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Welsh Ambulance Trust

New initiative to improve care for terminally ill patients

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The Welsh Ambulance Service has joined forces with Macmillan Cancer Support in Wales to launch a new initiative to improve the care delivered to terminally ill patients.

The collaboration, which launches this Dying Matters Awareness Week (10-16 May 2021), is designed to improve the training delivered to ambulance crews so they can provide the very best care for patients at the end of life.

The training will help to give staff a greater understanding of end of life care, supporting clinicians to better recognise when a patient is nearing end of their life, and improving communication and symptom management skills to prevent avoidable hospital admissions.

Ed O’Brian, Macmillan Paramedic and the Trust’s End of Life Care Lead, said: “The collaboration between Welsh Ambulance and Macmillan Cancer Support will bring huge benefits to patients and staff across Wales.

“Ambulance clinicians are often called to assist patients nearing the end of their life due to an advanced or terminal illness, so it’s vital they can do so having had the appropriate training and with the right support structure around them to deliver the best care.

Training is being provided to ambulance crews to help improve the care given to terminally ill patients (Image: Flickr)

“The network of support being developed as part of this project in conjunction with Palliative Care Wales is invaluable, such as the ability for an ambulance clinician anywhere in Wales to be able to contact a palliative medicine doctor 24/7 from the patient’s home to seek their advice and guidance in order to achieve the best outcome for the patient.

“The two-year project will also help us to identify why, where and when patients at the end of life are needing to access the ambulance service, so we can identify areas for further development across the health and care sector in Wales.”

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This is the latest in a series of initiatives between the Welsh Ambulance Service and Macmillan Cancer Support designed to improve the care that palliative patients receive.

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Richard Pugh, Head of Partnerships for Macmillan Cancer Support in Wales, said: “Macmillan is so very proud to be able to help fund this project through the fantastic and tireless support given by our fundraisers.

“This first-of-its-kind partnership means we can help people, and their loved ones, to spend their final days in the way they want.

“As people near the end of life, dignity and the knowledge that their final wishes have been met is the best comfort and gift we can give them.”

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Ambulance Service emergency contact centre (Image: Welsh Ambulance Service Trust)

In 2019, the Welsh Ambulance Service won an NHS Wales Award in the Delivering Person-Centred Services category for its End of Life Care Rapid Transport Service, as well as the Outstanding Contribution to Transforming Health and Care Award.

The End of Life Care Rapid Transport Service, delivered by the Trust’s Non-Emergency Patient Transport Service, works with teams across Wales to provide transport for terminally ill patients to their preferred place of death.

The enhanced service ensures patients and their families have minimal delays, helping to reduce any further distress and anxiety.

The dedicated service has made nearly 2,000 compassionate journeys since its introduction in 2017.

The Trust was also the first ambulance service in the UK to introduce ‘Just in Case’ medications to its frontline emergency vehicles, allowing paramedics to better manage the symptoms that may sometimes be experienced as terminally ill patients become more poorly.

Nikki Pease, Palliative Care Consultant at Velindre University NHS Trust, added: “Where and how people die matters.

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“This all-Wales collaborative project serves to ensure first class end of life care to all.”


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Welsh Ambulance Trust

New telephone triage support system for ambulance 999 calls in Wales

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THE Welsh Ambulance Service has introduced a new telephone consultation tool to help clinicians arrange the most appropriate care for 999 callers.

The service says the Emergency Communication Nurse System (ECNS) software supports control room clinicians to determine the best course of action for patients who call 999 through its evidenced based approach.

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Welsh Ambulance Service say ECNS is part of a comprehensive re-organisation of its control centres to help meet the increasing patient demand, changing healthcare environment and resource availability.

The system replaces a paper-based triage product and introduces digital features enabling clinicians to share patient information to their GP or another healthcare provider, making the process slicker.

But most importantly they say, the system is an evolving product.

The team behind the implementation are pressing on to introduce even greater functionalities to support both patient and clinician, with video functionality being an exciting future addition.

Dr Mike Brady (Consultant Paramedic) says: “Demand on our ambulance service is increasing year-on-year, so this is about thinking smarter about what we can do with the resources we have to keep up with the fast-changing picture.

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“The mix of combining people, process, and technology were the game changers, as well as the benefits of improved resource allocation.

