From Volunteer to the Frontline – Peter Bowles

Having spent 14-years as a volunteer in Cork City Civil Defence, Peter Bowles got the bug for the emergency medical service from an early age and allowed his training and experience from the civil defence be a stepping stone to a career in the ambulance service.

In 2011, he moved to London and worked in the private sector, but he was always on the hunt for a job as a paramedic, something he is passionate about. That break came in 2014 when he moved to Birmingham to begin a student paramedic contract. Peter qualified as a Paramedic with the West Midlands Ambulance Service in 2016. 

Report by Declan Keogh

Peter Bowles is very active on Twitter @wmaspeterbowles and provides a good insight to his followers into the operational, training and personal aspect to being a Paramedic in the West Midlands.

Emergency Times Peter Bowles
WMAS Paramedic Peter Bowles. (Photo Declan Keogh / Emergency Times)

In an interview with Peter at the EMS Gathering in Cork earlier this month, I started by asking him about the differences between the NHS Ambulance Service in the UK and the HSE National Ambulance Service in Ireland. “Within the UK there are so many services that do their own thing, some will focus more on urgent care, some will focus more on emergency care, some will offer different scopes and levels of clinical practice while others regions wont focus on those and direct their funds into that so it’s up to the individual ambulance services to focus their funds into either urgent care or emergency care.”

In Ireland, the National Ambulance Service supply services from 102 locations and operates a wide range of fleet including emergency ambulances, intermediate care vehicles, rapid response vehicles and a range of specialised support vehicles. The NAS has also invested significantly in the purchase of new vehicles and a fleet maintenance programme over the past number of years. 

HART – Hazardous Area Response Team

Having served as a paramedic in the West Midlands Ambulance Service (WMAS) over the past four years, Peter subsequently progressed into his current role as a paramedic in the WMAS’ specialist unit HART – Hazardous Area Response Team. HART provides paramedic care to patients within a hazardous environment that would otherwise be beyond the reach of NHS care. This can include working at height, collapsed structures or within confined or contaminated environments. HART staff can also operate within the Warm Zone of a firearms incidents to triage, treat and extricate patients.

“Working in HART is excellent. Paramedics in HART receive extra training and skills which enables us to have the ability to work within the hot zone and warm zones of different types of incidents and major incidents, things like HazMat, CBRN, heights, confined space, MTFA scenarios and so on” says Peter.

WMAS PB HART Screen

Ireland’s terror threat level

Thankfully, the threat level to Ireland is quiet low, however, while there is always the risk of such an event occurring in Ireland and the Principal Response Agencies are continually working to reach a level of preparedness, competency and training in dealing with the threat of, potential for or an actual terror related incident in Ireland.

An Garda Síochána and the Defence Forces regularly carry out tactical training exercises to prevent or deal with terror related incidents, some on their own and some jointly.

In its 2016 Operational Report, the National Ambulance Service outlined plans to provide specialist response teams to lead or support the Health Service’s response to maritime, public health (e.g. Ebola Virus Disease), public order, Hazardous Material (HAZMAT) and Chemical, Biological, Radiological or Nuclear (CBRN) incidents and the NAS carry out regular training exercise on these scenarios.

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HSE National Ambulance Service exercise. (Photo: NAS)

Bowles believes there are some factors which might challenge the establishment of a HART type unit in Ireland. He said, “I do see potential benefits for the National Ambulance Service to take on a role like Hazardous Area Response Team, certainly some of the training, but I think there are certain challenges in Ireland that are not necessarily present in the UK such as the population, the workload, roads network and so on.”

Terror related incidents which occurred across the UK have undoubtedly challenged the police and emergency services; operationally, mentally and financially. However, from dealing with those horrific incidents, it has made those people and services on the frontline more resilient and more prepared for future attacks or incidents.

