Working with Magpas Helimedix

Transcription

1 Patrons: The Lord Fairhaven K St J JP DL Lady Linda Vane Percy Dr Neville Silverston MBE Working with Magpas Helimedix Magpas The Emergency Medical Charity 105 Needingworth Road, St Ives, PE27 5WF T: W: magpas.org.uk Registered charity number:

2 Thank you for your interest in the Magpas Helimedix Team. We hope you find this information useful. This pack contains information regarding: 1 Magpas the Emergency Medical Charity 2 Magpas Helimedix 3 Operational Activity Appendix 1 Person Specification Helimedix Doctor Appendix 2 Person Specification Helimedix Paramedic Appendix 3 Frequently Asked Questions If there is anything further you would like to know, please contact us at the Magpas Helimedix Base: Telephone: or [email protected] If you wish to apply you will need to complete Magpas Helimedix Volunteer Application Form which is available on request. Simon Lewis Alistair Steel Dan Cody Natalie Norman Robyn Addison Helen Hale Helimedix Clinical Director, Helimedix Doctor Helimedix Associate Clinical Director, Helimedix Doctor Helimedix Associate Clinical Director, Helimedix Paramedic Helimedix Operations Manager Helimedix Administrator Helimedix Administration Assistant Page 2 of 18

3 1 Magpas the Emergency Medical Charity Magpas is a Care Quality Commission registered emergency medical charity based in Cambridgeshire. It provides the framework within which volunteer and employed staff are trained, equipped and governed to respond to life-threatening clinical emergencies in support of the NHS. The charity s constitutional aim is the provision of immediate medical care to any persons involved in accidents or medical emergencies within the East of England and the surrounding counties. In 1971, the Mid-Anglia General Practitioner Accident Service was created by local GPs who increasingly found themselves called to attend serious accidents on local roads. The organisation was one of the first Immediate Care Schemes in the UK, and provided training and equipment for volunteer doctors wishing to care for those involved in serious accidents. Since this time, Magpas has been at the forefront of pre-hospital care in the UK. The name s historical origins no longer accurately reflect either the membership or the range of activities currently supported by the charity and we are now simply referred to as `Magpas Helimedix, the emergency medical charity'. Magpas provides a clinical service in support of the NHS the Magpas Helimedix team. This is a specialist clinical team of doctors and paramedics who provide for the clinical needs of the most severely ill or injured patients when and where they need it in the East of England. This includes responding to incidents by land or air on behalf of the East of England Ambulance Trust and surrounding ambulance trusts. In partnership with Cambridge University Hospitals, we also provide a Major Trauma Outreach Service facilitating transfers of seriously injured patients from Emergency Departments around the region in a dedicated transfer ambulance. We are very proud to be approved to provide sub-specialist training in Pre-hospital Emergency Medicine as part of the Health Education East of England training programme, and were the first to appoint a trainee in the UK. We are developing this further with the Deanery and Cambridge University Hospitals and are also working hard with others to develop professional paramedic practice. In addition to the clinical services, Magpas undertakes and facilitates audit and research, including the Cambridgeshire Trauma Audit Research Project (CTARP). The charity is supported by a small team of administrative and fundraising staff. Clinical governance and leadership is at the heart of Magpas with experienced Clinical Directors leading the clinical services. The work of the charity and its volunteers has been recognised with the Queen s Award for Voluntary Service, the Investors in Volunteers Award and a GSK/Kings Fund Health Impact Award. Page 3 of 18

