A leading ambulance service clinician has urged people to familiarise themselves with the signs and symptoms of life-threatening sepsis, sometimes known as blood poisoning.
Mark Ainsworth-Smith MBE, a consultant pre-hospital care practitioner at South Central Ambulance Service (SCAS), said anyone can potentially develop the condition, which occurs when the immune system overreacts to an infection – including viral infections such as COVID-19.
However, those at higher risk of developing sepsis are people aged over 75 or young children under a year old, as well as those who have experienced physical trauma such as fractures.
Patients who have compromised immune systems, such as patients who have undergone recent chemotherapy, are particularly at risk.
Symptoms can be vague and initially often feel like flu, gastroenteritis or a chest infection but people can worsen very quickly. This can cause their blood pressure to fall and shock the body which, if not treated immediately, can result in organ failure.
There are around 245,000 cases of sepsis in the UK every year, causing at least 48,000 deaths and around 40% of all sepsis survivors suffer permanent, life-changing after-effects.
However, if recognised and diagnosed early it can be treated effectively with medicines such as antibiotics and intravenous fluids, avoiding such severe consequences.
“Most of us who develop an infection will be fine; we will recover and go completely back to normal, but certain people will suffer a dysregulated response in the body which means they can become very unwell very quickly,” said Mr Ainsworth-Smith (pictured), who spoke out as part of World Sepsis Day today (Monday, 13 September).
“This is of concern as, although there are higher risk groups, sepsis can affect anyone and it can sometimes be hard to spot, so it is really important people familiarise themselves with the signs and take action when they need to.
“The pandemic has been a complicating factor because some patients have attributed their symptoms to COVID-19 and some have been scared to attend hospitals and GP surgeries to be assessed in fear that they are going to catch COVID-19.
“This has led some patients to delay seeking medical attention. We want to take the opportunity to highlight the condition and again raise awareness of sepsis.”
Mr Ainsworth-Smith said it was important for anyone who develops a fever and high temperature or shivering to take it seriously and seek medical advice. He also said the development of new confusion was a particularly worrying sign.
“Symptoms such as a high fever or feeling really unwell or shivering badly are absolutely things that should be addressed and we would recommend people contact their GP, phone 111 or use 111 online if they are experiencing these symptoms and want to get a professional opinion,” he explained.
“However, if they truly think they’ve got sepsis – particularly if they are a person in a high risk group – that is an emergency and it’s perfectly appropriate to phone 999 in those circumstances where our expert staff will ensure they get the treatment they need as quickly as possible.”
Mr Ainsworth-Smith said ambulance services across the UK have developed extensive guidance and training programmes for staff on recognising sepsis, with SCAS the first to adopt the second version of the National Early Warning Score 2 (NEWS2) system in the UK to identify a person’s need for hospital treatment.
“We have done a lot of education with our staff to help them to recognise patients with sepsis. When sepsis is diagnosed, our staff are well trained to start initial treatment before transporting seriously unwell patients rapidly to hospital. Our crews will alert the hospital so that sepsis specialists are ready and waiting when they arrive.
“When we assess a patient we’ll have a look at their vital signs, including their blood pressure, heart rate, temperature and blood sugar. NEWS2 is a scoring matrix we use to identify the sickest patients; the higher the score the more unwell they are and the more likely they are to require intensive care.
“If patients have a score less than that then we can decide what to do and some of those patients, particularly if they don’t have signs of sepsis, may be suitable to stay at home under close supervision from their GP. Patients who do actually have sepsis will end up being transported to hospital.”
For more information, visit the SCAS YouTube channel to hear more from Mr Ainsworth-Smith or visit www.worldsepsisday.org.
South Central Ambulance Service NHS Foundation Trust (SCAS) has been shortlisted for NHS Trust of the Year in the HSJ Awards 2021 in recognition of the contribution made by the organisation and its staff to regional, national and global healthcare.
