Wednesday, 24 April 2013
Back door privatisation?
Recently we, in our area, are seeing more and more of what used to be considered 'Voluntary' Services providing front line Ambulance services. The staff working these vehicles are now being contracted, as is the Voluntary service, to provide additional services to the normal Paramedic vehicles. The vehicles are contracted from the one of the Voluntary agencies, whilst the other still provides additional resources at peak times to our Paramedic professionals.
Staff that were once on courses ran by our Ambulance Trust are now turning up at jobs aboard these vehicles, because they can actually get better paid by being on this contracted bank work, than they could have earned whilst working for the Trust.
They are being sent to every kind of Emergency imaginable, sometimes as First Responders, sometimes to back up our Rapid Response Vehicles and sometimes, and this is the scary bit, to Emergency calls on their own. This means that Patients are being attended by First Aid providers in situations where Paramedics are required to attend and stabilise the patient.
This is by no means a reflection on all the staff, as some of them actually recognise when a Higher degree of Primary aid is required and will ensure that it is called for in good time. Some staff will not however take this decision and seem to adopt a 'we were sent therefore we will deal' attitude. I regularly see staff from this Voluntary service, strolling around the Hospital wearing their stethoscope around their neck like a badge of honour.
An example of the calls that the crews are being sent to include RTCs, premature births and Cardiac emergencies. I have personal experience of staff attending a possible cardiac patient trying to stand me down before I get to the patient, which is worrying as I am not aware of any of them having done a ACS course, and they have only just recently got a Monitor that we use to actually put on a patient. They carry no advanced drugs, some are not even qualified to Technician level and yet they seem to be attending more and more 999 emergency calls that the public make.
If they are paid, does that mean they should be accountable to a professional body? Again there is evidence of Staff who would normally work in Hospital and need their actions signed off by a Dr, because they have no prescripting rights, nor any PGD for drugs, and are carrying out procedures under who knows what guidance. There seems to be a rash of complaints coming in against the staff provided, not because of who they are, but because of what they do and with no obvious direction to do it.
Surely if they are being brought in to provide additional resources to our overstretched A&E staff, there are better roles for them. As an example, why can they not be sent to 'GP Urgents', at least there the patient has been seen by a qualified medical professional and has been deemed stable enough for non emergency treatment and transport. This at least would release A&E staff to deal with the more urgent Emergency calls and the 'not so stable' urgent cases.
It is apparent that staff within the trust have no idea of some of the skill levels of these amateur crews as they are just logging on at the start of their shifts, and the assumption is being made that the skill levels are suitable for all kinds of Emergencies. Having spoken to staff within our contact centre I know that they are completely unaware that the Amateur staff attending are First aid qualified and are not even of Technician level. I have even encountered 'Advanced First Aiders' and I don't even know what that means!
I am genuinely concerned that the ignorance shown, the apparent improper use, and the lack of skill is going to lead to a serious incident, and only then will it all come out in the wash. So who then takes the blame for that scenario?
If we are to employ Amateurs then we are going to end up with an Amateur system and it does all seem that if they can provide a 'cheap A&E' service will we lose our Professional status and what will our patients lose?
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