“It means that patients are getting the right care, in the right place at the right time, and it also means we can protect our precious resources for those who need us most.

“We also try not to overwhelm the wider health economy if we can clinically care for patients at source and provide them the most appropriate care remotely and closer to home.”

(Lead image: Welsh Ambulance Service)

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Welsh Ambulance Trust

Calls to use ambulance services wisely this Jubilee Bank Holiday weekend

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The Welsh Ambulance Service is urging the public to use its services wisely over the four-day Bank Holiday weekend.

The Trust is also reminding people to collect any medication they require and stock up on first aid supplies to treat minor injuries at home as it prepares for a busy weekend.

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The NHS 111 Wales symptom checkers should be the first port of call for health advice, the service say.

Jubilee party-goers should also drink responsibly and treat emergency workers with respect.

Judith Bryce, Assistant Director of Operations (National Operations and Support), said: “We’re delighted to be celebrating Her Majesty the Queen’s Platinum Jubilee, and want people to have a safe and enjoyable celebration.

“We always see an uplift in demand as people take advantage of the long weekend, and this weekend is expected to be no different.

“More people are out and about socialising with family and friends, and this can lead to more people becoming ill or suffering injuries and requiring medical attention.

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“While there are plans in place to deal with the increase in demand, we only have a limited number of crews and vehicles available which means that we need to prioritise those sickest patients first.

“It also means that people not facing a serious or life-threatening emergency could wait longer for a response or be asked to seek alternatives to an ambulance response.”

Hundreds of events are happening up and down the country to mark the Queen’s Platinum Jubilee, the 70th anniversary of the accession of Queen Elizabeth II in 1952.

The Trust is gearing up by putting extra resources in place on the road and in control rooms so that it can support as many patients as possible.

“We’re also working with partners on a number of multi-agency initiatives to mitigate demand, including alcohol treatment centres in Cardiff and Swansea to offset the number of people needing to attend the Emergency Department presenting with alcohol intoxication,” said Judith.

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“Community First Responders will assist us not only by responding to calls in their local area, but by providing administrative support to colleagues in the Trust’s control rooms.

“We’re working hard behind the scenes to get us into the best place possible, but the public has a role to play too.

“Your GP surgery may be closed and your usual pharmacy may be closed or have altered opening hours, so check with them in plenty of time so you’re aware of any changes. 

“Please also ensure you have all the medicines you need before the Bank Holiday, be it everyday medication like paracetamol or cough remedies, or getting your prescription filled.

“If you need advice about medication or prescriptions during any out-of-hours period, a pharmacist should be your first port of call.

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“If your usual pharmacy is closed, search for an open pharmacy near you on the NHS 111 Wales website.

“The NHS 111 Wales website should also be the first place you visit for health advice and information if you’re ill or injured and unsure what to do.

“Help us protect our precious resources for those who need us most.”

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Welsh Ambulance Trust

Ambulance service issue Bank Holiday plea as emergency worker assaults continue to rise

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Emergency workers in Wales are reminding the public to treat them with respect in the face of a continued rise in assaults.

The monthly average of emergency worker assaults has increased from 203 in 2019, to 226 in 2020, to 237 in 2021, representing a year-on-year increase of 4.9 per cent.

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More than 1,440 assaults were committed in the six-month period 01 July 2021 to 31 December 2021, new figures have revealed.

The top five most common types of assault were kicking, spitting, verbal abuse, punching and shoving.

Among the victims is Joanna Paskell, a paramedic in Barry, Vale of Glamorgan, who was assaulted last May by a patient at Cardiff’s University Hospital of Wales.

Ambulance worker, Joanna Paskell who was attacked while trying to help a patient (Image: Wales Ambulance Service)

Joanna, an ambulance worker of 25 years, was subsequently left with panic attacks.

The mother-of-four recalls: “It was while we were trying to move the patient from the trolley to a bed that she lashed out and punched me straight in the chest.

“I was stunned as it was completely out of the blue, and there had been no indication that she was going to get aggressive.

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“Although shaken, I thought nothing of it at the time, just taking painkillers for the pain.

“It was only as I was getting ready for my next shift that realisation dawned, and I actually had a panic attack.

“I subsequently had to take time off work.

“It took a lot for me to come back, and even now, I’m very cautious around patients.”