4 2 Magpas Helimedix What is Magpas Helimedix? Magpas Helimedix is a specialist emergency response and retrieval team who have undertaken specific training for the role and are equipped to provide the full range of pre-hospital medical interventions. The team comprises a doctor and paramedic drawn from a pool of appropriately trained individuals. The paramedics are from the East of England Ambulance NHS Trust. Our team members are a mixture of volunteers, personnel on secondments and fully funded staff. The team is trained to provide: On-scene medical support On-line medical support Secondary transfer of trauma patients Special incident medical support Major incident medical support From a clinical perspective, the Magpas Helimedix concept is based on the principle that the most important determinants of survival following serious injury are severity of injury and time to meaningful intervention related to the specific injury pattern. It is recognised that many patients have clearly identifiable critical care needs at the time of their injury and that these needs may not be being met by the conventional ambulance service or traditional immediate care doctor response. Where does Magpas Helimedix operate? The Helimedix team is based centrally near the Cambridgeshire-Bedfordshire border at RAF Wyton near Huntingdon. It is activated via the control rooms of the East of England Ambulance Service, or occasionally at the request of neighbouring NHS Ambulance Trusts. More information regarding the Organisation and the service can be found in the FAQs attached. Training The Helimedix Training Programme comprises: Phase 1a Phase 1b Phase 2 the Helimedix Course the following 360 hours for volunteers or five months for PHEM trainees a further six months for PHEM trainees Phase 1a (the Helimedix Course) involves a mixture of single themed days and residential education and training courses. Training is supported by a distance learning package via our Virtual Learning Environment (VLE) and operational observer/training days with structured training activities. Phase 1 also contains elements of training in between the residential training courses, which are again supported by the VLE, utilising the most of on-line learning resources. Magpas Helimedix training is modular and summative. It combines simulator based and classroom teaching with supervised clinical practice. Page 4 of 18

5 The training programme comprises the following over 16 days: - Introduction to Pre-hospital Emergency Medicine seminar - Scene safety, rescue and extrication - Transport and patient packaging - Pre Hospital Emergency Anaesthesia (PHEA) course - Pre-hospital Team Resource Management course - Pre Hospital Critical Care (PHCC) course - Clinical Governance in Pre-hospital Emergency Medicine seminar - Transfer medicine - Operational observer shifts (with a duty team) - Phase 1a assessment The Phase 1a assessment determines whether candidates can progress at all (5% are unsuccessful) and, if so, the level of supervision required. All successful candidates have three further directly supervised clinical shifts and then progress, according to performance and confidence, to indirect (nearby) or remote (telephone or distant) supervision. The Helimedix Course is designed to allow doctors and paramedics to develop their skills and demonstrate all of the core competences covered in the new sub-specialty Competence Framework for Pre-hospital Emergency Medicine. The Helimedix Course assumes a baseline level of knowledge and is not aimed at the inexperienced. The course contains elements of directed reading, formal teaching, problem based and experiential learning, simulator based training and objective structured assessment. Keynote speakers are invited to present material and conduct discussion sessions. High fidelity human simulators are used throughout the course to give maximum opportunity for participants to practice their skills and demonstrate competence. There is also a formal assessment the Phase 1a assessment. This involves a written examination, OSCE (objective structured clinical examination) and incident simulations involving pre-hospital critical care interventions. Performance is assessed by an experienced faculty of pre-hospital critical care experts. Successful completion of this assessment will allow Helimedix members to progress to phase 1b of training. Phase 1b (Helimedix Operational Experience) involves completion of: For volunteers: an average of at least 20 hours of supervised Helimedix operational experience per month over a minimum 18 month period. For PHEM trainees: five months supervised Helimedix operational experience. Supervision is provided at three different levels according to pre-hospital experience and performance on the Helimedix Course. These levels of supervision are: Level 1 (Direct supervision) - a period with a nominated supervisor operating directly with the trainee Level 2 (Local supervision) - a period with a nominated supervisor operating in close proximity to the operational trainee. The supervisor is able to provide immediate online and on-scene support if needed Page 5 of 18

6 Level 3 (Remote supervision) - On-scene or online support is available to the operational trainee if required. This may be provided from any location. In addition to this, all Helimedix personnel must successfully complete the Annual Clinical Update and take part in regular Pre-hospital Forum meetings where cases are reviewed in detail and any lessons learned clarified. 3 Operational Activity What working patterns are there? Currently there are over 40 volunteer members and full-time employed staff of the Helimedix team operating a self-rostering shift system aiming to provide cover from 7am to each day of the week. There are two fixed shifts each day the early shift (from 7am to 5pm) and the late shift (from 4pm to 01.00). For those travelling long distances to a shift, accommodation can be provided at local hotels before or after a shift. We are working towards 24 hour working in the next 12 months as we increase the number of clinicians on the team. What facilities can I expect? The Helimedix base at RAF Wyton is equipped with all the medical and communication equipment necessary and also enjoys a full office arrangement for the members personal use and facilities to relax in. A library of books, journals and online resources is available at the base for personal study, along with continuing training resources including a simulator suite. Who manages and supports the Helimedix members? The Helimedix is led by a team of experienced pre-hospital professionals and administrative staff including: Nigel Brown, Magpas Chairman Daryl Brown, Magpas Chief Executive Simon Lewis, Helimedix Clinical Director and Helimedix doctor Natalie Norman, Helimedix Manager Alistair Steel, Helimedix Associate Clinical Director and Helimedix doctor Dan Cody, Helimedix Associate Clinical Director and Helimedix paramedic Robyn Addison, Helimedix Administrator Helen Hale, Helimedix Administration Assistant What is my commitment to the Helimedix Team? There is no financial charge for the Helimedix Training programme and potential volunteer team members are accepted on the basis of trust. You will be expected to make a formal written commitment to the Helimedix when you complete the application process. This agreement specifies what you can expect from Magpas in terms of training and operational support as well as what Magpas expects from you. The basic elements of the commitment are: Page 6 of 18

