Need to know
For #TeamEEAST Last updated: 18 May 2024 at 08:29
This week's We Are EEAST Briefing and Executive Q&A was led by our CEO, Tom Abell. This week Tom was joined by Melissa Dowdeswell, Director of Nursing and Interim Chief Operating Officer.
Introduction from Tom
Starts @ 00:09
Ends @ 03:27
Introduction from Melissa
Starts @ 03:30
Ends @ 09:34
Questions
Q1 - For two days running we missed our break and have been stuck at different hospitals waiting to offload. We receive vast amounts of emails containing platitudes however is anything being done about this? For 5 hours we had to listen to general broadcasts telling us of unassigned code 9s and this is extremely distressing to not be able to respond.
Answered by Tom
Starts @ 09:46
Ends @ 11:37
Q2 - With no ambulance clinician on the exec board currently, is there confidence that there is a clear understanding of the work that is undertaken in frontline operations?
Answered by Tom
Starts @ 11:38
Ends @ 12:14
Q3 - The Trust have moved to a standard load list for DSAs. There are numerous issues which can lead to patient safety incidents. Can I ask why there were no operational colleagues on the panel where these decisions are made, but just ‘management’ who probably have not set foot on an ambulance for years? Apparently, there is also no robust process in place to challenge and change any issues – can we do better??
Answered by Tom
Starts @ 12:15
Ends @ 13:34
Q4 - There has been an instruction to complete a form with staff who are unable to drive a Fiat. These individuals have already had a measurement form completed, OH report, and an ergonomic assessment. Why are the Trust now insisting on completing a form which will only result in the same outcome – that the individual is unable to drive a Fiat? I fear that by completing this form with no guidance, will only lead to staff feeling unsure of their future with the Trust. Are we really hammering away at staff morale even further with this process?
Answered by Tom
Starts @ 13:35
Ends @ 14:28
Q5 - Do we have plans like other Trusts to rapid release patients after 45 minutes of arrival?
Answered by Tom
Starts @ 14:30
Ends @ 15:56
Q6 – I’m sorry to ask anonymously, but I don’t feel I can speak up confidently. I know that the pressure on frontline staff is immense but has the Trust considered how burnt out and exhausted some areas of support services are. We have also worked consistently hard for the last 2 years and many with no recognition or thanks. Without the support services front line would be in an even worse position of burn out. Maybe some level of thanks to the support services without it being a second hand through attached to thanks for front line staff.
Answered by Tom
Starts @ 15:58
Ends @ 17:33
Q7 – Why is it that in my area, I get a text twice a day saying that EEAST are 'desperate for staff to come in on OT to help', yet when we ask for OT, we are told that the area is 'at its quota' so they cannot book us on OT. Since when was the target to hit a certain number of vehicles rather than to attend the calls outstanding in a reasonable timeframe? Staff are willing to volunteer their time to come in but being declined their offers? There are vehicles available to work on, it is not due to lack of vehicles.
Answered by Tom
Starts @ 17:35
Ends @ 18:46
Q8 - It has been reported in the media recently that LAS are implementing a 45-minute maximum handover time, after which the crews are being instructed to just leave the patient and clear. Bearing in mind we are only hearing this in the media, are you able to clarify if this is indeed the case and if EEAST will consider such an action?
Answered by Tom
Starts @ 18:48
Ends @ 19:11
Q9 - Hello Tom, can you please explain why given the Fiat's have been with us for over 2 years, yet we still do not use the fitted CCTV? Body worn cameras are in use so it cannot be a governance issue, I have been told it’s an issue between Unison and the Trust but I cannot find anybody who can explain what the trouble is and what is needed to solve it, it’s over 2 years the CCTV is for crew protection yet the Trust appears unable to switch on a fitted system because they feel it may cause an issue. Can you please give a simple direct clear answer with a timeline for this being switched on. Thank you, please understand this question is born out of frustration.