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“The UK has learned from those incidents but what we do in the UK is look at systems that happen outside the UK and apply them to the UK system to see would we be able to cope with that. In turn I think Ireland could benefit from doing the same thing even though the terror threat level may not be as high in Ireland as it is in the UK, there is still a chance there so there is an opportunity for them to learn even more, have shared learning with the UK, see how the UK responds and see the types of challenges that they encounter with those significant incidents that have unfortunately occurred.”

EMS Gathering

The annual EMS Gathering which is held in Cork provides a platform for emergency medical service personnel from different corners of the world to develop their skills and learn new ideas and see how things are done elsewhere. Some of the paramedics who to Ireland to attend the EMS Gathering may not have realised the considerable travel times for conveying patients to hospital, the significant waiting times at different parts of Ireland, both in the response of an ambulance arriving and the waiting time in A&E, and that’s not seen that much in the UK. 

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Peter Bowles observing ‘terror incident’ exercise at EMS Gathering in Cork. Top Photo (EMS Gathering), Bottom Photo (Declan Keogh / Emergency Times)

Having met with paramedics and trainee-paramedics at EMS18 from Coventry and other places in the UK, one of the big differences I found for paramedics who travelled over to Cork is that they get to see how the services operates here, it gives them a greater appreciation for the distances which crews must travel to reach patients and then convey them to hospitals.

Peter Bowles believes it is important for paramedics to see what other people are doing outside their own country. “In terms of visiting the EMS Gathering here, it is important for paramedics to come outside the UK and for paramedics within Ireland to see what happens outside their country. There is lots of exciting research in other countries that will inevitably impact your own clinical practice in the country you’re in at some stage.

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Dr. Jason Van der Velde guiding ambulance personnel from National Ambulance Service in Ireland, South East Coast Ambulance Service in Surrey and students from Coventry University Paramedics in the UK. Photo (Declan Keogh / Emergency Times)

I think it’s important to see what other people are doing because while they may be ahead of the trend in one aspect, you may be able to show them that your ahead of the trend in another aspect and that we can all learn. It’s about shared learning and a shared awareness about where we’re going as a profession globally.”

In England, people are used to having a regionalised system, regional trauma networks and regional assets where groups of hospitals will designate specialities in one hospital and other specialities in another, that is the norm in the UK, but not so much here, in Ireland its more of a District Hospital approach.

From voluntary to the frontline

Voluntary Services such as the Civil Defence, Order of Malta, Irish Red Cross, St. John Ambulance, and even the Garda Reserve and Reserve Defence Forces have all provided many volunteers and members with the knowledge, training, skills and learning tools to progress their careers further, as a stepping stone from volunteer to the frontline, and in Peter’s case, Cork City Civil Defence was that stepping stone.

Peter is still an active volunteer with the civil defence and returns to Cork regularly for duties and training sessions. I asked Peter about good interoperability and working relationships with other services, principal or voluntary, and what skills he learned from the Civil Defence and how it helped him to where he is today.

Cork City Civil Defence AFS

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Volunteers at Cork City Civil Defence. (Photos: via Twitter @cc_civildefence)

“For me the Civil Defence was a great stepping stone into the frontline services, first of all it gave me an insight into the various services and I met people that were already volunteers with civil defence that were also in frontline services, but also through exercises and emergency call-outs we’d get to see more of the job, I think that’s important that there is some interoperability between the voluntary sector and the frontline sector because inevitably a lot of people begin in the voluntary sector and progress to the frontline, and those frontline paramedics can then give back to the voluntary services and that’s a good circle to come around, from the voluntary into the frontline.”

Peter Bowles V2F Group WMAS

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Community Air Ambulance launched in Southern Region

A Charity funded community air ambulance for the Southern Region is expected to be operational next month.

The Community Air Ambulance is being operated by the Irish Community Rapid Response charity and will cost an estimated €2m a year to operate, much of which will be funded through public and corporate donations.