7 For Phase 1a (the Helimedix Course), all participants must: (a) (b) (c) Attend at least 90% of the scheduled activities on the Helimedix Course. Complete driver assessment and/or training as determined on an individual basis by the Magpas driving instructor (paramedics only) Successfully complete the Helimedix Course Phase 1a assessment. For Phase 1b (Supervised Helimedix Operational Experience), all participants must: (a) (b) (c) (d) Complete 360 scheduled Helimedix duty hours within an 18 month period of completing the Helimedix course. It is possible to undertake more monthly duties but the minimum requirement is an average of two shifts a month, however one must be a late shift (volunteers only). If you have not already done so prior to commencing the Helimedix Training Programme, take and pass the Diploma in Immediate Medical Care by August 2015 Participate in a minimum of half of the formal Pre-hospital Forum mission review meetings. Complete a Helimedix annual clinical update (from year 2 onwards) Are there opportunities for research and audit? Magpas runs an audit programme, and doctor and paramedic volunteers are encouraged to assist and lead audits. Encouragement and assistance is given in achieving publication of a range of material, and original research can be considered with the guidance of Dr Rod Mackenzie, Magpas Director of Research and Development. Joining the Helimedix Team The charity needs willing individuals who believe in what Magpas is trying to achieve and who are prepared to make the necessary personal effort and commitment. The main criteria for selection are a commitment to the Helimedix concept and the ability to work as part of the team. There are, however, only a limited number of vacancies on the Helimedix Training Programme. As the Helimedix Training Programme becomes more popular there is considerable demand from both doctors and paramedics. The charity is therefore likely to give priority to those doctors and paramedics who most closely fulfil the entry requirements, and who make an early commitment to the Helimedix concept and Training Programme. Each application will be considered on its own merits. Although Magpas does support secondments to the Helimedix, most of the roles within the Helimedix are purely voluntary and Magpas does not offer a contract of employment or any payment for services on the Helimedix other than outlined in the Magpas Volunteer Expenses Policy. We pride ourselves on investing in our volunteers and are committed to equal opportunities within the charity. Page 7 of 18

8 Appendix 1 Person Specification Helimedix Volunteer Doctor (please see IBTPHEM Guide for details of the sub-specialty training person specification) 1 Essential criteria (i) Fully Registered Medical Practitioner who is also licensed to practice medicine. (ii) Certificate of Completion of Training (CCT) in an appropriate specialty, preferably emergency medicine or anaesthesia. At least six months of training should have been in the practice of Emergency Medicine and six months in the practice of Anaesthetics. (iii) Commitment to the Helimedix team as evidenced by a written undertaking to complete the entire Helimedix Training Programme (phases 1a and 1b). (iv) Provider status in ALS, ATLS, and APLS or equivalent. (v) Hold a full UK driving licence with no more than three penalty points. (vi) Physically fit and able to undertake all aspects of the role. (vii) Support of your employer. 2 Desirable criteria (i) Documented evidence of pre-hospital care experience. This is ideally through a portfolio or log of courses, pre-hospital activities and, where possible, actual pre hospital experience. (ii) Reside within one hour driving distance of the Helimedix base (RAF Wyton). (iii) Diploma in Immediate Medical Care (Dip IMC) of the Royal College of Surgeons of Edinburgh (desirable). Doctors who are prepared to commit themselves to the Helimedix Training Programme but who do not have the Diploma may join the training programme provided that they undertake to complete the within 18 months from completion of the Helimedix course. Support is provided for this. Page 8 of 18