Answered by Tom and Melissa
Starts @ 19:12
Ends @ 20:26
Q10 - When booking OT, we have a situation where, when staff are able and 'allowed' to volunteer for OT shifts, they are not allowed to ask on booking to protect their finish times. We are being told that the Trust would prefer to have no staff come in on OT at all, rather than have a member of staff come in but finish slightly earlier... Is this a Trust position?
Answered by Tom
Starts @ 20:32
Ends @ 21:41
Q11 - The new ambulance loading list is appalling and is causing significant risk with several incidents of crews taking incorrect equipment into cardiac arrests as well as having to return both the DSA and RRV for restock after incidents due to different equipment loads - this must be reversed - immediately!
Answered by Tom
Starts @ 21:43
Ends @ 22:11
Q12 - Why is the government not re-opening the Nightingale Hospitals to free up beds to relieve the pressure on the system?
Answered by Tom
Starts @ 22:13
Ends @ 22:49
Q13 - Between WW1 and WW2, around 700,000 children were born each year. The following 30 years had ~900,000 births each year. This means that 80 years ago we have had a ~40% increase in births. This is why we have a struggle throughout the NHS. We have 40% more 60 years olds, 70 years and 80 year olds than we had a decade ago. We need a massive national input in resources, how can we raise this nationally?
Answered by Tom
Starts @ 22:51
Ends @ 24:03
Q14 - Vehicle based cohorting, with single members of staff in vehicles, is having a very real effect upon staff - in addition, the introduction of meal break cohorting has gone down like a lead balloon as it has proven to just make the crews available at the end of shift for a never-ending number of C2P and C1 calls - crews would rather miss a meal break than be 4 hours+ late off.
Answered by Tom and Melissa
Starts @ 24:05
Ends @ 26:39
Q15 - If we are under so much pressure why are we still responding to cat 3s and even cat 4s?
Answered by Tom
Starts @ 26:43
Ends @ 28:28
Q16 - We have our own inhouse PTS service - why don't we give the hospitals 2-3 discharge buses per 12 hours, sit them outside the hospital, when they are needed, they get called in, and they’re in and out of the hospital (be it A&E, wards etc) within 15-20 minutes. I've noted that some acutes have been waiting hours for discharge buses to arrive, meaning beds are being uses needlessly.
Answered by Tom
Starts @ 28:29
Ends @ 29:56
Q17 - Vehicles continue to be a major issue - our fleet locally is constantly running at 100% utilisation, there are vehicle faults and defects that are not getting fixed because we cannot afford to take what limited Fiat fleet we do have off the road, we regularly have crews waiting for vehicles, LOMs become fleet managers for half their shifts, the loading list is a complete disaster and dangerous, the list goes on. This is all as important as hospital delays, why isn't it being addressed and taken seriously? We must do better.
Answered by Tom
Starts @ 30:06
Ends @ 32:18
Q18 - Good afternoon, is there any more progress in making a hot 2 backup from an RRV the same priority as a C2. The only option currently is to make a hot 1 backup request for something that would normally be a hot 2 due to the high amount of outstanding C2 calls. Thanks.
Answered by Tom and Melissa
Starts @ 32:20
Ends @ 33:51
Q19 - In North Essex we are frequently sent to Mid Essex at the end of our shifts to cover outstanding C2 calls which have been held for hours despite having C2 calls in our area that need attendance.
Answered by Tom
Starts @ 33:56
Ends @ 35:11
Q20 - I am a graduate NQP, I have been working for the Trust for 4 weeks now; how comes my NQP hours haven't been completed? When I first started I only did 1 third manning shift with a band 6 paramedic, and by the second week I was no longer third manning but was working part of a crew with a paramedic. As of now, I have only done 4 shifts with a band 6 paramedic. I feel that the policy isn't fair when it places the responsibility on the NQP to get my NQP hours when I don't do the planning; I appreciate the demands, but I feel totally unsupported.
