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Issue RB180 – 011013 Issue 102 – 1 October 2013

Welcome to the Weekly Regional Bulletin which is issued every Tuesday and designed to keep the number of separate bulletins issued during the week by the Trust to a minimum. If any staff members have any comments or feedback they would like to share with the team, please feel free to get in touch by emailing: communications@nwas.nhs.uk.

NWAS LAUNCHES #TEAM 999! Yesterday, NWAS launched #Team999 – a new initiative designed to educate people across the North West about what can happen following an emergency call to the ambulance service. The initiative aims to educate the public about the changing role of the ambulance service and, in particular, how it no longer sends ambulances to all incidents or takes every patient to the emergency department. The #Team999 campaign will help the public better understand what to expect when they call 999, by introducing them to all of the team members they could come into contact with. The hashtag symbol (#) used as part of the campaign is used within social media outlets, such as Twitter and Facebook before a relevant keyword or phrase. Over the next six months, the representatives of #Team999 will be introduced one by one to enable the public to get a greater understanding of their roles and the part they play within NWAS and patients’ lives. The seven team members making up #Team999 include:

Ruth Thomas, Ambulance Technician and Pete Sutcliffe, Paramedic

Simon McCrory, Rapid Response Vehicle Paramedic

Jack Moseley, Emergency Medical Dispatcher

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Paul Walmsley, Dispatcher

Ester Hooper, Hazardous Area Reponse Team Paramedic

Carol Robertson, Urgent Care Desk Specialist Paramedic Each will take part in activities and events including live Twitter Q&A sessions, roadshows and short films – giving the public a glimpse into the day-to-day responsibilities of the full team. Bob Williams, Acting Chief Executive, said: “We want to break down any myths that exist about the outcome of calling 999 – predominantly that it doesn’t always mean a visit from an ambulance crew or a trip to hospital. Our aim is to provide every patient with the right care, in the right place. Sometimes this will be an ambulance and a visit to the Emergency Department, but not always. “Around two thirds of our 999 calls are for non-life-threatening incidents. Because of this, we have changed the way we work to make sure patients get the most appropriate care for their specific needs and, most importantly, keep emergency ambulances free for those who need them most.” Bob continued: “#Team999 really brings to life all of the elements that make up NWAS. It’s the first time the public will get the chance to ‘meet’ the individual team representatives and will give a clear understanding of what happens in the emergency ambulance service.” “We hope the public enjoy getting to know #Team999 and we look forward to receiving their feedback about the campaign over the coming months.”

NWAS BECOMES INVESTORS IN PEOPLE CHAMPION Following the Trust’s achievement of Investors in People Gold (IiP) and the Good Practice Award in Health and Wellbeing, NWAS has now become a Champion for IiP. Investors in People Champions are a prestigious group of role model organisations that work to promote the IiP framework, sharing best practice they have gained from their Investors in People experiences. By becoming an IiP Champion, the Trust is committing to sharing and also learning from experiences, encouraging good practice across the region and supporting continuous improvement. NWAS is keen to work with other organisations to support them in exploring the framework and understand the value of Investors in People. Michael Forrest, Acting Director for Organsiational Development, said: “We are delighted to become Investors in People Champions following on from our success in achieving Gold and the Health and Wellbeing Award. This will enable us to support other organisations that are in the

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process of achieving IiP, demonstrating our commitment to continuous improvement across the region.” NWAS has used Investors in People to embed a culture of continuous improvement and development within the organisation, gaining valuable feedback to support staff and ultimately our patients.

MAJOR INCIDENT – GRAYRIGG CUMBRIA At 8.25am, on Monday 23 September 2013, Broughton Emergency Operations Centre (EOC) received reports of a serious Road Traffic Collision (RTC) on A685, Grayrigg, Cumbria involving a HGV and a bus. Initial reports stated that there could be up to 20 casualites, many of which were high school students, with the Trust declaring a major incident at 8.44am. A total of 11 operational resources, along with three officers, were dispatched to the scene with the first crews arriving within ten minutes of the initial call. Ten patients were taken to hospital by land ambulance, air ambulance and a Patient Transport Service (PTS) vehicle. Fortunately no-one involved sustained any life-threatening injuries and major incident was stood down by 10.00am. Derek Cartwright, Acting Director of Operations, said: “As with any declaration of a major incident, staff and managers acted extremely quickly to ensure all the casualties were dealt with quickly and efficiently. I wish to thank all the staff involved, including those who were in a supportive role, and in particular the PTS staff who gave support in terms of transporting some of the children to hospital. “The timely response to this incident, which could have been much more serious, was another great example of the effective joint working with the other emergency services.”

SUCCESSFUL PROSECUTION OF MALE PATIENT! A male who physically assaulted a member of staff from central Manchester has been given a 12 week custodial sentence suspended for 12 months together with a 12 month supervision order. The attack happened after a crew were called to a male patient who was apparently intoxicated. The crew began to assist the male who was un co-operative and became verbally abusive. On assisting the male to the ambulance, so that further clinical assessment could take place, the male continued to be un co-operative and went on to place his hands around the throat of the paramedic, making a number of threats. Police assistance was requested and on their arrival the male was arrested and charged. After pleading not guilty the case was referred to trial and the member of staff was accompanied to Trafford Magistrates Court by Linda Snape, Safety and Security Practitioner, who commented: “Staff are encouraged to pursue prosecutions against those who subject them to this type of behaviour in order to send out the message that this behaviour will not be tolerated.”

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The male failed to appear in court for the trial but the case was heard and he was found guilty in his absence. A warrant was issued for his arrest and he was then arrested and appeared in court for sentencing. A small amount of compensation was also awarded to the paramedic concerned who said: “I felt it was a good result and hoped that this would deter the male from displaying such behaviour to our staff in future.” Any incident of assault on a member of staff is unacceptable and staff will be fully supported by the Trust when progressing a prosecution. For further information or guidance, please contact local management or your local Safety and Security Practitioners Linda Snape or Sandra Johnson Linda.Snape@nwas.nhs.uk, Sandra.Johnson@nwas.nhs.uk.

PRIDE OF BRITAIN AWARDS – ALL WILL BE REVEALED! The Daily Mirror’s annual ‘Pride of Britain Awards’ are fast approaching and NWAS is delighted it will be playing a part in this year’s ceremony! Make sure you tune in to ITV on Tuesday 8 October, where all will be revealed on the night! The awards are set to recognise remarkable people in the following categories:

Outstanding Bravery

Child or Teenager of Courage

Young Fundraiser of the Year

Neighbour of the Year

Emergency Services

Teacher of the Year

Fundraiser of the Year

Lifetime Achievement

Special Recognition

You may just see someone you know, so don’t miss out! The Press Office would like to thank everyone involved in making the filming a success!