9 Appendix 2 Person Specification Helimedix Volunteer Paramedic 1 Essential criteria (i) Hold current registration with the Health and Care Professions Council and be free from any suspensions, cautions or conditions of practice. (ii) Currently employed by the East of England Ambulance NHS Trust (Bank is acceptable) and undertake regular pre-hospital clinical activity. (iii) Three years post registration experience. (iv) Hold a full UK driving licence including categories B and C1, with a maximum of 3 penalty points. Hold IHCD Ambulance Driving qualification or equivalent. (v) Evidence of post registration professional development. (vi) Physically fit and able to undertake the physical aspects of the role. (vii) Commitment to the Helimedix team as evidenced by a written undertaking to complete the entire Helimedix Training Programme (phases 1a and 1b). 2 Desirable criteria (i) Diploma in Immediate Medical Care (Dip IMC) of the Royal College of Surgeons of Edinburgh. Paramedics who are prepared to commit themselves to the Helimedix Training Programme but who do not have the Diploma may join the training programme provided that they undertake to complete the Diploma within 18 months of completion of the Helimedix course. Support is provided for this. (ii) Reside within one hour driving distance of the Helimedix base (RAF Wyton). (ii) Provider status in PHTLS, PHPLS (or PEPP) and MIMMS or equivalent. (iii) Relevant academic qualification or equivalent post-registration qualification. Page 9 of 18

10 Appendix 3 Frequently Asked Questions 1. What is Magpas? Magpas was originally formed as the Mid Anglia General Practitioner Accident Service. It was a type of voluntary doctor organisation which became known as an Immediate Care Scheme. It was one of the earliest such schemes in the UK and it became a registered charity in The charity s constitutional aim is the provision of immediate medical care to any persons involved in accidents or medical emergencies within the East of England and surrounding areas. The name s historical origins no longer accurately reflect either the membership or the range of activities currently supported by the charity. It is now simply referred to as `Magpas, the emergency medical charity.' 2. What does Magpas do? Magpas exists to provide an organisational framework within which volunteer doctors, paramedics and other healthcare professionals can be trained and equipped to provide an appropriate level of immediate care. Although the provision of immediate medical care by volunteer doctors has historically been the charity s main activity, Magpas now also funds and manages the Helimedix Team, and the Cambridgeshire Trauma Audit and Research Project. It developed and managed the Cambridgeshire Community First Responder Scheme, over a 10 year period before handing this over to the East of England Ambulance Trust to continue running. Magpas has also been instrumental in developing the concept of Pre-hospital Emergency Medicine as a recognised specialty and advocating competence based training in pre-hospital critical care. 3. What is an Immediate Care Scheme? Immediate care has been defined by the British Association for Immediate Care (BASICS) as the provision of specialist medical help at the scene of injuries or medical emergencies and whilst in transit to hospital. A traditional Immediate Care Scheme is simply a group of volunteer doctors who have grouped themselves together to provide a local coordinated response to incidents. There are now a number of volunteer Immediate Care Schemes across the UK. Although this is how Magpas started, the charity is now a much more sophisticated professional organisation and Independent Healthcare Provider. It is widely regarded as the leading Immediate Care Scheme in the UK even though it is no longer simply a group of enthusiastic volunteer doctors. Paramedics, nurses and members of the public have all benefited from the training and infrastructure support provided by the charity. 4. What is BASICS and how do Magpas and BASICS relate to each other? BASICS is the British Association for Immediate Care. It was formed in Magpas was one of the founding Immediate Care Schemes and has supported BASICS since its inception. The objectives of BASICS are to: Foster co-operation between existing Immediate Care Schemes; encourage and aid the formation and extension of schemes in the United Kingdom and its surrounding waters; Page 10 of 18