The award recognises trusts which are offering excellent patient-centred care built on strong engagement between clinicians within and outside of an organisation and takes into account the effects of one of the most challenges years since the NHS was formed.
Among the areas of focus for the judging panel were initiatives which deliver performance against targets, clinical quality and safety, as well as how trusts have managed their way through the pandemic along with financial pressures, staff wellbeing and integrated care.
In recent years SCAS has taken a leading role in the delivery of regional healthcare by shaping and defining emergency and urgent care services and positioning itself as a ‘care navigator’ for the needs of patients through close collaboration with partners.
This has included the SCAS-led development and implementation of integrated urgent care models which facilitate enhanced clinical guidance in areas such as mental health, maternity and dental care via NHS 111, demonstrating further expansion from the traditional model of 999 ambulance care.
Other service transformation has included a pioneering initiative to help patients receive the right treatment more quickly – the urgent care pathways project – which has so far seen more than 30,000 people avoid unnecessary transfers to emergency departments.
The project, established in 2019, sees ambulance service clinicians take a leading role in assessing and treating patients over the phone or in their homes when handling 111 or 999 calls and determining their next destination for ongoing care.
It has led to many patients being treated at home, referred onto their GP, transported to a treatment centre or admitted directly into a specialist hospital service covering medical, surgical, paediatric, respiratory, frailty or mental health needs – by-passing busy emergency departments.
As the NHS 111 provider for the South Central region, SCAS has also led the successful rollout of NHS 111 First, a triage and booking system for emergency departments to help manage demand and capacity at hospitals across the region.
In addition, SCAS took on a significant national role establishing COVID Response Services on behalf of NHS England including a dedicated arm of NHS 111 – the COVID Clinical Assessment Service (CCAS) – made up of GPs, nurses and pharmacists to help manage the needs of patients with COVID symptoms.
During 2020, SCAS also pushed ahead with its launch of a healthcare consultancy initiative in India – the first NHS partnership of its kind in the country – to improve healthcare provision and ambulance services in the south-eastern coastal region of Andhra Pradesh.
SCAS has also been shortlisted in the Military and Civilian Health Partnership category alongside the Ministry of Defence for the work of Military Co-Responders who work with SCAS clinicians to respond to emergencies in their communities.
A total of 160 MoD volunteers operate 13 blue light ambulance response cars across the South Central region, volunteering an average of 650 hours at more than 140 incidents a month – bolstering the service at times of need.
Among the other shortlisted entries to involve staff at SCAS are Portsmouth Hospitals University NHS Trust’s project to automate ambulance handovers for faster, safer and less stressful patient information processing and Southern Health NHS Foundation Trust’s NHS 111 mental health crisis pathway across Hampshire and the Isle of Wight.
These feature in the Driving Efficiency through Technology and Mental Health Innovation of the Year categories respectively.
Will Hancock, Chief Executive of SCAS (pictured below), said: “We are thrilled to be shortlisted for these distinguished national awards, particularly as the Trust of Year encompasses all of the work we have been doing and our partnerships – including with the military and neighbouring trusts – are so valuable to us and our patients.
“This recognition really does reflect the collaborative efforts and dedication of colleagues across SCAS and within our partner organisations and it is a wonderful achievement for everyone involved to make the shortlist.
“I want to say a personal thank you to all of our staff and volunteers for helping us get there – each and every one of them should be immensely proud of the role they have played in achieving this recognition.”
HSJ editor Alistair McLellan said: “On behalf of all my colleagues I’d like to take this opportunity to congratulate SCAS on being nominated in the categories of Trust of the Year and Military and Civilian Health Partnership in this year’s HSJ Awards.
“The applications we receive always present our panel of judges with a very difficult task as the standard is unfailingly high and the breadth of innovation and passion for patient care is always so inspiring.
“This year we really have been overwhelmed with the level of entries, particularly when set against the backdrop of the COVID-19 pandemic and the huge challenges faced by our health and social care workforce.”
