robert Gordon, Queen Margaret and West of Scotland Universities will all commence their programmes at the end of this month (September 2020).

There is ongoing and continued work to recruit more Paramedic Practice Educators/Mentors to support undergraduate students across the Service from each of the universities.

Meanwhile, as a consequence of the Covid-19 pandemic, the diploma programme was suspended for a period of time to enable students and staff to return to frontline operations.
We are pleased to say that the Diploma programme recommenced on the 20th of June 2020.

Finally, the process for our 2020 recruitment campaign recommenced on the 7 of August 2020. Successful applicants will be allocated to the remaining 2020 cohorts and recruitment to the final Dip HE cohort for 2021 will commence in due course.

Positive patient stories

We receive many compliments from patients who have been treated by the Scottish Ambulance Service. We are very proud to share with you just a handful of the compliments we received from patients and their families during Covid-19.

Firstly, we were sent a lovely compliment from a mum who gave birth prematurely at home. She wrote:
“Of all the things that went differently about my birth experience and especially being premature - all the things that could have went wrong - I felt listened to, respected, validated, heard, like my choices still mattered. Although scared, I felt safe and secure with these people looking after me and I trusted they would do everything they could to keep me and babe alive and well.

“Covid barely came into my mind at this point, other than the checks that no one had symptoms, and I can happily say that it did not make their care any less thorough or any less compassionate. I will rave about and compliment the Scottish Ambulance Service, those paramedics and the NHS to anyone that will listen, pandemic or no, lockdown or no - they were the paragons of professionalism, competence and done what they needed to do, even in the midst of a global disaster.”

We also received a compliment from a patient who was suffering from mental health difficulties. She thanked two Aberdeen Ambulance Station staff members for the care she received. 

In an email she says “I sort of phoned 999 out of sheer desperation late Friday night, early Saturday morning.... Not really knowing what was going to freak me out less between either yourselves or the police, I ended up asking for the ambulance service. I was scared.

“The paramedics were brilliant. They let me probably tell them utter nonsense as, situationally had nothing to do with them. But, they listened, they made me feel like they cared and they helped me when I felt so lost. I do want to highlight, something I notice they’re very skilled at, there has been a previous issue I had whereby paramedics attended my flat as I had an allergic reaction and totally panicked. They treated me at home and because I knew what had caused it, and my symptoms significantly improved at home, they didn’t feel I needed A&E and I agreed with them.

“This particular incident and, others as well, they’re very insistent in a gentle kind of way that, I needed help from someone other than them. Let me get round to the idea of A&E on my own. I know I didn’t have a choice but, in my head at the time, I felt safe with them and that means more to me than anything.  They didn’t judge me.”

We also proactively shared a story of young mum, Stacey Stevenson, who gave birth only a few days after finding out she was pregnant. She praised the two Falkirk staff members for the excellent care she received.