11 strengthen and develop co-operation between all services dealing with emergencies resulting in injury or risk to life; encourage and assist research into all aspects of Immediate Care and accident prevention; raise the standards of Immediate Care and training of all who undertake it. BASICS consider it to be the professional association for all those involved in the practice of Immediate Care. It has a code of practice for Immediate Care practitioners and it has developed both individual and scheme accreditation procedures. With the development of the Faculty of Pre-hospital Care, BASICS has focused more on the delivery of training and the professional representation of Immediate Care practitioners. Magpas is a BASICS accredited Immediate Care Scheme and all Magpas volunteer doctors and paramedics are encouraged to become individual members of BASICS. Magpas is much more than simply an Immediate Care Scheme however and it remains completely independent of BASICS. In addition, many Magpas doctors have served on BASICS committees and some continue to participate actively in the organisation (see for further information). 5. What is the Faculty of Pre-hospital Care? The Faculty of Pre-hospital Care of the Royal College of Surgeons of Edinburgh was established in 1996 to: set and maintain standards of practice in pre-hospital care; promote education in and teaching of pre-hospital care; initiate technical developments and research in pre-hospital care; integrate effectively the efforts of all participants in pre-hospital care, and to harmonise and facilitate the onward management of the sick and injured. The Royal College of Surgeons of Edinburgh has a reputation for innovation and for many years it was the only college to offer a postgraduate examination in Accident and Emergency Medicine. The College s Diploma in Immediate Medical Care was introduced in 1988 and has become an internationally recognised benchmark for immediate care practitioners. The creation of the Faculty represented a major milestone in the development of pre-hospital and retrieval medicine as a specialty. The Faculty plays a major part in the accreditation of training and education material and is responsible for the Diploma and Fellowship examinations in Immediate Medical Care (see Many Magpas doctors have been influential in supporting the development of the Faculty. Some Magpas doctors are examiners and members of the Faculty Committees. 6. What is on-scene medical support? On-scene medical support may involve the full spectrum of pre-hospital critical care at the scene as well as in transit to the most appropriate hospital. On-scene support most commonly involves major trauma patients who are trapped at the scene. The Helimedix team will however respond to any request from an Ambulance Crew or Fire Officer for assistance at the scene of an incident. After information gathering, the Helimedix team deploy to scene by the most appropriate means available (response car or air ambulance). In practice, the Helimedix team is deployed between one and five times a day. There are typically only one to two patients a day who require pre-hospital critical care interventions. Page 11 of 18

12 7. What does on-line medical support mean? This refers to telephone requests for clinical advice from ambulance crews at the scene of acute medical or traumatic illness. This role is supported by specific training and access to a range of decision support resources (including poisons information, the current Joint Royal Colleges Ambulance Liaison Committee guidelines and the East of England Ambulance Service Clinical Instructions and protocols). Typical requests for on-line medical support may include telephone advice regarding increased doses of analgesics or information regarding clinical interventions, poisons or drug interactions. Occasionally, the Helimedix team may deploy to the scene in order to provide on-scene medical support. 8. What are secondary transfers of trauma patients? In addition to the Helimedix team being available for primary missions, the secondary transfers refer to the additional service (Major Trauma Outreach Service) that is provided and has been set up in partnership with the region s Major Trauma Centre, Addenbrooke s. The Outreach service is an acute transfer service provided by the Helimedix team, utilising a specific transfer ambulance. The service aims to facilitate the transfer of actually injured or ill patients from one emergency department to another emergency department. This group of patients largely reflects those critically injured or ill patients that the Helimedix team would also deal with on a primary (scene) mission and are within the competencies of the sub-speciality curriculum of Pre-hospital Emergency Medicine. The Helimedix team members receive specific training during phase 1a of the course and are joined by a Transfer Technician/Drier who has been training to support the medical team with the transfer of patients. 9. What does special incident medical support mean? This refers to an advisory or technical medical role in incidents which involve unusual circumstances. Typically, these involve firearms, civil disturbance, toxic chemicals, deliberate release of substances and terrorist threats. Specific familiarisation training in each of these areas is provided. In addition, the Helimedix have the opportunity to take part in specialist training sessions and exercises on a regular basis. It is important to appreciate that these incidents involve specialists from the other emergency services who have undertaken extensive training specifically for that role. Helimedix members are not expected to develop expertise in these areas. They are however expected to understand how these incidents are managed in order that they can provide close medical support and advice in the pre-hospital phase. 10. What does major incident medical support mean? This refers to acting in the role of a Site Medical Officer or Medical Commander (Bronze or Silver Command) at the scene of suspected or declared major incidents in Cambridgeshire or surrounding areas before such time as the formal Ambulance Service infrastructure can be put in place. 11. What about insurance? All members of the Helimedix team become members of Magpas. They are provided with third party liability and personal injury insurance (full details can be obtained from the Magpas office). Individual doctors must also be members of a medical defence organisation and they must inform that Page 12 of 18