Answered by Tom
Starts @ 35:13
Ends @ 35:56
Q21 - This delay problem has been increasing for over 6 months now, on the ground nothing has changed, in fact getting worse. Simple truth unless the acutes unload in a timely manner the patients will suffer, I spend most of my shift delivering personal care to patients on the back of my ambulance, I even recently had a struggle to get food and drink for my patient who had specific dietary needs…
Answered by Tom
Starts @ 35:58
Ends @ 36:59
Q22 – Good afternoon Melissa and Tom. Following recent visits to ED over the festive period HALOs of all 3 of our acutes are absolutely maxed out. Can we consider a fixed term contract arrangement for the next winter for a HALO assistant role and/or doubled up HALOs over pressured hours in our busier acutes?
Answered by Tom
Starts @ 37:00
Ends @ 38:00
Q23 - (Adding to previous point) Our hospital at Colchester actively manages cohorting but Broomfield stacks outside on vehicles which means we all get moved to mid Essex and then miss our own calls and finish extremely late, AOC don’t seem to care and it’s very demoralising, why is this allowed to continue?
Answered by Tom
Starts @ 38:02
Ends @ 39:27
Q24 – With the patients in mind - due to 20 hour + delays at our local acutes, can we put some real thought in across EEAST about skin integrity and pre-hospital pressure ulcers . We have done our own piece of work locally, but we need to invest in more training and provisions such as REPOSE on every ambulance. We have asked but was met with minimal interest. This is a real problem.
Answered by Tom and Melissa
Starts @ 39:29
Ends @ 41:20
Q25 – Please can we include the patient safety team in the standard load list forum - we have made a change since the implementation following datix submissions, but we need to be involved to support changes. Thanks. Colleagues - please datix if there's any patient safety concerns.
Answered by Tom
Starts @ 41:21
Ends @ 41:45
Q26 - How can your admin teams support the frontline & control room staff, is there a way to volunteer to free up clinician's time? Maybe with admin, welfare checks or manning welfare trucks?
Answered by Tom
Starts @ 41:46
Ends @ 42:42
Q27 - Drop and go process can work. We were released for an unassigned cat 1. This patient was a time critical bleed who we got into hospital quickly for the emergency treatment they needed. Without drop and go I suspect the patient would not have made it to hospital.
Answered by Tom
Starts @ 42:45
Ends @ 43:47
Q28 - With regard to iPads being issued, if this is going to be an ongoing investment, is it possible to switch on the air print function? This will potentially mean that the Trust won't need as many desktop PCs on stations as people will be able to print from their iPad?
Answered by Tom
Starts @ 43:49
Ends @ 44:12
Q29 - I fully understand that acutes are in the same boat as us, but why do we fold to there every demand? When PCH goes on divert EMAS still show up? Why is this? Is it an agreement between EEAST and NWANFT? Are we letting our hospitals get away with bending the rules and not declaring their real situation to NHS England?
Answered by Tom
Starts @ 44:15
Ends @ 46:56
Q30 - Whilst we welcome a loading list feedback process, this is not enough - it needs to be rolled back and reviewed before we proceed. The current situation is SO inefficient. Whilst we're at it, let’s move into the 21st century - Why in 2023 do we not have electronic tracking/tagging/sign in/sign out/stock and drug management/etc. Sounds like we need to follow other amb services with purpose designed bags/pouches with consistent labelling, barcodes/RFID tags etc - let’s make it happen, ASAP!
Answered by Tom
Starts @ 46:59
Ends @ 47:34
Q31 - I heard today that an advert for Specialist Paramedics for the Advanced Paramedic project was published today. Does this mean that rotas and HR2’s etc have been actioned by HR et al? As I believe these where stumbling blocks with the previous intake of Advanced Paras resulting in many delaying their start with the project until these had been in place, as well as secondments.
