Category: Addressing an overall National Service Framework
Name: Tracy Ligema
Job Title: Deputy Director of Modernisation
Organisation: Lincolnshire Ambulance Service NHS Trust
Email: tracy.ligema@lincsambulance.nhs.uk
Telephone: 01522 832638
Key team: Steve Pratten And Mark Furneaux - Ambulance Technicians.
Title: New opportunities for ambulance technicians
Whilst the Trust recognises, and is actively addressing the problem of a shortfall of Paramedics in certain areas, to simply address this through the recruitment of additional Paramedics will take some time taking into account the selection, training and assessment process. Clearly a shortage of Paramedics has consequences for the level of care given to patients as Technicians are unable to administer certain potentially life saving drugs such as glucagen, GTN spray or nebulised salbutamol. In addition Technicians are unable to intravenously cannulate patients. The Technicians who proposed this idea believed that Advanced Technician Training would help to bridge this gap in pre hospital care and could give more Technicians the confidence to proceed to Paramedic training.
It was expected that staff would benefit, Technicians because they would have an opportunity to obtain additional skills and Paramedics because they would be supported by a more highly skilled group of Technician colleagues. The Trust would benefit because the proposal and development helped to provide a more highly skilled response whilst additional Paramedic numbers are being built up. Patients would benefit because they would be attended by more highly skilled staff and the Technicians with additional skills would not have to request Paramedic assistance to carry out certain life saving treatments therefore any delays in treatment would be minimised. The project was developed first by examining the role of Technicians in other ambulance services. This established the evidence-based practice in this area with technicians in other services employing some additional skills in comparison to Lincolnshire. This survey also informed the development of the training programme as it introduced consideration of the inclusion of other skills that hadn't previously been considered as part of the Advanced Technician Training proposal. The project then proceeded to the development of a pilot training programme and is now routinely available to all Technicians at the time that they have their refresher training.
The work was proposed to the Trust's Chief Executive who personally supported and encouraged the two Technicians to progress the proposal and helped them to take it through Board Approval and the development of a full training programme.
Achievement is measured by the success that the project has met in being accepted and in the development and full implementation of a fully-fledged training programme that can be delivered within existing Trust resources yet will make a considerable impact on the level of care afforded to patients. Technicians in the Trust have shown considerable interest in taking up the training and feel that it will be of great benefit.
The biggest challenges faced were around the detail of certification of the training and ensuring that the programme and assessments were rigorous and could be approved. Selling the proposal to staff and the Trust Board was not a big challenge as it was universally recognised as being beneficial in every aspect.
The unexpected benefits of the work being undertaken were the personal development of the Technicians involved who have presented their work to a number of high profile groups and have been asked to share their work with other ambulance trusts. It has also helped to generate motivation to gain additional skills amongst the Trust's Technician grade staff. The next steps are to strengthen the training programme as required to accommodate any additional training needs for the future and to ensure that every new Technician recruit receives the Advanced training at the outset - the Advanced training therefore replacing the previous Technician training.
The Trust continues to disseminate information internally about this to promote uptake by existing technicians when they fall due for their refresher training and will continue to publicise the work as best practice for other Trusts, not only in respect of the training programme itself but also in respect of the way in which an idea generated by frontline staff has been unfailingly supported by the Trust's senior management team right through to complete implementation and full adoption as standard practice.