More than 1,000 entries were submitted for this year’s HSJ Awards, with 205 organisations, projects and individuals making it to the final shortlist. SCAS is the only ambulance service and one of only nine trusts in the country to make the Trust of the Year shortlist.
The full list of nominees for the HSJ Awards 2021 can be found on https://awards.hsj.co.uk/shortlist-2021. Winners will be announced during a ceremony at Evolution in London on 18 November.
South Central Ambulance Service NHS Foundation Trust (SCAS) has marked a year of its pioneering healthcare consultancy initiative in Andhra Pradesh, India with a visit from the British Deputy High Commissioner.
Dr Andrew Fleming met SCAS representatives based in the region yesterday (Wednesday) who, in partnership with the Aurobindo Pharma Foundation (APF), have been working to improve healthcare provision and ambulance services in the country.
The project became the first NHS international partnership with India when it was launched in July last year – and attention quickly turned to SCAS supporting the country’s response to the COVID-19 pandemic.
It followed a decision by the Indian Government to begin a significant investment programme to address wide gaps in healthcare provision inspired by the ‘free at point of contact’ NHS ambulance services available in the UK – and resulted in an approach to SCAS for guidance.
Over the course of the year, SCAS staff have supported the expansion of 108 Emergency Response Services – the equivalent of the UK’s 999 service – and the introduction of 104 Mobile Medical Unit Services – the equivalent of the UK’s NHS 111 and GP visiting services – in Andhra Pradesh.
The south-eastern coastal region in India is the seventh largest state in the country with a similar population size to the UK.
The agreement between SCAS and APF is due to run until 2027 and will include the development of SCAS-supported clinical guidelines and governance, education, wider healthcare system development and a workforce development programme.
The partnership is supported by Healthcare UK, an initiative led by the Department of Health and Social Care, NHS England and the Department for International Trade to promote the NHS in overseas markets and the model has the potential to be rolled out across other states and countries in the future.
“We have had a very successful first year operating internationally as an organisation, securing the first NHS contract in India and launching enhanced equivalents of both 999 and a combined 111 and GP visiting service for a significant population of India,” said Richard McDonald, Clinical International Liaison Officer for SCAS.
“Within the first month we oversaw the introduction of 1,000 new ambulances in addition to the existing 350 vehicles already in service and have shared our knowledge to help with the much-needed rapid development of ambulance services and healthcare provision in India.
“We have also been on-hand to support the country through the pandemic by providing valuable input and guidance and our local team enjoyed welcoming Dr Fleming to the 108 Emergency Response Services control room this week to find out more about our progress.”
Buckinghamshire New University, in partnership with South Central Ambulance Service NHS Foundation Trust (SCAS) and London Ambulance Service NHS Trust (LAS), has launched a new BSc (Hons) Paramedic Science course which will start from next month (September).
The three-year degree course will be delivered from the University’s High Wycombe and Uxbridge campuses, supporting workforce development in the Thames Valley and London regions. The programme received development funding (£100k) from Health Education England alongside capital investment from the University to develop the new programme.
This addition to Buckinghamshire New University’s course catalogue, alongside new midwifery and physiotherapy programmes, will support the expansion of the institution’s impressive healthcare portfolio.
Students will take part in placements supported by SCAS and LAS to help meet the strategic national workforce development priorities for this sector.
The programme will be led by Associate Professor of Paramedic Science, Will Broughton, who recently joined the University.
He said: “Paramedics have been front and centre in our response to the COVID-19 pandemic and we need to continue to grow this critical part of the health and social care workforce.
“We are very excited to be welcoming our first cohort of student paramedics to High Wycombe in September 2021, who will be undertaking frontline ambulance placements with South Central Ambulance Service NHS Foundation Trust.
“By partnering with two NHS ambulance services, as well as acute and community health and social care providers, we are providing students with excellent opportunities to gain clinical experience and core capabilities prior to joining the workforce on completion of their studies.”