Answered by Tom
Starts @ 47:36
Ends @ 48:21
Q32 - Could army medics be used to cohort at the governments expense, instead of our Trust having to spend ridiculous amounts of many on private companies.
Answered by Tom
Starts @ 48:28
Ends @ 49:13
Q33 – Thank you for your answer Tom, regarding the aging population, I note that the messages being put out by the NHS bodies are not explicit about the issue of the "baby boomers" and the lack of investment from concurrent governments. The issue of under investment is touched on, but no explicit data is shown on births. This issue could have been foreseen for decades. All of our projects that we are doing to help, are effectively meaningless compared to the issues we are facing.
Answered by Tom
Starts @ 49:15
Ends @ 51: 43
Q34 - Did the Nightingales also sell off all our ventilators as they never returned??
Answered by Tom
Starts @ 51:45
Ends @ 51:56
Q35 – Hello Tom, I really feel for your support services messenger, but can understand how they feel. Maybe if the Trust equalized the recognition for the support services with front line this would help. Last awards night most awards went to front line, just have a winner for each category from both sides? Afterall both FL and SS can have those that excel in care. My team still have not received water bottles from Christmas 2021 let alone the coffee mugs from Christmas 22.
Answered by Tom
Starts @ 51:58
Ends @ 52:56
Q36 - I feel there is no excuse for any employer not to be able to offer better end of shift protection. Being late off should be the exception and not the accepted norm. Road staff are increasingly frustrated with the attitudes and occasionally, rudeness, of dispatchers who are insisting crews to calls where they know that will make them 3,4,5hrs late off yet, knowing those same dispatchers will be going home on time.
Answered by Tom
Starts @ 52:57
Ends @ 52:56
Q37 - Hi Tom, meal breaks as you’ve said are very important for staff to have, why is it the case that staff are disturbed immediately after 30mins to respond to an upgraded C3 call that has been held for 12hours plus, where is the balance of welfare over response. Thanks.
Answered by Tom
Starts @ 54:10
Ends @ 54:57
Q38 - Legislation says meal break is a must??? Enforcing overtime is an issue… I have on times just felt like booking a taxi and going home after 3 hours waiting past my shift… acute hospital staff are busy but finish on time, even delaying offloading whilst doing handover. We should be billing the hospital for staff held up at hospital past shift finish times… the situation isn’t becoming unbearable it has been like that for months… work life balance is not happening…
Answered by Tom
Starts @ 54:58
Ends @ 55:34
Q39 - Fleet challenges are significant at every sector not just Suffolk! Is this a case of who can shout the loudest gets the support? I booked loads of staff short notice leave tomorrow as we do not have enough vehicles!!
Answered by Tom
Starts @ 55:35
Ends @ 56:10
Q40 – Hi Tom, happy new year! I know it's very random, but are staff that are non-operational who are working in training centres able to order jumpers as part of their uniform entitlements? Currently our colleagues in the AOS's are able to order and wear them however in training school we can only wear the jackets which aren't always comfortable whilst teaching. Thanks :)
Answered by Tom
Starts @ 56:13
Ends @ 56:47
Additional information - Hi Justine - I know that we are changing our uniform supplier and that we are all part of a national procurement programme. So, once we have the new supplier we will know what is available, hope that helps.
Q41 - Why did we reduce to a 40% resilience model with fleet to save money? You reap what you sow? Any comeback for the decision maker on this one?
Answered by Tom
Starts @ 56:48
Ends @ 57:21
Q42 - Is it true that we are moving away from Fiats and towards a Ford ambulance as the Fiat box test was never crash tested? Or is this just a rumour?
Answered by Tom
Starts @ 57:25
Ends @ 58:29
Close from Tom
Starts @ 58:30
Ends @ 58:51
You can catch up on previous We Are EEAST Briefings on our Archive page. You can also catch up on Local Manager's Briefings here.
Published 9th January 2023