Community Specialist Paramedic, Phil Strange

Phil StrangeMonday
As I am new to the sector I have spent some time studying the local hospital Trust’s Deep Dive Report for response activity in the Fylde. A brief meeting with my Sector Manager is interrupted for a local RED 2 response. After arriving on scene and assessing the patient using pathfinder, the patient is referred to the local Acute Visiting Service (AVS) scheme. The patient is also believed to be a high intensity user or frequent caller. After contacting colleagues to confirm this, I make a call to GP services, to discuss future care management. A positive process, it leads to an invitation into the practice to deliver a session on Healthcare Professionals admissions and provides an opportunity to send them the new booking guidance which in turn may reduce the health care RED admissions locally.

I have been given the privilege of a ‘hot desk’ within the local Clinical Commissioning Group (CCG), a great place to start networking and get to understand the world of commissioning. The Fylde is a location highlighted as a response hot spot as it is in a rural ‘hard to reach area’ for performance. It is here where I am introduced to the Lead Commissioner on falls prevention and the building better bones initiative and pick up my first big task as CSP, which is to assist with the implementation of a falls car service. Planning starts with a joint training day for Paramedics and Occupational Therapists on joint working and practical manual handling and even portable hoist training obtained for free on a six month trial basis.

Today is a drive out to Knot End, a rural coastal location with a higher than average elderly population. I attend an audience with an outing from Age UK at the village library - they are a passionate and vocal crowd whose main concern is why they don’t have an ambulance station! Tact and diplomacy is key, whereby the offer of a surgery-based Rapid Response Vehicle goes some way to answering their concerns. This is also an ideal opportunity to raise my profile and assist the Community First Responder by supplying the library with recruitment leaflets.

Today is spent researching practices and suitability for a joint contract to work alongside GPs and Nurses. I meet with the Senior Nurse Practitioner who is responsible for the creation and update of the community care plans, currently there are 240 in total. These are online acting as a ‘virtual ward’ with close links to the District Nurse team who provide face to face visits on a three monthly basis or with 48 hours post discharge. This work stream could prove a vital link to better communication and information sharing with the mobile data transmission, ensuring patients receive the most timely and appropriate care. Our meeting is cut short due to a request from EOC to attend a RED 2 chest pain. I am able to respond in a timely manner with the nearest ambulance some 20 minutes away. The patient is conveyed due to the acute episode but his care plan is absent, crucial evidence for my previously mentioned work stream. 

Today, I have extended my shift to cater for a school visit in the morning and a visit to a Rainbows group in the evening. I base myself within the Broughton EOC and make some calls to gather resources for the visits and plan the activities. The visits go well with educational activities such as, how and when to phone for an ambulance, applying dressings and slings, a show and tell of the RRV equipment and of course… the obligatory play with the blues and twos! Finally, it’s time to head back for base to restock the vehicle and complete my weekly vehicle audits and catch up with service email. Then homeward bound for a weekend off and think about next week’s agenda of frequent caller nursing homes.