“The North East Ambulance Service aims to achieve excellent out of hospital care.”
PATIENTS: putting patients first
About UsWe provide accident and emergency (A&E) and non emergency patient transport (PTS) for the 2.55 million people living in Northumberland, Tyne and Wear, County Durham and Teesside, covering an area of approximately 3,230 square miles. See the map for details
In 2007/08 NEAS A&E crews dealt with 320, 000 emergency calls from the public. PTS crews carried out 1, 048, 941 out-patient journeys.
The trust employs 1842 staff.
North East Ambulance Service headquarters is situated in Bernicia House on Newburn Riverside Business Park, Newcastle upon Tyne where operational and administrative offices are housed. The A+E control is shared between Bernicia House and the Ambulance control in Cleveland Police HQ, Ladgate Lane, Middlesbrough. PTS control is also housed in Bernicia house as well as at Tower house, Thornaby, Teesside Throughout the region there are 66 Trust locations including 57 ambulance stations. A number of the stations also house the non-emergency Patient Transport Service employees and vehicles.
Some sites are shared with the Fire Service in an effort to increase ambulance cover and reduce overheads. Due to the urban and rural areas of the Trust, we operate various types of vehicles to cope with the differing road conditions. In total, the Trust runs 103 A+E Ambulances, 50 rapid response cars, and 30 Urgent Care Ambulances. The Trust also makes use of helicopters funded by the Great North Air Ambulance, and also RAF Boulmer when available. We have 224 non emergency vehicles within the Patient Transport Service. These vehicles travel over six million miles per year.
The role of the Emergency Planning Department is many fold, but one of the key responsibilities is the preparedness of the NEAS to respond effectively to significant or major incidents. Whilst no two major incidents will be the same, certain common response procedures will be invoked by the North East Ambulance Service (NEAS) for the National Health Service response to the specific Major Incident. When the scale, type and location of the scenario can vary so widely, it is important to ensure that any response is effective and flexible. Generally, most major incidents will involve either transportation or premises, however the NEAS should also be capable of responding to other sources, which could have significant impact, e.g. flooding, toxic gases or radiation.
The Ambulance Service forms part of the National Health Service response to major incidents and is principally geared to the immediate medical needs of those directly or indirectly associated with the incident and their subsequent transportation to established medical treatment centres.
The Ambulance Service is primarily responsible for the alerting and mobilising of all National Health Service resources necessary to deal with the incident. They are the ‘gateway’ to the NHS and in the first instance contact the necessary Acute Hospitals likely to be effected and the Health Protection Agency (HPA). The HPA will cascade the relevant information to specialist departments within the HPA (Radiation, Public Health etc) and the appropriate Strategic Health Authority (SHA) and Primary Care Organisations (PCO).
It is accepted that the Police will normally undertake the overall control and co-ordination at the scene of a major incident, whilst the Fire Service will undertake control of the inner cordon when hazards are present.
The primary areas of Ambulance Service responsibility are summarised as follows:
Where permanently located ‘Special Risks’ establishments exist, e.g. airports, seaports, chemical plants, oil installations and venues for public events, local plans should be drawn up specifically related to responding to a major incident at the installation. The plan should also be subject to periodical practice to ensure that staff are made familiar with the procedures and equipment.
In 2004 the Ambulance Service Association (ASA) and the Department of Health asked the ASA Civil Contingencies Committee to look into the feasibility of ambulance personnel joining other emergency personnel to work within the inner cordon (also known as ‘the hot zone’) of a major hazardous incident.
The HART programme
Traditionally the Ambulance Service had always operated within the ‘cold zone’, areas where contamination was not present and the area was deemed to be a safe working environment. Various major incidents in recent years, alongside the increasing threat of a chemical, biological, radiological or nuclear occurrence resulted in ambulance staff being trained and equipped to work within a ‘warm zone’ environment, in order to provide decontamination to casualties and emergency services workers under medical supervision.
The inner cordon
In January 2005, experts in mainstream ambulance services, clinicians and specialists in the CBRN field acknowledged that not being able to operate in the ‘hot zone’ (inner cordon) of a major incident meant that the ambulance service was potentially being impeded in its ability to undertake the clinical interventions necessary to preserve life at the early stages of a CBRN/HAZMAT incident.
Subsequent experience from the terrorist bombings in London on 7th July 2005 also proved that being able to work in the centre of these scenes, when there was no contamination present, meant that many lives were saved that would otherwise have been lost.
As a result, the decision was taken to explore the possibility of being able to train and equip personnel who would be able to work safely in such environments even when there are contaminants or other serious hazards present (whether caused deliberately or accidentally). This resulted in the beginnings of the HART programme.
The Department of Health was later approached by the Fire Service with a request to consider training paramedics to work in the Urban Search and Rescue (USAR) environment, alongside their own personnel. The decision was subsequently made, during 2006, to add a USAR capability to the HART project.