NHS STAFF SURVEY 2013 – HAVE YOUR SAY TODAY! The NHS staff survey 2013 has arrived and 850 staff members have been selected at random to complete this year’s questionnaire. As a result of last year’s survey, the Trust has formulated an action plan to address the areas where you felt there could be some improvement, examples include: You Said: 34% staff experience violence from staff, patients or public We Did: ‘Stop Abuse’ posters will be on clear display on all ambulances by the end of this year. If you receive a questionnaire, please complete it and return it as soon as you can. Your answers will be treated in confidence and no one from your organisation will be able to identify individual responses. Don’t miss out on this opportunity to have your say!

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FIREARMS INCIDENTS Please could all staff make sure they are familiar with the following Firearms Incidents procedures found at the back of today’s issue of the Regional Bulletin:

Ref: OI366 – Paramedic Emergency Service Instructions Fire Arm Incidents Procedure Ref: OI367 – Emergency Operations Centre Procedure EOC0013- Firearms Incidents

Please can all operational managers ensure these are available to staff and put on staff notice boards.

NEW GP REFERRAL SCHEMES GO LIVE IN OLDHAM AND STOCKPORT Two new schemes are scheduled to go live on Tuesday 1 October 2013, within Oldham and Stockport. Within Oldham, GoToDoc have been commissioned to provide a GP referral scheme, for all patients registered with an Oldham GP. Over in Stockport, Mastercall have also been commissioned by Stockport Clinical Commissioning Group (CCG) to provide a scheme for patients who are registered with a Stockport GP. Referral schemes are seen as a clinically led, safe alternative to emergency department conveyance that supports NWAS’ Urgent Care Strategy. Over the last 12 months, the Paramedic Pathfinder team has continued to work with CCGs throughout the North West, to identify potential areas for implementation and the development of GP referral schemes. Patients assessed as at AMBER, aged 16 years and over and in their own home, should be considered for a GP referral by Pathfinder trained clinicians. Siobain Penpraze, Pathfinder Implementation Manager, said: “Over the last 12 months, the Pathfinder team has worked tirelessly with local CCGs, highlighting the benefits of developing and commissioning GP referral schemes. By having a scheme in place, NWAS clinicians and the service providers can access and share vital care information quickly and efficiently.” She added: “Paramedic Pathfinder supports the schemes, as it enables NWAS clinicians to assess patients using a clinically safe, evidence based triage process, so that patients receive the best quality of care, in the most appropriate place, in a timely manner. Stockport and Oldham are the latest schemes to go live and there are currently another four which are due to go live before the end of the year”.

PARAMEDIC EMERGENCY SERVICE (PES)

Name/Sector Date Time Venue

Phil Howcroft - West Thursday, 12 September 2013

18:00 hours Highfield Station

Patrick McFadden - Central

Thursday, 10 October 2013

18:00 hours Salford Station

Mike Hynes - East Thursday, 14 November 2013

18:00 hours Rochdale Station

Annemarie Rooney - South

Thursday, 13 February 2014

18:00 hours Sharston Station

PARAMEDIC EMERGENCY SERVICE (PES)

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For further information, please contact your Advanced Paremedic, the Paramedic Pathfinder Implementation team at Ladybridge Hall or refer to Clinical Information Bulletin; Ref: CI273, General Practitioner (GP) Referral Schemes – which can be found on the intranet.

MENTAL CAPACITY ACT AWARENESS SESSIONS Two half day Mental Capacity Act (MCA) 2005 sessions will take place in October in conjunction with Liverpool Council, which aim to increase knowledge of the MCA using drama and scenarios that can be applied to everyday work. The sessions will take place as follows:

Wednesday 9 October 2013, 9.30am – 12.30pm Toxteth Annexe, Aigburth Road, L17 7BN

Friday 15 November 2013, 9.30am – 12.30pm Toxteth Annexe, Aigburth Road, L17 7BN By the end of the session you will:

Understand your role and responsibilities under the Mental Capacity Act (MCA) 2005

Recognise the five key principles of the Act

Have the knowledge to determine when someone may lack capacity to make a specific decision when the decision is required

Understand how to assess mental capacity

Understand lasting powers of attorney

Know how to access and make a referral to the Independent Mental Capacity Advocate (IMCA) Service

Understand how assessment of capacity and best interest decisions are recorded. This event is specifically for staff that require an understanding of the MCA, for example: care assistants, social workers, support workers, domiciliary aids, home carers, auxiliaries, nurses, community matrons, doctors, housing officers, transport, ambulance staff, police, fire and rescue staff, and staff who deal with service users/patients that may lack capacity to make specific decisions eg. opening a bank account, entering into contracts etc. This event is also a refresher for staff who have not attended any MCA updates within the last three years. To book a place on this half day event, please email: mental.capacity@liverpool.gov.uk.

PTS STAFF FORUM - MERSEYSIDE Staff are reminded of the following Patient Transport Service (PTS) forum, scheduled to take place next week in Merseyside:

Date Time Location

Monday 7 October 5pm Anfield Ambulance

Station

PATIENT TRANSPORT SERVICE (PTS)

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Staff forums are a great way for staff to voice their views and opinions. All staff are welcome to attend. Posters containing all PTS forums for the year in your area are now available on stations. Further details of staff forums for the year are also available on the staff intranet. These are accessible by clicking on the ‘Staff Forums’ icon under ‘Out and About’ column found on the intranet homepage.

TDA PUBLISH FIRST MAJOR REPORT ON NHS TRUSTS The Trust Development Authority (TDA) has published its first report on the performance of the NHS trust sector from the period of 1 April to the end of July 2013. The report highlights that most NHS trusts have continued to perform well in delivering care for their patients and communities, with most of the standards set out in the NHS Constitution being met by the sector as a whole.

There has also been measureable improvements in the quality of care provided by the NHS trust sector since the beginning of the year. In relation to the ambulance sector, the report highlights that there is a lot of variation in performance against the set standards. As a result the TDA’s regional delivery and development teams are working closely with some ambulance trusts to improve their performance.