Howard Farley, Senior Education Manager at SCAS, said: “Building upon a long standing history of supporting and developing individuals to achieve registered paramedic status, SCAS is proud of this new partnership with such a well-respected university.
“This new programme will ensure the continuation of world leading paramedic education into the healthcare system and the development of future initiatives to develop not only new graduates but also existing registrants.
“The challenges faced by the NHS during the global pandemic have been well reported and to develop a new degree level clinical healthcare programme during this time has been nothing short of extraordinary and is testament to both Buckinghamshire New University and SCAS colleagues.
“We look forward to a collaborative and successful partnership with Buckinghamshire New University and are excited to be welcoming each and every new student Paramedic into our wonderful NHS family from September 2021.”
From February 2022, the University will also welcome a cohort of student paramedics to the Uxbridge campus and they will be undertaking frontline clinical placements with London Ambulance Service NHS Trust.
Dr John Martin, Chief Paramedic and Quality Officer for LAS, said: “Gaining experience on the frontline whilst studying to become a paramedic is so invaluable, and a great way to put theory into practice.
“We’re looking forward to supporting students from Buckinghamshire New University when they start in February 2022, and providing placements to enable them to become great paramedics.”
Simulated patient encounters are a core component of the innovative new programme.
Alongside the University’s existing simulation provision at both the High Wycombe and Uxbridge campuses, and thanks to £100,000 in development funding from Health Education England and significant capital investment from the University, students will have access to the latest patient simulators, clinical equipment and two fully functional simulation ambulances to support their learning and teaching experience.
HEE Regional Head of Allied Health Professions, Rebecca Tyrrell, said: “We are delighted that the strategic development funding has enabled BNU to provide a new Paramedic Science programme and support such valuable growth in paramedics required within our region.
“We should also like to thank all our stakeholders in supporting the expansion of quality learning environments for the new cohorts of Paramedic learners.”
South Central Ambulance Service NHS Foundation Trust (SCAS) continues to drive forward with improvements to its Patient Transport Service (PTS) and has welcomed NHS England’s focus on the important role it plays in the wider healthcare system.
The PTS provides non-emergency transport for people who need regular hospital care but cannot travel by themselves to attend appointments such as radiotherapy, chemotherapy or renal dialysis, while the service also includes transfers, discharges and other outpatient appointments.
At SCAS the PTS handles the complete experience for these patients, covering everything from call handling, planning and dispatch of vehicles through to the 900 trained Ambulance Care Assistants who make around a million journeys a year.
The service operates across Berkshire, Buckinghamshire, Hampshire, Oxfordshire, Surrey and Sussex.
In 2019, former NHS England Chief Executive Simon Stevens commissioned a national review into the services in collaboration with patient groups including Age UK, Healthwatch England and Kidney Care UK and its findings were published this week.
The review sets out a path to improve patient experience and utilise learning from the impact of COVID-19, make greater use of technology to better communicate with patients and coordinate journeys, expand the role of community transport and improve accountability, procurement and contracting.
It also includes specific measures including a new universal transport support offer for patients travelling to and from renal dialysis, overhauling the Healthcare Travel Costs Scheme to make it easier for people on a low income to claim back journey costs and a commitment to 100 per cent zero emissions journeys by 2035.
A number of new initiatives have already been introduced at SCAS which relate to the findings of the review, including the implementation of an online booking system called Passenger Zone which enables patients or their families to manage booking details and check journey status.
The team also developed a pioneering modelling system which helped to ensure thousands of patients continued to receive life-saving treatment in hospitals at the height of the pandemic. It was able to forecast the expected demand for each day of the week using historic data and factored in staff absences, reduced patients in vehicles and extended journey times to calculate the ability to cope on any given day.
Additionally, the PTS is already preparing for the introduction of electric vehicles within the next six months – following the launch of the Trust’s first two fully electric emergency response vehicles in May – with the ambition of being fully electric within the next three to five years.
