Update from Medical Director, Dr Mark Patten (1st December)

Dr Mark Patten web

I recently visited the A&E department at Peterborough City Hospital and witnessed first-hand the amount of time patient-facing staff wait at hospital to handover their patients. As an example, the first crew I spoke to had been waiting an hour and a half – and I know that this is by no means the longest delay and is certainly not unusual. I recognise the frustrations, as a clinician myself I understand the want to help and care for all of our unwell patients rather than spending time waiting in a queue. I met with our hospital providers this week to see how we can better work together, and we should be able to share the outcomes of that with you very soon.

Providing the best patient care we can is always at the heart of everything we do as a service, and safeguarding their details is essential. This is more than part of my role as Medical Director. I am the Caldicott Guardian for the Trust, which means I have a responsibility to protect patient identifiable information and promote the safe sharing of information. As part of my work as guardian, patient care records and the information within them fall under my responsibility, and I do have some concerns at the moment about the number of incidents we attend where a patient care record isn’t completed. A patient care record means we have an accurate log of the care we have provided; as well as being important when handing over a patient to hospital, it also supports our audit trail should we be asked to present the record as evidence. It’s about safeguarding you all, especially in the rare event where something goes wrong. For more information on why it’s important to have completed patient care records, please take a look at the article published on Need to Know last week.

I’m happy to report that we’re in the middle of recruiting people to every stage (bar one) of the revised clinical career pathway that we launched at the start of the year.  We have recruited intermediate ambulance practitioners (IAPs), associate ambulance practitioners (AAPs), student paramedics and specialist paramedics, and our training and education team are looking into ways of recruiting an academic partner to help support the AAP to paramedic element of the pathway.  We know we are on the right track as we are now getting interest from graduates interested in our clinical focus and we are seeing a continual drop in staff attrition. Our Trust now has a lower rate of staff leaving or retiring compared to some other ambulance trusts.

Unfortunately though, the university that was supporting our technician to paramedic pathway has discontinued their involvement, so we are now working to find an academic partner to develop this option with us. This new clinical career pathway was launched in January 2016 in tandem with the recruitment of graduate paramedics, and provides a clear, internal, apprenticeship-type model.  In this regard, there appears to be much confusion about the role and future of our IAPs. To be very clear, they are not ECAs with a different name, and are on a clearly defined pathway of clinical progression. The next steps will be for me to review their scope of practice, and, if possible, expand it.  Once we reach a critical mass of IAPs and AAPs, we will then be establishing an intermediate tier to focus on middle to low acuity work. This approach will position us well to ensure we dispatch the right clinical team to meet the needs of our patients rather than the current model of sending ‘anybody to anything’.

I know it often divides opinion in the ambulance service, but as medical director I would really encourage and ask you to have the flu jab if you haven’t already. It’s our duty to protect our patients from contracting flu, and to play our part in stopping the spread of what can be a life-threatening illness for some people. All of our available flu clinics are listed on East24, so please take a look.

I know it feels like the pressure never stops and having now entered the winter period, we are now hitting our busiest time of year. I’ll be responding myself over the coming weeks and I look forward to meeting some of you out on the road.

Have a great week,


Published 1st December, 2016

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