Trust figures for the first four months of the year show that both the 75% Category A Red 1 standard for responses within 8 minutes and the 95% standard for responses within 19 minutes have both been met as at end of July 2013.The 75% Category A Red 2 standard for responses within 8 minutes fell just short with performance of 73.8%.

The report also highlights the importance of clear signposting to patients and service users about the care available across the community in GP practices and elsewhere, considering the impact this has on emergency care.

To continue to improve performance for accident and emergency departments this winter, the TDA has taken a number of measures, including:

Working more closely with the poorest 24 performing NHS trusts to help them develop better plans to improve performance

Ensuring that £157 million is invested in 34 health economies where accident and emergency performance is most challenged

Developing plans with the emergency care intensive support team to provide expertise and support to the most challenged trusts

NHS UPDATE

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AGENDA FOR CHANGE NATIONAL TERMS AND CONDITIONS CHANGES TO SICK PAY As you will be aware, the Trust has been advised nationally of the implementation date for changes to Agenda for Change Sick Pay arrangements. In February the NHS Staff Council agreed a number of changes to the handbook which covers staff on Agenda for Change contracts in England, with effect from 31 March 2013. These changes ensure the handbook remains sustainable for the future, fit for purpose, fair to staff and continue to be used by NHS organisations. In the case of the ambulance sector, the implementation date was deferred until 1 September 2013.

Staff are reminded that these changes do not affect staff employed on pay points 1-8, which cover pay bands 1 and 2 and part of band 3. In addition, there will be no adjustments to sick pay where absence is work related. Information has been published earlier this week on the national decision to proceed to implement these changes, which also identified how the changes to sick pay would be calculated. Arrangements have now been made with the NWAS Payroll provider, ELFS, to implement these changes in October for all absence days which have occurred in September, even where the start of the period of absence pre-dates 1 September. This is consistent with the national implementation arrangements. For absence to be considered as work related, staff must have submitted an Incident Report Form (IRF) either via the online reporting system or on paper. This will then be investigated and a decision made as to whether the criteria for considering the absence as work related has been met. In order to avoid overpayments, all absence will be treated as non-work related until incidents can be investigated and a decision reached on the nature of the absence. Sections 14 and 22 of the Agenda for Change Handbook include further guidance on the factors that the Trust is required to consider when deciding whether absence is work related. The nationally published staff guide to Injury Allowance also provides some guidance on the factors the Trust is required to consider. This has been previously circulated and is available on the HR Portal. A set of Frequently Asked Questions on how the process will be applied in the Trust can be found at the back of this week’s issue of the Regional Bulletin.

CHANGES TO EXPENSES CLAIMS NWAS is currently in the process of implementing a web based electronic expenses system. This is provided by Software Europe and is already in place within a number of NHS organisations including other ambulance trusts. The system will enable staff to input their expenses on-line and claims sent automatically to the correct manager to be authorised, before being sent immediately on to payroll for payment.

HR UPDATE

POLICIES AND PROCEDURES

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The system brings a number of benefits. For individuals it provides a more secure and faster way of completing and submitting expenses. Staff will be able to submit a claim to their line manager at the touch of a button and also see exactly where a claim is up to in the process. Staff will also be able to keep a record of expenses on the go using the mobile phone application. The new system can also scan or take a picture of receipts to submit electronically and will allow staff to view a complete claims history on-line rather than having to keep copies of claims. For the Trust, it will help managers to validate claims by flagging anything which is outside of policy, and should also help to speed up the authorisation process. The first phase of the implementation will commence for October expenses claims which will need to be submitted in early November for payment that month. The first phase includes a cross section of parts of the service and will help us to develop the look and feel of the system and the guidance information to ensure that it meets your needs. The groups of staff to be included in the first phase of implementation are:

Human Resources

Finance, including supplies and commissioning

HART, Liverpool

PES Central Station and Manchester North

PES Altham, Burnley and Stacksteads

EOC Team D, Parkway

PTS Birkenhead and Wallasey Individuals will be contacted shortly with further details of the arrangements for roll out. Access to the system to start recording expenses will be available from mid-October at the latest, following some final set up changes. Staff will be supported to use the system through guidance documents and drop-in sessions which will be arranged at the locations affected by the first phase. The system itself also has a comprehensive help and support section. The Trust would like to encourage staff to feedback their experiences of the guidance and system to ensure that it can adapt as it is implemented further. Further information will be provided in future editions of the Regional Bulletin, as the system is rolled out across the Trust.

LEARNING AND DEVELOPMENT BID A FOND FAREWELL TO SARAH MONTGOMERY On Friday 27 September 2013, the Learning and Development team said goodbye to Sarah Montgomery who left NWAS after 11 years of working for the Trust.

LEARNING AND DEVELOPMENT

LEARNING AND DEVELOPMENT

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Reflect &

Develop!

Sarah originally started with Greater Manchester Ambulance Service back in 2002 as a HR Assistant, prior to moving to the Learning and Development team and taking on the role of Senior Learning and Development Manager. Sarah said: “I just wanted to say thank you so much for my lovely gifts and for all your kind words – I am truly overwhelmed. It’s been such a pleasure working with you all over the last 11 years and I have some amazing memories of my time at NWAS.” A leaving bash has been arranged to take place in Manchester on 12 October prior to Sarah starting her new role with Wrightington, Wigan & Leigh NHS Foundation Trust. Staff will be meeting at the Slug and Lettuce on Albert Square at 7pm and all are welcome to attend.

TAKE FIVE! The Learning and Development team is delighted to announce the next topic for Take Five is: Reflective Practice Reflective practice is defined as: “Consciously and systematically thinking about personal actions. The ability to review, analyse and evaluate situations, during or after events,” - Churchill Livingstone’s Dictionary of Nursing, seventieth edition (1996). Remember, all we are asking you to do is Take Five! minutes out of your day to think about Reflective Practice. Taking Five in itself is a great way to build on your reflective skills! To build your knowledge further on this topic, please contact the Learning and Development team.

CMI LEARNING OPPORTUNITIES CMI Level 5 Award in Coaching and Mentoring An additional cohort has now been arranged for the CMI Level 5 Award in Coaching and Mentoring Programme. The Award is a two day programme which will help you to have great coaching conversations in the workplace. It is CMI accredited and designed to ensure participants take a flexible approach to learning and coaching skills development with an emphasis on practical coaching skills and supporting the development of others. Core areas of the programme include:

Personal development as a manager and leader

What is coaching and mentoring and what it is not

Understanding what impact coaching and mentoring can have on individuals and organisations

Practical application of coaching and mentoring skills as a manager

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The additional session will take place on 7 and 8 November at Ladybridge Hall. If you are interested in attending, please submit completed CMI application forms to CMI@nwas.nhs.uk at your earliest convenience. Places will be allocated on a first come first served basis.