“Our PTS conveys upwards of a million patients a year, ensuring the most vulnerable patients can access healthcare and supporting patient flow through the system through the timely discharge of patients from hospitals – and our PTS staff and volunteers continue to play a pivotal role in the pandemic response,” said Paul Stevens, Director of Commercial Services at SCAS.
“As one of the leading providers for PTS in the country, we welcome the review which captures learning from the COVID-19 response, leads to a consistency in contract eligibility criteria for patients, gives national standards for all providers and sets a clear directive for zero emissions of which SCAS has already started to work towards with introduction of electric vehicles set to be included within six months into our PTS.
“We are proud of the progress we have already made across our service and will work closely with our commissioners and the NHS England implementation team to introduce further changes with a continued focus on providing excellent patient experience.”
He added: “We are also fortunate to benefit from a fantastic cadre of dedicated volunteer car drivers who support hundreds of patients in accessing hospital services every year and I would like to take the opportunity to thank them all for their outstanding work over the past year.”
The PTS at SCAS has not changed its practice regarding personal protective equipment (PPE) and social distancing and continues to operate using level two PPE and “Hands, Face, Space” principles. With reduced vehicle capacity as a result, transport should only be used for those requiring support for medical needs. Any patients travelling with the PTS are expected to wear a face covering unless exempt.
Anyone interested in finding out more about becoming a volunteer car driver should email volunteer.cardriver@scas.nhs.uk or visit the SCAS website.
South Central Ambulance Service NHS Foundation Trust (SCAS) has opened a new education centre for staff and students in Hampshire and the surrounding areas which includes state-of-the-art simulation facilities.
Whiteley Education Centre, near Fareham, boasts an immersive interactive suite and mock-up ambulance vehicles which provide real-life training environments.
It also includes six large classrooms, tutorial rooms, rest areas and office space, with all classrooms having the capability for filming and recording of sessions for immediate review and group learning.
The introduction of eight ‘mobile vehicle’ classrooms means driver training can also be delivered at the site.
The development follows the opening of the education and recruitment centre at Bone Lane, Newbury in 2017 which brought three former education sites together in one place.
The immersive interactive training suite offers the latest technology including virtual reality projections which enable staff and students to learn in a lifelike 3D environment complete with sounds and smells such as burning wood or nightclubs that are released via diffusers.
A mock-up ambulance is also built into a classroom which is kitted out with everything found in the modern ambulance, while the surrounding areas offer opportunities for outdoor scenarios – providing students with circumstances that are as close to reality as possible.
The SCAS clinical education, driving, higher education and quality assurance teams based in Hampshire have relocated from multiple sites to the new centre, bringing them together in the same place for the first time.
Workforce courses, along with statutory, mandatory, driving and clinical education for current SCAS employees, will take place at the centre in Whiteley Business Park, as well as student training and courses including the University of Cumbria’s BSc (Hons) Paramedic Apprenticeship Degree.
Ian Teague, Assistant Director of Education at SCAS, said: “This centre is a fantastic addition to our education facilities and provides the very latest equipment to teach our clinical staff to the highest standards.
“This not only benefits our patients and service-users, it means we continue to be able to offer potential new recruits and students access to some of the best facilities in the country which is key to attracting and retaining staff across all our services.
“The unique selling point of this site is what it offers in terms of clinical, driving and simulation education, attracting and producing high quality learners.”
He added: “As we see increasing interest and recruitment from overseas and via nursing routes in paramedic apprenticeship, specialist paramedic and ambulance practitioner roles, this centre provides the perfect learning environment.”
Melanie Saunders, Executive Director of Human Resources and Organisational Development at SCAS, said: “I am extremely pleased and very proud that our new education centre is now completed and open for staff and students.
“Whiteley is an ideal location for us due to its transport links and we are also really pleased to move several disparate arms of the education team under one roof.
“With clinical, driving, quality assurance and higher education teams based there we are able to deliver the entire suite of SCAS training and education in one place.”
04 August 2021
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