13 organisation of the nature and extent of their immediate care activity. If a medical defence organisation requires an additional premium, Magpas has undertaken to make up the difference for individual volunteers. Members of the Helimedix team are also loaned a full range of personal protective equipment and complete formal safety training as part of the Helimedix Training Programme. The specialist Police and Fire Service units involved in special incidents are also aware of the limitations of the Helimedix as well as its capabilities. East of England Ambulance NHS Trust paramedics are indemnified by the Clinical Negligence Scheme for Trusts when they undertake duties on behalf of the Trust. Volunteer duties with the Helimedix are currently considered by the Trust as equivalent to normal Ambulance Service duties. Any interventions the paramedics may undertake on the Helimedix which are beyond the normal scope of practice of a Trust employee are undertaken under direct medical supervision and, where necessary, instruction and thus remain the responsibility of the Magpas Helimedix doctor. 12. Why did Magpas develop the Helimedix team? Since its inception in 1971, Magpas has set the standard for the conventional model of an Immediate Care Scheme. This initially involved a large number of locally based volunteer doctors (typically General Practitioners) who agreed to undertake some training and carry additional equipment. As Magpas and the NHS Ambulance Service have evolved, many GPs have withdrawn and more volunteer doctors have come from hospital backgrounds such as Emergency Medicine or Anaesthetics. In the conventional model, volunteer doctors were asked to make themselves available whenever possible within their agreed area of call-out. Individual doctors were activated by the Ambulance Service (or a third party call centre) as necessary and asked to attend incidents. Typically, the incidents were road traffic collisions or industrial, sporting or agricultural incidents. This traditional Magpas doctor activity continues to be valued by the charity, the public and the other emergency services. It remains the model for out-of-hours cover by Helimedix trained doctors who live locally. However, the Trustees and membership of Magpas decided that individual volunteer doctors should no longer be recruited and supported in anything other than a first responder or Helimedix capacity. Other factors that led to this decision were: (i) (ii) (iii) There were diminishing numbers of active local doctors and few existing (or new) doctors wished to continue (or commence) pre-hospital immediate care activity on an ad-hoc or unplanned basis. There was a clear need for the charity to be seen to be fulfilling its charitable aim. There was a perception that this would not be possible unless the operational structure changed to one which included widespread Community First Responder Groups and a county wide dedicated Helimedix. The traditional service provided by Magpas was unpredictable in terms of availability, response times and level of clinical intervention at the scene. Page 13 of 18

14 (iv) There was considerable anecdotal evidence to suggest that every aspect of the traditional Magpas operational structure was prone to major failures. Examples included incidents where: (a) (b) (c) (d) critically injured patients were managed by ambulance crews without making any attempt to mobilise a doctor when one was available, ambulance crews who did request medical support at the scene did not receive it (or received it very late) due to control room and/or callout system failures, some doctors attended accident scenes but undertook no specialist interventions to facilitate either extrication or resuscitation, some ambulance crews stood down doctors inappropriately. (v) (vi) (vii) (viii) A four year review of road traffic related deaths in Cambridgeshire (deaths within 30 days of a road accident between 1997 and 2000) revealed that traditional Magpas doctors only attended 55% of appropriate incidents. When they did attend, there were poor records of any interventions undertaken. On analysis of available records, there were some examples of very good practice. For the majority of cases however, the interventions undertaken by conventional Magpas doctors in these very seriously injured patients were no more advanced than those employed by paramedics. A three-month audit of patients who attended hospital after being involved in an incident where a traditional Magpas doctor attended revealed that most patients were discharged from A&E on the same day and that only a small number of patients had major injuries. Amongst these, the interventions performed by doctors were, again, highly variable. In addition, a very small core of doctors saw the majority of the major trauma patients. In the same period, a large number of injury incidents occurred where no doctor attended the scene. Ambulance crews are becoming increasingly skilled and capable of dealing with a wide range of incidents and injuries. Magpas activity is naturally being focused on smaller numbers of more serious or difficult cases. The challenge is therefore how to get the doctor with the right skills to these rare patients. Re-organisation to provide a new type of service represented an extraordinary opportunity for Magpas to shape the development of pre-hospital immediate care in the future. It was therefore proposed that Magpas developed an operational model which delivered a guaranteed high level of service whenever it was needed. Thus Helimedix concept was created. The first Helimedix Training Programme commenced in January 2003 and the team went live in June From a clinical perspective, the Helimedix concept is based on the principle that the most important determinants of survival following serious injury are severity of injury and time to meaningful intervention related to the specific injury pattern. It is recognised that many patients have clearly Page 14 of 18