NEW WORKSHOPS The Learning and Development team is pleased to announce two new workshops that will be piloted at Broughton House on Monday 14 October 2013:

Disability Awareness Running from 9.30am - 12:30pm the workshop will look at:

Disability and what it means

Disability and the Equality Act

How different disabilities can affect a person’s everyday life

Effective communication, including body language and sign language - British Sign Language/Makaton

Blindness and visual impairment

Deaf Awareness This session will run from 1 – 4pm and covers the following:

What is deafness?

Effective communication and body language

Fingerspelling - the British Sign Language/Makaton Fingerspelling alphabet, how to use this as an excellent communication tool

Deaf people’s needs and deaf culture To apply for the above workshops, please complete an internal development application form, available from the intranet or via a member of the Learning and Development team, and forward it to: learningdevelopment@nwas.nhs.uk.

MOTIVATION AND PERSONAL EFFECTIVENESS WORKSHOP Don’t forget to book your place on the motivation and personal effectiveness workshop! The first event, organised by Senior Paramedic Phil Baggaley, was hugely successful and received some very positive feedback from colleagues! The motivation and personal effectiveness workshops are due to take place as follows:

Tuesday, 8 October 2013, 1 – 4.30pm, Westmorland County Agricultural Society, Crooklands

Tuesday, 22 October 2013, 1 – 4.30pm, Formby Ambulance Station

Book your place today and improve individual and team focus and boost morale!

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To book a place, please complete an internal development application form, available from the intranet or via a member of the Learning and Development team, and forward it to: learningdevelopment@nwas.nhs.uk.

NWAS WORKS WITH PRINCE’S TRUST NWAS has been working in partnership with Greater Manchester Fire and Rescue Service (GMFRS) and the Prince’s Trust to introduce the chain of survival to 16 – 25 year olds.

GMFRS deliver a 12 week team programme three times a year in seven locations across Greater Manchester. The programme consists of careers advice, work placements, a week of team building activities and a series of community based projects.

Sara Harris, Chain of Survival Partnership, County Lead for Greater Manchester, worked on the project in the Bolton area, teaching 11 members of the Bolton group Cardio Pulmonary Resuscitation (CPR) and how to use an Automated External Defibrillator (AED). Sara also set the group the challenge of presenting to her what a heart attack, cardiac arrest and AED was. After the presentation, Sara talked it through with the group adding more detail and providing real life examples and learning resources to back it up. After their training session, the Bolton team decided they wanted to pass on what they had learnt to the community and raise money for an AED in Bolton Town Centre. They held a one hour session for community members which included a presentation, group work hand outs and an end of course questionnaire designed by the group. Sara Harris was on hand for support throughout the day which in all saw a further 20 people trained in CPR and AED skills. The team managed to raise just under £500 for an AED, which was donated to the Bolton Implantable Cardiac Defibrillator (ICD) support group, where they placed an AED in Bolton College. Sara Harris said: “I found the experience extremely rewarding and saw the difference the programme can make to young people.”

NWAS COMMUNITY RESUSCITATION TEAM NEWS

NWAS COMMUNITY RESUSCITATION TEAM NEWS

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NWAS WELCOMES A SPECIAL GUEST! Recently, NWAS played host to visitor, Hadiur Rahman, (pictured) in a bid to help with his quest to set up an emergency first aid business in Bangladesh.

During his time with the Trust, Hadiur spent a day with Lyn Nolan, Senior Paramedic and EMT1 Amanda Collins at Fazakerlery. He also visited the Trust’s Emergency Operations Centre (EOC) at Elm House, as well as spending time with Jenny Helbert, Personal Assistant and Marie Fisher, Operational Service Manager. First Aid Bangledesh is a non-profitable organisation devoted to promoting emergency health care from 2014, with the aim to provide timely treatment towards the accident affected people in Bangladesh. Hadiur said of his visit: “It was a wonderful time at NWAS and I appreciate your endless cooperation. I wish, one day to invite you to see our projects in Bangladesh.”

For further information, please visit: www.firstaid.com.bd.

NWAS LGBT NETWORK MEMBERSHIP The Trust’s Lesbian Gay Bisexual Transgender (LGBT) Network is currently updating its membership list! If you would like be a part of the Network and keep up to date with the activities of the Network, please email the LGBT inbox: lgbt@nwas.nhs.uk. Please include your preferred contact email, role and location of work. Please note that any contact will be treated in the highest confidence.

CHESTER PRIDE IS NEARLY HERE! On Saturday 5 October, Chester’s first large-scale PRIDE festival is taking place in Chester city centre! The free event is a celebration of the Lesbian, Gay, Bisexual and Transgender (LGBT) community and of diversity in the local area! Live acts will be on the main stage in front of the Chester Town Hall, Northgate Street, Chester, CH1 2HJ from 2pm until 6.30pm featuring X Factor finalists Chris Maloney and Amelia Lily!

NWAS COMMUNITY NEWS

NWAS COMMUNITY NEWS

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As well as a main stage there will be a lifestyle area featuring information, advice and freebies from public and voluntary sector services and community groups in Chester Town Hall, Northgate Street, CH1 2HJ. There will also be an outside marketplace and local artists in the Town Hall Square! NWAS will have a stand in the lifestyle area to engage with the LGBT and diverse communities through basic first aid demonstrations, Foundation Trust membership, opportunities for volunteering, and accessing and provision of information to ambulance services. Further information about the event, can be found at: http://chesterpride.co.uk/.

FYLDE COAST HEALTH MELA 2013 On Saturday 5 October 2013 the first Fylde Coast Health Mela will take place at Blackpool Winter Gardens in the Spanish Hall. The free event is open to the public and will include the following services:

Health assessment (including height, weight and BMI measurement)

Blood sugar and cholesterol testing

Blood pressure checks

Eyesight and hearing checks

Advice on healthy living, exercise, smoking and alcohol abuse

Personal and confidential health counselling

Falls prevention pathway

Activities for children

Complementary medicine taster workshops

There will be more than 80 organisations at the event to give advice and information, including NWAS. The Trust will be providing basic first aid demonstrations for visitors, signing up members of the public to FT membership, discussing opportunities for volunteering with NWAS and provision of information to ambulance services. Refreshments will be available for visitors throughout.