Meanwhile, Andy Davies, a paramedic in Llangefni, Anglesey, was left with a dislocated shoulder when he was assaulted by a patient last June.

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Andy recalls: “The patient was becoming verbally aggressive to the point where we actually called for police back-up.

“As I tried to assess him, he threw me to the floor, partially dislocating my left shoulder.

“I had to have six weeks of physiotherapy afterwards to help me recover from the injury.

“I’m ex-military police so I’m quite good at compartmentalising these things, but it doesn’t mean to say we should accept it.”

Ahead of the extended Bank Holiday weekend, when assaults will typically spike, emergency workers are appealing to the public to treat them with respect.

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Jason Killens, Chief Executive of the Welsh Ambulance Service, said: “The last couple of years have been a fraught time for all of us, but that’s no excuse to assault an emergency worker, who are people, just like you and I.

“With a Bank Holiday weekend comes lots of people enjoying the revelry, and with alcohol consumption usually comes an increase in assaults.

“There were 80 verbal attacks alone on our ambulance control room staff in the second half of last year.

“We know it’s distressing when you’re waiting for help, but abusing our call handlers is not the answer – if anything, it could potentially delay help.

“On the road meanwhile, crews might have no choice but to leave a scene if their safety is compromised, and that’s not helpful for anyone, especially the patient.

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“The debt of gratitude we owe to our emergency workers has never been greater, so please treat them with respect.”

In the six-month reporting period, almost half of emergency worker assaults took place in South East Wales; Cardiff, Rhondda Cynon Taf and Bridgend were the most prolific local authority areas.

For 2021 as a whole, Denbighshire in North Wales had the highest rate of emergency worker assaults at 1.24 per 1,000 population.

Offenders aged 26-35 account for the highest portion of offending (21.9 per cent), and alcohol intoxication continues to apply to a third of incidents.

Twenty three incidents involved the use or threat of use of a weapon, eight of which caused injury to the victim.

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Assaults on police account for more than two thirds of the total number; there were an average 165 victims each month in 2021, up from 152 in 2020.

Pam Kelly, Chief Constable at Gwent Police, said: “Every day, our officers are working to protect and serve local residents and businesses.

“Being a victim of hate crime or being assaulted on duty is not acceptable for members of our own community as they go about their job.

“We already ask a lot of our officers and staff in the course of their working day as they often deal with situations most of us hope never to encounter.

“Working where the threat of verbal or physical assault is an increasing possibility makes the role even more challenging.

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“We work hard to support any officer who has faced this situation and we will take firm action against those individuals who cause them harm.”

Carl Foulkes, Chief Constable at North Wales Police, added: “Every single day our officers, staff and volunteers are often dealing with very difficult and challenging situations, putting themselves in harm’s way to uphold the law and protect the public.

“They must be able to carry out their duties as safely as possible.

“Being assaulted is not and should never be regarded as ‘part of the job’.

“Assault is a traumatic offence that causes great distress to anyone, and it is no different when the victim is an emergency worker.

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“It is wholly unacceptable for them to be threatened, attacked, verbally abused or spat at – and those responsible should face the full force of the law.

“Assaults stay with the victims for the rest of their careers, and none of my officers and staff should have to go to work serving the public and be afraid of being assaulted.

“With the busy summer season almost upon us, please respect and protect our emergency workers.”

May 2021 saw the highest volume of emergency worker assaults with 294, rising as Covid-19 restrictions were eased across Wales.

More than 100 instances are known to be Covid-19-related, for example, where an assault occurred during police attendance for a breach of regulations.

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Under the Assault on Emergency Workers (Offences) Act, the definition of an emergency worker includes police, fire and ambulance staff, as well as prison staff and NHS workers.

Judith Paget, Chief Executive of NHS Wales, said: “Emergency workers provide life-saving and life-changing care every day in often difficult circumstances and deserve to be treated with respect.

“Any form of attack on emergency workers is completely unacceptable and can have a significant impact on someone’s mental health and wellbeing.

“During the pandemic emergency workers worked tirelessly on the frontline to keep Wales safe and now they deserve to feel safe and appreciated for the great work they do.

“We must all work together to reduce their risk of being exposed to violence.”

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(Lead image: Wales Ambulance Service)

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