15 identifiable critical care needs at the time of their injury and that these needs may not be being met by the conventional ambulance service or traditional immediate care doctor response. 13. What if I don t meet the entry criteria? There clearly needs to be a defined entry standard for the Helimedix team as it is a specialist role. The current demand for places within the team will often mean that places will be given to those applicants meeting all the criteria. The charity recognises that it has for many years been the entry point to practice in pre-hospital care for many with limited or no experience. We would support these individuals in gaining relevant experience in order to meet the entry criteria to the Team. Observer sessions with a duty Helimedix are available to those interested in finding out more. 14. Is the course accredited? In terms of CME or PGME credits for General Practitioners and Career Grade doctors, the course has been accredited by the College of Emergency Medicine, the Royal College of Anaesthetists, and the Faculty of Pre-hospital Care of the Royal College of Surgeons of Edinburgh. In terms of training grade doctors, the Helimedix can be regarded as a consultant led specialist pre-hospital training opportunity. The supervising consultant is Dr Simon Lewis, Consultant in Emergency Medicine and Pre-hospital Emergency Medicine. Several Deaneries regional specialist training committees in Emergency Medicine are aware of the Helimedix Training Programme and have recognised parts of the programme as a non-essential secondment for the purposes of higher specialist training in Emergency Medicine. Helimedix is currently recognised by the East of England multi-professional Deanery for training in Pre-hospital Emergency Medicine. Each Training Programme participant receives an extensive training portfolio and a number of core texts to support the course. The portfolio also contains results of objective assessments of performance and has been used by training grade doctors at their ARCP meetings during the first and second Helimedix Courses. The portfolio has been considered to be of an exceptionally high standard. Paramedics are encouraged to apply for professional or study leave for the purposes of the course and to incorporate it into their personal development plans and portfolios. It is not at all certain that the Trust will feel able to support applications for substantial periods of leave and the Helimedix Training Programme currently remains voluntary. Magpas is committed to supporting any applications made by paramedics who are prepared to undertake the Helimedix Training Programme. 15. Is the course evidence based? One of the main objectives of the course is to develop competence across the full range of pre-hospital critical care skills in different circumstances and environments. It is absolutely central to the Helimedix concept that the decisions made by team members are as evidence based as they can be. The course therefore incorporates development of an understanding of the existing evidence surrounding the provision of pre-hospital care. Page 15 of 18

16 Magpas has previously contributed to major research studies concerning pre hospital care and both the Helimedix competency based training programme and the actual Helimedix clinical activity are themselves part of research projects (see the National Research Register at for further details). 16. Can I miss part of the course? The official answer is no. However, Magpas recognises that volunteers have many demands on their time and that many people come to Magpas with existing skills and competencies. Therefore, on an individual basis and only after discussion with the Helimedix Clinical Director, it may be possible to miss certain elements of the course. It is not possible however to avoid the assessments! 17. Do Helimedix team members receive payment? Those doctors who have been appointed as Pre-Hospital Emergency Medicine Trainees are employed to work with the charity. Honorarium payments are available to team members for shifts they complete after two voluntary shifts each month in order to ensure the charity fulfils its constitutional aims. Further information can be found in the Volunteer Expenses Policy. It is important to remember that Magpas is funded entirely through public donations. Were it not for the generosity of the people of Cambridgeshire, none of this would be possible. A key aspect of our fundraising strategy is the voluntary nature of the activity. 18. How much does it cost to be part of the Helimedix and complete training? It costs approximately 5000 per person to deliver the full Helimedix Course. It is not possible to purchase the entire training or operational experience offered by the Helimedix Training Programme. Training, equipment and the opportunity to develop and practice immediate care skills in a quality assured and supportive environment is provided free of charge to those individuals who undertake to make the commitment to the team. 19. What if there was more than one request for on-scene medical support at the same time? This scenario is actually quite rare (especially with respect to the actual need for specialist medical intervention at the scene) but it occasionally happens. The philosophy is that the duty team can only do one thing at a time and while they may be able to move rapidly (by land or air) from one scene to the next, they cannot be in two places at once. The East of England Ambulance Service has a central Critical Care Desk which coordinates and activates the specialist resources in the region. They would be responsible for activating another resource or service if appropriate. 20. What if the Helimedix team needs help at the scene? In terms of the period of supervised Helimedix Operational Experience, supervision is provided at different levels according to pre-hospital experience and performance of the Helimedix members on the Page 16 of 18