MAKE THE MOST OF DISCOUNTS FOR STAFF AVAILABLE ON THE INTRANET! Everton Football Club has kindly given all NWAS employees, access to discounted tickets for two matches in 2013 and two matches in 2014. Games include: Everton v Tottenham - Adults £26, Child £13

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Everton v Sunderland - Adults £26, Child £13 Everton v Crystal Palace - Adults £22, Child £11 Everton v Swansea City - Adults £22, Child £11 For further information on each of these offers and more, please visit the staff discount page on the intranet – this is assessable from a quick link on the right hand side of the intranet homepage.

INFORMATION FOR LOCAL COMMUNITIES AND AGENCIES – SPRINGFIELDS PLANT There was a filter failure from a chemical facility on the Springfields site this morning (Tuesday 1 October 2013). Filter paper was ejected from a stack on one of the plants, which was undergoing a routine shut down at the time, and deposited in a small area to the west of the site. Some of the paper was blown off site. Whilst the paper contained extremely low trace substances, it presents no health hazard to the public or workforce and is completely safe to handle. Temporary road closures were set up to allow Springfields staff to safely collect the paper from the road and carry out reassurance monitoring without risk from vehicles. Clean-up was simply a task of picking up the filter paper by hand. However, it may be that over the next few days you may find some small pieces of paper in your garden or near your house. These will be white pieces of filter paper – they will be very small pieces about 1cm in diameter. It is perfectly safe to pick up the paper and dispose of it in your bin. Alternatively if you would prefer us to collect and dispose of the paper, then please contact the following number and Springfields staff will come out and collect it: 01772 764120 or visit www.springfieldsfuels.com.

NWAS INFORMATION BULLETINS From page 17 onwards, please find the following information bulletins, for your reference: HR Message

Ref: HR053 – Agenda for Change National Terms and Conditions – Changes to Sick Pay – Issued by Lisa Ward on 30 September 2013.

Agenda for Change National Terms and Conditions – Changes to Sick Pay Work Related Sickness Authorisation Process – Employee FAQs.

Operational information Bulletins

Ref: OI365 – Dress Uniform – Issued by Ged Blezard.

NWAS STANDALONE INFORMATION BULLETINS

NWAS COMMUNITY NEWS

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Ref: OI366 – Paramedic Emergency Service Instructions Fire Arm Incidents Procedure – Issued

by Ged Blezard.

Ref: OI367 – Emergency Operations Centre Procedure EOC0013 – Firearms Incidents – Issued

by Ged Blezard.

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30 September 2013 HR053

AGENDA FOR CHANGE NATIONAL TERMS AND CONDITIONS – CHANGES TO SICK PAY Please find below an important message from NHS Employers regarding the arrangements for implementation of the nationally agreed changes to Agenda for Change Sick Pay terms and conditions. The message concerns the nationally agreed method for implementation of these changes which is being applied across all ambulance trusts with effect from 1 September 2013 and also includes a Question and Answer document to help address any queries you may have. Further guidance covering specific local arrangements for implementation will be issued shortly via the normal Weekly Regional Bulletin. National Methodology A number of options for implementation of the change to Agenda for Change sick pay arrangements have been discussed nationally with Trade Unions over the last six months. A methodology was presented to them during July 2013 and they confirmed that they would be prepared to communicate with their members on this. This methodology was rejected on 23 August 2013. This position is deemed untenable by English ambulance employers without an agreed methodology for the deduction of USH payments. Ambulance sector HRDs have reviewed the options available to ensure that employers are transparent to staff in terms of the deduction and that they do not have a double impact on the next rota pattern, following an absence period. All English ambulance services have therefore decided, in the absence of any agreed formula, that unsocial hours allowance will not be paid during any period(s) of sickness absence from 1 September 2013.

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Frequently Asked Questions

1. What formula is being used to deduct unsocial hours payments (USH) during periods of sickness absence from salaries for ambulance staff paid under Annex E? Annex E unsocial hours allowance has been converted to an hourly rate which will then be deducted for each hour of sick leave falling in a rostered period of work. For example:

annual salary: £27,901

rate per hour: £14.27

USH rate: 25%

USH sickness deduction per hour: £3.57

A table showing the hourly rate of unsocial payment for each pay point, in each AforC pay band, is attached.

2. I am sick and away from work for two days. Consequently, I miss two shifts which were each 12 hours long (ie. I would have worked 24 hours – dependant on meal break provisions). I am on pay point number 4 in pay band 5 (pay spine point number 19: £23,825). I receive unsocial hours payments at 25 per cent. What deduction would be made from my pay? The hourly rate of unsocial hours payment for an employee on pay point 4 in pay band 5 (AforC) pay spine point number 19 when the unsocial hours payment is at 25 per cent, is £3.05. As 24 hours have not been worked as a result of sickness absence, 24 x £3.05 = £73.20 is deducted from total pay one month in arrears or as soon as is possible after this. Any periods of unpaid meal breaks that are included in shifts by ambulance trusts will not be included for the process of USH deductions. Therefore if a 12 hour shift only contains 11 hours paid work (with 2 x 30 minute unpaid rest breaks), the USH deduction for sickness on this shift would be for 11 hours (the example above would therefore be for a 22 hours deduction). Where a Trust applies 1 x 30 minute unpaid meal break and the shift is 11.5 hours then this would be a total 23 hours USH deduction.

3. I am away from work due to illness and miss one 10 hour shift. Would the USH deduction be made to all ten hours? Yes. The deduction will be taken for all rostered hours you were due to work for, so ten hours’ USH pay would be deducted from your pay. Any unpaid meal breaks would be excluded from the deduction.

4. I am ill on my rest day. What amount is deducted from my pay? No deduction would be made as you were not due to work.

5. What will be deducted if I am absent on long-term sickness absence?

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The unsocial hours allowance will continue to be deducted at the hourly rate for all hours not worked. Therefore for periods of on-going and long term sickness no unsocial payments would be paid. N.B. Where rostered hours have not been allocated, or in circumstances where the employee works relief, the hours deducted will be on a calendar day basis, i.e. 5.36 hours per calendar day lost during sickness absence (37.5 contracted hours per week divided by 7 calendar days per week (pro rata for part time employees as appropriate).

6. If I am getting 25% Annex E unsocial hours payment before my sickness absence begins, what will I get when I return to work? For employees on prospective shift patterns, on return to work the unsocial hours allowance will continue to be paid at 25%. This is providing there have been no planned and consulted changes to work patterns or rotas generally at this time.

