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Are the NHS short of paramedics?

littlewoman

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#1
I know there's quite a few here who work in the civilian ambulance service in the UK.
Could anyone tell me if there are currently too many paramedics for the jobs available, or are they suffering from the same recruitment problems as most other medical professions.

I ask because the proposed downgrading in our local A&E would require more ambulances and crew. I'm wondering how feasible that is.

Also, can I ask and serving paramedics how they would feel about working in an area with a high population that was over an hour on bad roads to the nearest A&E or other surgery. Therefore having to transfer women needing a crash C.section, heart attack patients, people with severe injuries from road accidents etc.
 
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dazzler2439

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#2
Hi.
We are desperately short of paramedics at present in the NHS. There are many reasons for this, and they will differ by region, however I think the biggest problem is the current workload and general lack of support. There are a number of roles that paramedics can now move in to, including custody, 111, urgent care centres and GP practice. This is becoming increasingly attractive to many with the current workload as it is.
We are currently in the UK better trained and educated than we have ever been, and longer transfer times are becoming the norm, however there will always be occasions were patients just need to be in hospital, and I think we all dread the complex maternity patient for example who is a long way from hospital.
Cheers
Daz
 

littlewoman

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#3
Many thanks Daz, that is what I thought.

One situation that occurred to me with the proposals locally is that if a pregnant woman were seriously injured in a road accident you might get the situation where a paramedic has to decide on getting her to the closest A&E that has no obstetric or paediatric support and saving the life of the mother, but losing the baby, or getting to the nearest hospital that has obstetricians and paediatricians and losing the mother but saving the baby.

That is a decision that no-one should have to make.
 

Starlight

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#4
Many thanks Daz, that is what I thought.

One situation that occurred to me with the proposals locally is that if a pregnant woman were seriously injured in a road accident you might get the situation where a paramedic has to decide on getting her to the closest A&E that has no obstetric or paediatric support and saving the life of the mother, but losing the baby, or getting to the nearest hospital that has obstetricians and paediatricians and losing the mother but saving the baby.

That is a decision that no-one should have to make.[/QUOTE

In those circumstances, the mom will always (well, almost always) take priority over the baby, so making for the nearest trauma centre would be the pathway for that incident.
 

littlewoman

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#5
Many thanks Daz, that is what I thought.

One situation that occurred to me with the proposals locally is that if a pregnant woman were seriously injured in a road accident you might get the situation where a paramedic has to decide on getting her to the closest A&E that has no obstetric or paediatric support and saving the life of the mother, but losing the baby, or getting to the nearest hospital that has obstetricians and paediatricians and losing the mother but saving the baby.

That is a decision that no-one should have to make.[/QUOTE

In those circumstances, the mom will always (well, almost always) take priority over the baby, so making for the nearest trauma centre would be the pathway for that incident.
I see, so there is a standard protocol.
But what happens once they get to A&E, stabilise mother's injuries and still need an obstetrician? They'd have to put her back in an ambulance and take her for another hour (or more) to the other hospital. It's also possible that they'll only have urgent care at the local A&E (stabilise and transfer) and minor injuries, so that complicates things further.

I mean we've only got a population of 167,000 and the biggest nuclear facility in the country, it doesn't really matter if it's an hour to the nearest hospital (as long as the roads aren't blocked by flooding).
 

premier

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#6
I see, so there is a standard protocol.
But what happens once they get to A&E, stabilise mother's injuries and still need an obstetrician? They'd have to put her back in an ambulance and take her for another hour (or more) to the other hospital. It's also possible that they'll only have urgent care at the local A&E (stabilise and transfer) and minor injuries, so that complicates things further.

).
LW,
The what if scenario will provide endless possibilities and more challenging questions, in this case I'd suggest the obstetrician would come/ be brought to the patient.

Regards
premier
 

Starlight

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#8
Pay and conditions for paramedics is horrendous. I am guessing that doesn't help
And it's not getting better. Personally, I don't know why anyone would consider joining the profession under the current circumstances, when there are better options available....
 
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#9
And it's not getting better. Personally, I don't know why anyone would consider joining the profession under the current circumstances, when there are better options available....
Absolutely agree, when you look at the pay, with is horrendous, then you look at how paramedics are treated by the public, which is abysmal and then you consider that you are lumbered with poorly trained work colleagues because the NHS has no real desire to adequately recruit paramedics who cost more.

The mental health support for paramedics is non existent and given the role, they see more than most
 

littlewoman

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#10
LW,
The what if scenario will provide endless possibilities and more challenging questions, in this case I'd suggest the obstetrician would come/ be brought to the patient.

Regards
premier
That would seem sensible, but since when did the powers that be do sensible.

The current proposals are that the local hospital will have obstetrics and paediatrics daytime only and the obstetricians will only be dealing with ante-natal appointments. There will be a Midwife Led Unit for births, but they have been very clear that the obstetricians on site will not deal with any birth complications and the midwife will have to make the decision to transfer to the hospital an hour away if there are complications. I reckon there'll be about 5 emergency transfers a week. So if they're not going to bring obstetricians for a woman that needs a crash C.Section or any of the other urgent complications, I can't see them doing it for a road accident.
 

dazzler2439

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#11
This is the current reality at the moment. The emphasis on large specialist units that see everything, leaving smaller local units to downgrade further, and even close. Starlight is correct, in the current climate the job offers of a Paramedic offers little. In fact, I recently left an NHS Ambulance service to go back and work as an ECP. Prior to leaving I had a fantastic student with me, and my overriding advice to him was get your qualifications, do the time on the road to consolidate it, and then look to move on. Is it not a little sad that this is the advice we are giving to the younger generation.

Daz.
 

littlewoman

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#12
Just an update on this. The people planning the cuts in our local services have now clarified the situation - well sort of. They are going to decide what services they are going to cut, likely paediatrics will be daytime only and no obstetrics, and then they will risk assess and decide how to manage the various scenarios.

So they will make the decision about what they're doing and then start doing risk assessments and figuring out if it can work at all! You couldn't make it up.
 

premier

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#13
Just an update on this. The people planning the cuts in our local services have now clarified the situation - well sort of. They are going to decide what services they are going to cut, likely paediatrics will be daytime only and no obstetrics, and then they will risk assess and decide how to manage the various scenarios.

So they will make the decision about what they're doing and then start doing risk assessments and figuring out if it can work at all! You couldn't make it up.
Kind of like...

Shutting the stable door after the horse has bolted!!

Sounds about right.

Regards

premier
 
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