The Health Service Executive has yet to approve a Doctor/Paramedic medical team for the air ambulance but said it is prepared to explore a Doctor led medical team that in the future,. In the meantime however, the crew will consist of an Advanced Paramedic (AP) and an Emergency Medical Technician (EMT) until a doctor led team is approved by the HSE.

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Photo: (Irish Community Rapid Response)

GRA criticises overtime cuts by Garda Commissioners

The Garda Representative Association has criticised a decision by the Garda Commissioner Drew Harris, to cut discretionary overtime in An Garda Síochána.

The cuts will affect discretionary and administrative overtime but will not affect specific policing and security operations.

The garda overtime budget of €91m is €20m overspent so far this year and is likely to reach up to €30m by the end of the year.

The Garda Commissioner said it was not a sustainable position to maintain.

It is expected certain court proceedings and escorts and deportation orders will be part of the cuts.

Gardaí have been told that no more discretionary overtime will be approved, only in exceptional circumstances.

The GRA has criticised the overtime cuts which they said will impact on the ability of frontline gardaí to investigate the activities of crime gangs. The GRA also said overtime is essential for gardaí to provide an effective policing service and has called on Commissioner Drew Harris to reinstate the overtime.

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(Photo: Emergency Times)

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Three Departments at Galway University Hospitals shortlisted for Awards

The Irish Institute of Radiography and Radiation Therapy have shortlisted three Departments at Galway University Hospitals for the 2018 Medray Awards.

The X-ray Departments at University Hospital Galway and Merlin Park University Hospital were both short-listed for the X-ray Department of the Year and the Radiotherapy Department at UHG was short-listed for Radiotherapy Department of the year.

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Chris Kane, General Manager, Galway University Hospitals said, “We are absolutely delighted that the X-Ray Departments at University Hospital Galway and Merlin Park University Hospital have been shortlisted for this year’s Medray Awards. The third and final X-ray Department shortlisted is in Roscommon University Hospital so already we know we have a winner within the Hospital Group!

“The second category of awards is for Radiotherapy Department of the year and we will be hoping that University Hospital Galway will be able to keep off the stiff competition posed by two Dublin hospitals (St Luke’s and the Beacon), to bring home the prize.

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“The Medray awards aim to recognise where staff go above and beyond the call of duty to ensure their patients and clients receive the utmost of special care and attention and this is what makes it such a meaningful award to be in the running for.

“The nominations followed a rigorous elimination process which involved an inspection by the Irish Institute of Radiography and Radiation Therapy, site visits and even a ‘secret shopper’ who observed our staff interaction with patients.”

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The winners will be decided by combining the results of a public vote and site visit. The online voting system is open until the end of September where members of the public can cast their votes at www.iirrt.ie.

London school fire under control

A fire at a primary school in Dagenham, London has been brought under control.

London Fire Brigade received calls at around 4.50am to a fire at the school on Hewett road.

In total, twelve fire engines and around 80 firefighters from Dagenham, Barking, Ilford and surrounding fire stations attended the incident.

A large part of the single storey building has been damaged by fire. LFB Station Manager Rod Wainwright said “Flames could be seen from some distance away and crews were faced with a serious blaze when they arrived on the scene. They worked very hard to bring the fire under control but given the intensity of the fire, there is unfortunately significant damage to the school.

“It is unfortunate timing that this fire has occurred just before the start of term. It is too soon to speculate on the cause of the fire but as soon as they’re able to, fire investigators will enter the site to start their work.”

During the fire, firefighters removed a gas cylinder and cooled it down as cylinders can explode when exposed to heat.

Firefighters had the fire under control by 7.49am and firefighters remain at the scene to fully extinguish remaining pockets of fire. Eight fire crews remain at the scene as of 9am and LFB says it is likely that firefighters will be there for the rest of the day.

There were no injuries and the cause of the fire is not known at this stage.

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Photo: London Fire Brigade via Twitter @LondonFire

Ambulance staff defend CE Robert Morton over comments by East of England Labour MEP

East of England Ambulance staff have backed their outgoing Chief Executive, amid criticism by a Labour MEP.