7. How will the information needed to make these calculations be collected? In order to make calculations based on the number of hours not worked, additional information about rotas will need to be given to payroll. We will ensure this information is provided to payroll.

8. What if I have sustained an injury whilst at work, will I have my unsocial payments deducted? If you are absent from work due to an accident or incident which occurred whilst you are discharging your duties at work, you will not be deducted unsocial payments for this period of absence, subject to approval of industrial injury. You will need to ensure that you report any accident at work using the correct procedures to ensure that an assessment and approval can be made as appropriate. The procedures relating to the reporting of accidents/incidents, approval of IA (Injury Allowance) and RIDDOR (HSE reporting) will be managed carefully to ensure that payments are made correctly. Deductions may be made in advance of a decision on industrial injury where these processes are not followed or where further investigation is required. Where approval of work related injury is made USH payments will be re-imbursed.

9. If I am absent from work due to a pregnancy related illness will my unsocial payments be deducted? No exemptions have been agreed nationally for pregnancy related absences and therefore deductions would be made in the same way as all other absences. If the rostered shift is not worked then no unsocial payments will be made.

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10. If I am absent from work before 1 September and continue to be sick when will the deductions start from? The deductions will commence for all shifts rostered on or after 1 September 2013. This concession to delay the implementation of this national agreement from 31 March 2013 to 1 September 2013 applies only to the ambulance sector.

11. Will the unsocial deductions affect pension contributions?

Unsocial payments are included as pensionable pay, therefore where unsocial payments are deducted this will impact on total pensionable pay calculations.

Tables showing the hourly rates for unsocial hours allowance payments for each pay point, in each Agenda for Change pay band affected by the changes, are included on the following pages.

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Pay rates including 1 April 2013 pay award AFC Work Outside Normal Hours %

Unsocial Hours Allowance per hour

Please note pay points 1-8 are exceptions to the agreement and are unaffected by the changes so they have been excluded from the tables

Band 3 Point Annual salary

Per month

Hourly rate

25% 21% 17% 13% 9% 5%

6 16271 1355.92 8.3212

Pay points unaffected by changes

7 16811 1400.92 8.5974

8 17425 1452.08 8.9114

9 17794 1482.83 9.1001

2.28 1.91 1.55 1.18 0.82 0.46

10 18285 1523.75 9.3512

2.34 1.96 1.59 1.22 0.84 0.47

11 18838 1569.83 9.6340

2.41 2.02 1.64 1.25 0.87 0.48

12 19268 1605.67 9.8540

2.46 2.07 1.68 1.28 0.89 0.49

Band 4 Point Annual salary

Per month

Hourly rate

25% 21% 17% 13% 9% 5%

11 18838 1569.83 9.6340

2.41 2.02 1.64 1.25 0.87 0.48

12 19268 1605.67 9.8540

2.46 2.07 1.68 1.28 0.89 0.49

13 19947 1662.25 10.2012

2.55 2.14 1.73 1.33 0.92 0.51

14 20638 1719.83 10.5546

2.64 2.22 1.79 1.37 0.95 0.53

15 21265 1772.08 10.8753

2.72 2.28 1.85 1.41 0.98 0.54

16 21388 1782.33 10.9382

2.73 2.30 1.86 1.42 0.98 0.55

17 22016 1834.67 11.2593

2.81 2.36 1.91 1.46 1.01 0.56

Band 5 Point Annual salary

Per month

Hourly rate

25% 21% 17% 13% 9% 5%

16 21388 1782.33 10.9382

2.73 2.30 1.86 1.42 0.98 0.55

17 22016 1834.67 11.2593

2.81 2.36 1.91 1.46 1.01 0.56

18 22903 1908.58 11.7130

2.93 2.46 1.99 1.52 1.05 0.59

19 23825 1985.42 12.1845

3.05 2.56 2.07 1.58 1.10 0.61

20 24799 2066.58 12.6826

3.17 2.66 2.16 1.65 1.14 0.63

21 25783 2148.58 13.1858

3.30 2.77 2.24 1.71 1.19 0.66

22 26822 2235.17 13.7172

3.43 2.88 2.33 1.78 1.23 0.69

23 27901 2325.08 14.2690

3.57 3.00 2.43 1.85 1.28 0.71

Band 6 Point Annual salary

Per month

Hourly rate

25% 21% 17% 13% 9% 5%

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21 25783 2148.58 13.1858

3.30 2.77 2.24 1.71 1.19 0.66

22 26822 2235.17 13.7172

3.43 2.88 2.33 1.78 1.23 0.69

23 27901 2325.08 14.2690

3.57 3.00 2.43 1.85 1.28 0.71

24 28755 2396.25 14.7058

3.68 3.09 2.50 1.91 1.32 0.74

25 29759 2479.92 15.2192

3.80 3.20 2.59 1.98 1.37 0.76

26 30764 2563.67 15.7332

3.93 3.30 2.67 2.05 1.42 0.79

27 31768 2647.33 16.2467

4.06 3.41 2.76 2.11 1.46 0.81

28 32898 2741.50 16.8246

4.21 3.53 2.86 2.19 1.51 0.84

29 34530 2877.50 17.6592

4.41 3.71 3.00 2.30 1.59 0.88

Band 7 Point Annual salary

Per month

Hourly rate

25% 21% 17% 13% 9% 5%

26 30764 2563.67 15.7332

3.93 3.30 2.67 2.05 1.42 0.79

27 31768 2647.33 16.2467

4.06 3.41 2.76 2.11 1.46 0.81

28 32898 2741.50 16.8246

4.21 3.53 2.86 2.19 1.51 0.84

29 34530 2877.50 17.6592

4.41 3.71 3.00 2.30 1.59 0.88

30 35536 2961.33 18.1737

4.54 3.82 3.09 2.36 1.64 0.91

31 36666 3055.50 18.7516

4.69 3.94 3.19 2.44 1.69 0.94

32 37921 3160.08 19.3934

4.85 4.07 3.30 2.52 1.75 0.97

33 39239 3269.92 20.0674

5.02 4.21 3.41 2.61 1.81 1.00

34 40558 3379.83 20.7420

5.19 4.36 3.53 2.70 1.87 1.04

Band 8 Range A Point

Annual salary

Per month

Hourly rate

25% 21% 17% 13% 9% 5%

33 39239 3269.92 20.0674

5.02 4.21 3.41 2.61 1.81 1.00

34 40558 3379.83 20.7420

5.19 4.36 3.53 2.70 1.87 1.04

35 42190 3515.83 21.5766

5.39 4.53 3.67 2.80 1.94 1.08

36 43822 3651.83 22.4113

5.60 4.71 3.81 2.91 2.02 1.12

5 45707 3808.92 23.3753

5.84 4.91 3.97 3.04 2.10 1.17

38 47088 3924.00 24.0815

6.02 5.06 4.09 3.13 2.17 1.20

LISA WARD Head of Human Resources

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Agenda for Change National Terms and Conditions – Changes to Sick Pay

