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David Kirkwood: The Unknown Emergency Service!

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Over the past year there has been a lot of comment and criticism regarding the performance of various NHS services in our four nations during the COVID-19 crisis. To many it would appear that the NHS has been almost completely realigned to cope with just one illness.

The widespread reduction of elective surgery and the refocusing of GP services to remote consultation have been very visible to the general public. But one important aspect of the health services was shut down completely for several months.

In many areas of the country we have First Responders, volunteers who have had training in advanced first aid. Their role is to attend medical emergencies local to themselves and act as literally a first aid before the professional ambulance paramedics are able to reach the patient.

A First Responder’s job can be summarised as keeping a seriously ill person
alive until specialist help is available. They carry a surprisingly basic but effective range of life-saving equipment including a defibrillator, oxygen and airways.

Edinburgh, Scotland, UK. 9 March 2021. Pictured: David Kirkwood. Candidate photos and photoshoot for Reform UK Scotland Party for the up and coming Holyrood Scottish Parliamentary Elections in May 2021. Michelle Ballantyne MSP is Leader of the Party. Credit: Colin Fisher

This all comes in a very large and very heavy rucksack.

They are controlled by the Scottish Ambulance Service Control Centre. Coverage is generally provided out of normal GP surgery hours, including weekends. It is not unknown for a call to be received in the middle of the night, and a pair of First Responders to be dealing with a seriously ill patient within ten minutes. In our rural area the experience of the
First Responders over the past few years is that they can be on site for between 5 and 90 minutes before an ambulance crew can arrive.

The demand on the ambulance service has been growing steadily over the past year as people who have had elective surgery cancelled or postponed become ill as their condition progresses to an emergency state. As well as this there has been a marked increase in emergency calls for mental health emergencies: these tend to take longer for the crew to deal with on site, taking the ambulance out of service and causing greater delays for other calls.

The increasing load on the ambulance service for both medical and mental health emergencies has meant that the need for immediate interim assistance has grown over the past year.

However, the First Responders were all stood down early in 2020 because
of the perceived risk from COVID-19 and it is almost certain that people will have died because of their absence. Duties have started again recently, but attendance at calls is now impacted by delays added because of mandated COVID-19 precautions before treating the patient.

One thing that has not restarted, is training for new volunteers, who are needed to replace the natural attrition of the existing personnel. This has left many teams even more under strength than they were before and needs to restart soon.

David Kirkwood