17 Helimedix Course. This may mean that any one Helimedix member may have to ensure that their duty availability matches the availability of an appropriate supervisor. If the Helimedix team attend an incident at which they feel further Helimedix level assistance is needed, there are a group of senior individual Helimedix Doctors that may be able to respond to provide assistance. In the context of a major incident, the Helimedix would be able to activate the Ambulance Service major incident procedures. At the present time, none of the hospitals in Cambridgeshire have the capability to deploy an appropriately trained and equipped ED retrieval team. 21. What about out-of-area requests such as Lincolnshire, Norfolk, or Suffolk? The current Magpas constitution allows for the provision of immediate care in the entire East of England and immediate areas surrounding this. Requests for assistance further afield would have to be carefully reviewed by the duty Helimedix Team and the availability of helicopter transfer (and retrieval) would need to be taken into account. 22. What are the advantages to the individual of taking part in the Helimedix scheme? These can be summarised as: (a) (b) (c) (d) (e) (f) Specialist professional training; More consistent pre-hospital immediate care activity; Pre-planned (scheduled) pre-hospital immediate care activity compared to the variable and often complex existing arrangements for traditional immediate care scheme members; A comfortable environment with full office and library facilities to allow doctors and paramedics to utilise any free time productively on duty days; The opportunity to practice pre-hospital critical care as part of a well equipped and quality assured team; Access to supervised pre-hospital care experience and practice. Magpas is a highly respected charity which has served the people of Cambridgeshire and worked alongside the statutory emergency services for over 40 years. It is a unique and special organisation which many volunteers are proud to be part of. Some volunteer doctors and paramedics also regard the opportunity to provide medical care in some of the most dangerous, distressing and challenging circumstances as a privilege. 23. How does the Helimedix concept compare with pre-hospital care developments elsewhere? There are parallels in other parts of the UK and Europe which many people are familiar with. In the UK, the Birmingham CARE car is manned by volunteer Diploma level immediate care doctors from a very wide area and is available on weekends only. It is manned by a doctor/nurse/paramedic team and responds to any serious illness or injury. The Liverpool based ATACC team operate in a similar way. The Great North Air Ambulance and a number of other air ambulance operations have developed elements of medical staffing. The London HEMS service is the main pre-hospital service which directly employs doctors to provide a full time pre-hospital care response. Page 17 of 18

18 24. How do we know if Helimedix makes a difference? Magpas has provided pre-hospital care across Cambridgeshire for over 40 years. On an individual patient basis, there are literally dozens of examples of patients whose pain, time to meaningful intervention and outcome has been dramatically improved by appropriate pre-hospital care. However, there is no formal evidence of this and certainly no evidence that the provision of pre-hospital care can have a significant impact on mortality following major trauma. Magpas recognised the need for formal evaluation and funded and managed the Cambridgeshire Trauma Audit and Research Project (CTARP). The central component of this project is a population based injury research register which gives unprecedented access to all aspects of the health and emergency care systems in the county. Every aspect of the service is evaluated from operational availability to clinical care. 25. Where can I find out more information? Magpas has a website containing basic information about the charity and its activities ( Password controlled areas of the site are used for the Helimedix Training Programme and rota. The website also includes details of training, forum minutes and portfolio material. The Magpas office is also able to provide further details (telephone or [email protected]). Page 18 of 18