Work Related Sickness Authorisation Process – Employee FAQs

1. If I believe my absence is work related what should I do?

You should complete an Incident Report Form (IRF) using the online incident reporting process or by using a paper IRF which should be sent to your manager. Guidance on how to complete and submit IRFs is available on the Intranet in the Performance and Patient Experience Section.

2. How will a decision be made on whether the absence is work related?

Your line manager will investigate the incident and will make a recommendation to the relevant Senior Manager for a final decision. This will generally be: - A & E - Sector Manager - PTS - General Manager - Corporate Services - Assistant Director

3. How will I know what the decision is?

Your line manager should advise you of the outcome of his/her investigation and this should include the decision as to whether it is considered to be work related for pay purposes.

4. What will happen if I was absent from work prior to 1 September?

The deductions will commence for all shifts rostered on or after 1 September 2013. The implementation of this agreement has been delayed by six months to enable full consultation therefore no further delay in the national application will be included. A review of all staff on continuing long term sickness will be undertaken to assess whether the absence is considered to be work related. Individuals will be advised of the outcome of this decision.

5. How will my pay be affected if I think my absence is work related?

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All sickness will be treated as non-work related in the first instance and where required under the terms and conditions unsocial hours, on call or R & R payments will be reduced during absence. If your absence is subsequently deemed to be work related the payroll provider will make the necessary adjustment to refund any deduction through the next available salary. This will avoid any overpayments being made.

6. What do I do if I am not happy with the decision about whether my sickness is work related?

In the first instance you should approach the manager who made the decision to discuss it and if you remain dissatisfied you may raise the matter via the Grievance Procedure.

7. What sort of factors will be considered by managers when they decide on whether an absence is work related?

The fact that an incident has occurred at work is not necessarily sufficient on its own to

determine that absence is work related. Agenda for Change provides guidance on when absence should be considered as work related in section 14 and section 22.

The following circumstances will not qualify for consideration as work related:

Injury whilst on a normal journey travelling to and from work

Absence as a result of dispute relating to employment matters, conduct or job applications

Injury, disease or other health condition due to or seriously aggravated by the employee’s own negligence or misconduct

8. What happens if I have a pre-existing condition or disease?

For this to be considered as work related absence, then there must be a new work related incident over and above the original problem.

9. If it is decided that my absence is work related when will I be paid?

Your line manager will advise payroll of the decision and your pay will be adjusted through the next available payroll.

10. If I continue to be absent as a result of a work related injury, will I automatically

receive Injury Allowance? No, any decision about Injury Allowance will be made in the context of the agreed

criteria for Injury Allowance and will be reviewed should absence continue. The Trust will need to take account of whether the reason for absence continues to be the same. There is separate information available about Injury Allowance on the HR Portal.

11. Can my absence be reassessed?

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Yes, if the reason for your continuing absence changes and is no longer work related then entitlement to sick pay may be changed during absence on the basis of occupational health information and following discussion with you.

12. How will I know what has been deducted from my pay?

Until changes are made to the national pay system, deductions will appear on your payslip as a separate deduction and will be identifiable as a sick pay adjustment. This will enable you to see the gross deduction in pay arising from your absence.

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1 October 2013 OI365

DRESS UNIFORMS

You will all be aware that the Trust has purchased a number of formal dress uniforms that any member of staff can access and wear for special events. The feedback from both staff and members of families, public and other services have commented on how appropriate, smart and professional we look when wearing it. Over the last few months we have become concerned that some staff who have used this facility have returned the uniform in a poor condition. eg. in a plastic bag 'screwed up' a tie missing and the caps which are issued in a cardboard box to keep them neat and tidy are coming back in plastic bags. This has led to cost to repair damaged articles. More importantly four hats and ties remain missing. For those of you who have accessed uniform for special events may I ask that you respect this facility and ensure uniform is cared for and returned complete. We don’t want to introduce a bureaucratic time consuming system for application, collection and return but if this problem persists we may be forced into re considering how we issue dress uniforms. The uniform is stored and controlled by the Procurement Team at the Whitefield Store. Contact the Procurement and Supplies helpdesk via phone or email to arrange borrowing dress uniform:

Procurement Helpdesk Shoretel: 4888

Procurement Helpdesk Direct Telephone: 0161 279 4800

Procurement Helpdesk Email: procurement.supplies@nwas.nhs.uk

GED BLEZARD Acting Director of Emergency Services

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1 October 2013 OI366

PARAMEDIC EMERGENCY SERVICE INSTRUCTIONS FIRE ARM INCIDENTS

1. In the event that NWAS crews are informed that they will be attending an incident

involving firearms, a Rendezvous Point (RVP) will be allocated by the area Emergency Operations Centre (EOC).

2. If notification of the incident is received from the Police, a nominated RVP will have been received from the Police and this will be relayed to the NWAS crew by EOC.

3. Consideration should be given by EOC to dispatching an Advanced Paramedic (AP) to the RVP to assist with clinical intervention/advice if required.

4. In the event NWAS receive notification of the incident before the Police, EOC and the NWAS crew/AP allocated to the incident will mutually agree an RVP. This RVP will then be passed on to the Police.

5. In the event that the RVP is changed by the Police, the crew will be informed by EOC and requested to proceed to the updated Police nominated RVP.

6. The RVP should be at a safe distance from, and out of the line of sight of the scene/incident.

7. On arrival at the RVP, the NWAS crew/AP must inform EOC of their arrival and update them with regular situation reports. The time of arrival at the RVP must be recorded on the Patient Report Form (PRF).

8. When the NWAS crew/AP arrive at the RVP they should locate if present at the RVP the most senior Police Officer present to undertake a Joint Dynamic Risk Assessment prior to any deployment to the patient’s location.