Robert Morton announced his resignation last Friday and MEP Alex Mayer took to Twitter to slate the CE for ‘three chaotic years’ at the helm of the East of England Ambulance Service Trust (EEAST).

Ambulance staff have rallied to the defence of their outgoing chief executive after his tenure was criticised by an East of England Labour MEP. Alex Mayer wrote that Robert Morton had overseen “three chaotic years” at the helm of the East of England Ambulance Service Trust (EEAST). Ms Mayer tweeted: “I welcome the resignation and hope that a new chief executive can be found swiftly who will put the concerns of staff and patients at the heart of every decision. Our ambulance service can and must do better. Patients deserve it and so do our hardworking paramedics.”

Ahead of a response by Mr. Morton, ambulance staff were quick to support and defend the Chief Executive. One ambulance staff member, Diane Dingley, tweeted “Another groundless and uneducated comment from the uninterested……. get your facts straight before you make statements in future. @EEASTCEO will be sorely missed by the staff and will be a hard act to follow!”

Also responding to the East of England MEP, Ambulance Service Emergency Operations Manager Andrew Beardlsey tweeted “I’d welcome your resignation. Please check, check & check again your facts before you pass incorrect & inaccurate information out to the public. Please do get in touch with one of my many colleagues who have commented and we will arrange for you to come and spend that day with us.”

Robert Morton also responded to Labour MEP Alex Mayer’s tweet and said “@EastEnglandAmb not contacted by @alexlmayer since becoming an MEP. 4500 staff & 2000 volunteers helped 1.6m patients last year. If she has concerns, she hasn’t told us directly or through union partners. Will write to Alex to ask what her concerns are @GMB_union @UnisonEeas.”

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Outgoing EEAST Chief Executive Robert Morton

The official Twitter feed for the ambulance service’s Emergency Operations Centres said: “The CEO of over 4500 staff, countless volunteers, 6 counties… @EEASTCEO will walk away with head held high, he will be sadly missed and hard to replace, but then we’re just “call takers” and “ambulance drivers” in the eyes of the uninitiated…” East of England Ambulance Service has undergone many changes and restructures over the past number of years and Robert Morton has been behind many of those changes in thre past three years.

In a statement, Chair of the EEAST Sarah Boulton said “For three years Robert has successfully secured long-lasting changes on behalf of patients and staff. Together, we have found a talented and steadfast board to lead a wider team to deliver those improvements. The biggest achievement of the board he built was to secure a six-year contract with our commissioners. This means we can recruit more staff over the next three years and increase the numbers of ambulances we have on the roads”.

The statement continued that the EEAST can expect to see improvements in performance, particularly in the least densely populated areas of east of England such as Norfolk and Suffolk. “Robert’s legacy is a great one. He has had the vision and compassion to get us into a great place and our highly skilled board members will continue on their course to leading EEAST to becoming a high-performing trust.”

In his resignation, CE Robert Motron “While I feel privileged to be the chief executive of EEAST my future plans mean I cannot commit to a further three years. I feel this is the right time to hand over to someone else. I wish to record my thanks to our trust chair, Sarah Boulton, and my board and executive colleagues for their unwavering support and commitment over the last three years. I also want to thank staff for their care, compassion and commitment to our patients and to supporting each other.”

The East of England Ambulance Service Trust became financially balanced during his tenure and according to the EEAST, there was a reduced variation in the quality of care for patients.

Ireland and Australian Posts
Formerly a Director of the National Ambulance Service in Ireland and Chief Executive of the South Australian Ambulance Service, Robert Morton was officially appointed as the new Chief Executive of the East England Ambulance Service in August 2015, taking up his position on August 24th.

Mr. Morton has worked in the ambulance service at various levels for almost thirty-years. Starting off as a paramedic and a first responder with the National Ambulance Service, Robert became Director in Ireland for three years before taking up the position of Chief Executive in South Australia.

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