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Ambulance

Photo: Mark Anderson

Counterfire spoke to an ambulance worker about the serious failures of management in response to coronavirus

How staff feel about our response to the pandemic depends on which area you’re in within the health service. Much of the system worked and health workers everywhere stepped up. But in some areas at the leadership level there were catastrophic failings.

I first became anxious that something was wrong in December 2019 when our trade union started asking when we were going to have our annual protective mask tests. Every time we tried to go for our appointments we were told there was too much work to go. Against the background of the news about coronavirus from China this seemed very wrong.

In January there was a sudden burst of activity and we were all given test slots. But the process was chaotic and random. I didn’t get my equipment test done until late February. Others didn't get one until March when the pandemic was in full swing. Meanwhile the information coming in about the pandemic from Italy and Spain was terrible.

I was watching YouTube videos of carnage in hospitals and listening to pleas from doctors to make all possible preparations. And yet there was no sense of urgency at work. The mask testing was slow, there was no stockpiling of gowns gloves or aprons, no training, no real sense of preparations being made.

On top of this there was no effective system for track and trace in the service. We were never given information or training as to how to deal with the specific problems posed by the virus. There was no attempt to organise crew members into bubbles. After the government started putting some measures in place there wasn’t even any discussion about the two metre rule. Management displayed a lack of basic forethought and sustained incompetence.

The deadly backdrop

This was bad enough in itself. What made things worse was that despite World Health Organisation recommendations about stockpiling, and despite the fact that Britain was relatively well prepared a few years ago, Boris Johnson had scrapped the organisation dedicated to infection control and run down the stockpiles. The results were disastrous. 

Quite simply, our lives and the lives of patients were being put at risk. The WHO recommends that ambulance workers use double gloves, specialist FFP3 masks and goggles, an apron covering arms and legs down to the knees. If we were lucky we were operating with a surgical mask and a sandwich-making apron. We were told not to wear suits unless we were sure that we were dealing with a Covid case. This was shocking when we were seeing photos from all over the world of health workers fully kitted out.

At one point there was a message sent down saying to us only one person in each vehicle is to use PPE because stocks were so low. We were told the other member of staff needs to stand back. This is a horrible joke. We sit close to each other. If you are dealing with an ill person you need someone to help you enter the property and carry them out. The instruction was unworkable.

There were situations where we were down to zero masks. We were taken out of service to go and get some. We would drive miles to pick up three or four, use our supply up and then have to stop again and go somewhere else to find more.

It got so bad that we were made aware that there were vans going around collecting PPE from dentists and GP surgeries and day surgical units. This put other health service staff at risk or created a situation where surgeries and units had to close.

Spreading the virus

To make matters worse they closed down ambulance stations to concentrate people in stations where there was PPE. This had the effect of crowding ambulance workers together in places where social distancing was impossible. We were spreading the disease amongst each other and then going into private homes and care homes without goggles and just with masks at best. It is a terrible thing to admit, but I have to say I think we became a vector for spreading the virus.

These kinds of policies meant that by early March we were in meltdown. At one point we had more than 20% of staff off sick or isolating. Management drafted in police officers and firefighters to drive ambulances. Any sense of care for staff was out the window. We had a colleague who did a procedure on a badly ill patient who was taken into hospital by blue lights. The doctor then did a chest X-ray and found that the patient had Covid. The doctor phoned up my colleague to warn them. But management would not let them go off road because of the staff shortage. To put it politely we were treated as if we were impervious to the virus. We began to realise that the actual reality was that as far as management were concerned we were expendable.

Other instructions we were given made matters a lot worse. Early on management changed the standards to assess people's needs. Normally if a patient gets what is called a 'new score' of one you would take them to hospital. The level was changed to seven. This meant we were allowing people who were extremely unwell to stay at home. This was tantamount to euthanasia. I find it very disturbing to admit this, but quite simply we left lots of people at home to die. I joined the service to care for people who were suffering not to put them at risk. My management put me in this painful situation.

Meanwhile huge numbers of older patients were being taken out of hospital and sent to care homes to clear space for Covid patients. Over a three week period in March and April 25,000 were returned to care homes. This was a disaster. Care home workers had little training and next to no PPE. They were doing intimate personal hygiene and they couldn’t operate in isolation because you need a lot of PPE and they just didn’t have anything like the required amounts. The carers were put in a tragic and impossible situation.

Going to care homes was traumatic. I remember one time I went into a care home and as I approached reception they said they had had thirteen dead. I went into the corridor to fetch out a patient and residents who had seen us take people out were obviously terrified.  And that afternoon we went back and took someone else out. It was really very upsetting.

Public image not public health

Overall I have to say it looks to me and colleagues as if much of the policy was driven by concern about the public image of the institutions not the safeguarding of staff or even the prevention of deaths. The Nightingale hospitals were a case in point. They were opened to a big fanfare but they were hardly used at all. This wasn’t because of lack of demand. This became clear when a colleague who ran an intensive treatment unit said she had reached capacity and asked to send people to the Nightingale Hospital.

The response she got was that she could only send patients who had a high chance of survival! Just as bad, if she wanted to send patients there she would have to send equipment and a member of staff as well. This is unheard of and completely impractical. It’s clear that at a minimum the Nightingale hospitals were never properly resourced.  I think there was a worry that they would end up becoming a site of mass deaths which would look bad and so they were abandoned. 

What happened instead is that almost all other work was suspended in existing hospitals. The health service had been transformed into a massive Covid unit. The service normally looks after about a million people a day. If you suspend most of that there will be absolutely huge numbers of people not being diagnosed and dying or people not getting the support they need – this is another way in which thousands of people were being killed by lack of preparations.

There are very few of us who will walk away without post traumatic stress disorder or some form of stress related illness. To add insult to injury I am not able to mention where I work because I feel as if we are being monitored and I risk victimisation. Whatever the government likes to say or think, we are in the middle of this pandemic, not the end of it. It is still burning away under the surface. Change has got to come.

NHS Staff Voices Conference - Saturday 18 July

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The NHS is under threat, and it has been for years. We have all seen how austerity and privatisation has left the NHS incapable of managing particularly during this crisis. Things won't get better unless we take collective action. NHS Staff Voices is holding an NHS worker/activist conference on the 18th of July. If you're an NHS worker in any capacity, please join the discussion and invite others.

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