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9. If there are no Police Officers present then the crew/AP must make a Dynamic Operational Risk Assessment (DORA) prior to any deployment from the RVP to the patient’s location keeping EOC updated of any intelligence received.

10. The decision for staff to deploy from the RVP to scene will be dependent on a number of factors including:

o A Police assessment of the incident either remotely by the Force Duty Officer in

the Police Control or by the senior Police Officer on scene

o An EOC remote assessment of the incident in liaison with the Police Control to

determine any continuing risks

o Risks identified can be mitigated

o The confirmation of person / persons shot

o Confirmation that the shooter has left the scene

11. It is recognised that the resources available to a Police Commander will not always allow

the provision of a Police escort for Ambulance crews. This however should be the

exception and not the rule and wherever possible Ambulance crews should be escorted

by Police Officers in ballistic environments.

12. The lack of an armed Police escort should not preclude the safe deployment of crews

where there are life threatened patients.

13. In cases of multiple casualties at a shooting incident EOC will dispatch one of the

following to attend the RVP:

o Ambulance Intervention Team Commander

o Operational Manager

o Advanced Paramedic

o Bronze On Call Manager

o Silver On-Call Manager

o In the event that none of the above are available, then other Managers within the

Operations Directorate are to be utilised.

14. It will be that Managers responsibility to make decisions on deployment utilising the

Dynamic Decision Making Model DDMC.

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15. NWAS crews must be acutely aware of staff safety in such incidents including the potential

need to move position to maintain their own safety. Should such measures need to be taken, the crew must immediately inform EOC giving the reason for the move, and the position of their new location.

16. It is imperative that EOC receive regular situation reports from any NWAS resources

deployed to the incident.

GED BLEZARD Acting Director of Emergency Services

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1 October 2013 OI367

EMERGENCY OPERATIONS CENTRE PROCEDURE EOC0013 - FIREARMS INCIDENTS

1.1 NWAS NHS Trust has a requirement to all staff at all times to ensure that risks are reduced,

whether they are working alone or not. 1.2 Operational staff protection must be a high priority when attending potentially dangerous

incidents. 1.3 This procedure provides protection to operational staff by way of providing a clear

methodology when attending incidents involving firearms. It is expected that by following the procedure, the following will be achieved:

a) The safety of individual Trust staff attending such incidents will be met.

b) The needs of patients will be protected as far as is reasonable 2. Scope 2.1 There are a wide range of factors which may result in a responding crew being allocated a

Rendezvous Point (RVP); these include:-

- Information received by the Call Handler that the assailant is armed and still on scene

- Notification of the incident is received from the Police already on scene that the assailant is still armed

- EOC is informed by crews they are withdrawing from scene to maintain their own safety 2.2 Information received at the call handling stage of a 999 call is vital in ensuring an

appropriate response to any incident. It is critical that any information which suggests that a responding ambulance crew (or other Trust response) may be in danger from violence is forwarded in a timely fashion.

2.3 The Trust has a responsibility to protect its staff under Health and Safety at Work legislation.

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3. Procedure 3.1 On receipt of an incident involving firearms, the EOC must immediately inform the Police

and establish an RVP with Police consultation. The Police Incident Log number and the identity of the Police Control Room Operator (PCRO) should be recorded in the notepad of the call within Alert C3.

3.2 The EOC Supervisor should be informed immediately who will subsequently inform the

Performance Manager who will assume responsibility for the duration of the incident. 3.3 In the event that NWAS crews are informed that they will be attending an incident involving

firearms, an RVP will be allocated by the area Emergency Operations Centre (EOC). 3.4 If notification of the incident is received from the Police, a nominated RVP will have been

established by the Police and this will be relayed to the NWAS crew by EOC. 3.5 Dispatch a Paramedic resource to the RVP; consideration should be given by EOC to

dispatching an Advanced Paramedic (AP) to the RVP to assist with clinical intervention/advice if required.

3.6 In the event NWAS receive notification of the incident before the Police and an RVP has not

yet been defined, the Performance Manager and the designated NWAS crew/AP will mutually agree an RVP; this RVP will then be passed onto the Police by EOC.

3.7 In the event that the RVP is changed by the Police, the crew(s) must be informed

immediately by EOC and requested to proceeed to the updated Police nominated RVP. 3.8 The RVP should be at a safe distance from, and out of, the line of sight of the

scene/incident. 3.9 On arrival at the RVP, the NWAS crew/AP will inform EOC of their arrival and provide

updates with regular situation reports which must be accurately logged in the notepad of the call.

3.10 In the event that there are other unrelated incidents in the vicinity of the firearms incident

(police cordon), EOC will inform the NWAS resources allocated to such incidents of the ongoing Firearm incident in that area and the RVP being used.

3.11 EOC will discuss the need for the crew to wait and standby at a safe location away from

both incidetns or to continue away from the vicinity of the firearms incident. 3.12 Should there be any delay to any other incident, EOC will make contact with the

patient/caller to apprise them of the situation.

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3.13 The lack of an armed Police escort should not preclude the safe deployment of crews where there are life threatened patients.

3.14 In cases of multiple casualties at a shooting incident, EOC will dispatch one of the following

to attend the RVP:

Ambulance Intervention Team Commander

Operational Manager

Advanced Paramedic

Bronze On Call Manager

Silver On Call Manager

In the event that none of the above are available, then other Managers within the

Operations Directorate are to be utilised.

Note: Tactical Advisors are to support Silvers and not be routinely deployed to scene though could be part of the Other Managers within Ops Directorate

3.15 NWAS Crews must be acutely aware of staff safety in such incidents, including the potential

need to move position to maintain their own safety. Should such measures need to be taken, the crew must immediately inform EOC, giving the reason for the move, and the position of their new location.

3.16 The Performance Manager must to ensure that EOC receive a situation report from the

NWAS Crew and Manager as soon as possible on arrival at the RVP and subsequently at regular intervals for the duration of the incident, using METHANE as the standard.

3.17 NWAS personnel must not be deployed from the RVP to the actual scene until the Police

Incident Commander has confirmed:-

a) They have assessed the situation

b) They have eliminated or mitigated all identifiable risks, and 3.18 In the event a Liaison Officer is not available at the RVP, the PCRO will inform the EOC when

the scene is secure. The NWAS Crew/Manager must remain at the RVP until directed otherwise by the EOC

3.19 All decisions made by EOC Managers must be conducted and recorded in the log utilising

the Dynamic Decision Making Model.

GED BLEZARD Acting Director of Emergency Services