Following the roll out and commencement of training on the new Fiat ambulances, Unison Health & Safety has received a high number of contacts raising concerns and issues relating to the variations in training which suggests a lack of consistency across the service.
Before tackling the questions relating to the training it is most important to first understand WHY the training is being undertaken and WHAT makes it mandatory.
The Provision and Use of Work Equipment Regulations 1998 (PUWER) places a responsibility and subsequent duty of care upon companies / services / organisations who have employees that use equipment which is provided by their employers.
Within these regulations there are requirements that the equipment used by the employee MUST:
The regulations further clarify that PUWER covers any machinery or apparatus and includes “starting, stopping, programming, setting, transporting, repairing, modifying, maintaining, servicing and cleaning”.
The employees must also ensure that ALL persons who using, supervising or managing the use of the work equipment are provided with adequate, clear health & safety information, including written instructions on its use and they MUST have received adequate training, which should include the correct use of the equipment, the RISKs that may arise from its use and the precautions to take.
Where mobile work equipment is provided, employers MUST ensure that it is suitable for that purpose, the risks from rolling over are minimised and persons carried are protected in the event of a fall or rollover through the provision of suitable restraints (eg seatbelts).
Item 1: Be suitable for its intended use. The Trust spent several years with a vehicle working group, identifying how to move forward and this included the design and provision of four different concept ambulance which were viewed & assessed by employees before a final specification was reached.
Item 2: Be maintained in a safe condition and does not deteriorate. The current fleet is becoming tired yet still achieves high mileages due to the exceptionally high volume of 999 calls received in our call centres. The new Fiat ambulances will replace the aging fleet.
Item 3: Must only be used by persons who have received adequate information, instruction and training.
During the design and development phase it was agreed that familiarisation training would have to be carried out because the service was going to introduced the entire work force to a totally new ambulance which was moving away from the traditional layout that we have endured over the past 20 years. The design is so revolutionary that every shelf, latch, bolt, window and seat had to be sited and re-sited; cupboard and stowage areas re-jigged to reduce the risk of post–production corrections.
We have moved away from a semi-automatic to a manual gearbox, introduced a powered stretcher and a powered stair chair and this has impacted on the way we have traditionally worked; making do, getting by. We can now look towards a future when early retirement as a result of permanent injury caused by excessive manual handling and lifting of patients would be a thing of the past.
All these changes bring with them a cost, but it was agreed that within the cost of transforming our fleet of emergency ambulances would be the cost of carrying out the mandatory training that was required under PUWER and that training of employees should be achieved within a maximum of 3 hours duration.
There have been many concerns raised by employees that they are not being afforded any opportunity within the three hours to familiarise themselves with the handling characteristics of the new Fiat ambulance because “you don’t need to take it for a drive” to understand or experience how it handles or “it does not state in the Training Sign Off sheet that you must take the vehicle for a familiarisation drive”.
Concerns have also been raised that in certain areas within our region, employees are only being allowed one and a half hours for the training which is half the 3 hours previously agreed.
Just because the Fiat Ambulance Sign Off sheet does not specifically state that the employee MUST take the vehicle out on the highway to gain experience in the different handling characteristics, it does NOT mean the employee should be denied the opportunity to gain valuable experience in driving that new type of vehicle BEFORE they are expected to drive it under emergency road conditions in response to a 999 emergency medical call. I believe the average man in the street would believe it is imperative that employees are actively encouraged to take the new Fiat for a familiarisation drive during the mandatory training so that they feel confident, competent and safe to do so under emergency road conditions.
The Provision of Work Equipment Regulations specifically state that “Only persons who have received adequate information, instruction and training, including how to start, operate and stop the vehicle should be allowed to use it”. If employees do not receive training that includes gaining practical experience in how the new vehicle handles, one must ask two questions:
(1) should the Trainer be signing the candidate off as being competent?
(2) should the employee be signing the document, stating that they are safe, confident and competent to drive the new ambulance when they have not been afforded the opportunity to actually drive it and gain valuable experience in how the handling characteristics are different from the Mercedes?
How can employees safely learn how to correctly drive the new ambulance, avoiding risks and correcting errors if they have not received practical training out on the highway. Talking about it is not enough.
The Provision of Work Equipment Regulations are the corner stone which mandates that the employer MUSTensure that employees MUST receive all the necessary training in the safe use of the new equipment before it is introduced and before the employee can be expected or required to operate it.
Unison health and safety cannot support or condone the use of a new ambulance with a different drive unit and different handling characteristics, by employees who have not been afforded adequate and proper conversion / familiarisation training. It is of great concern that not all ambulance crews have been afforded the opportunity to take the Fiat ambulance for a drive on open highways to gain valuable experience of how the new ambulance handles under normal road conditions.
In particular, our concerns are raised with regard to the safety of ambulance crews, patients and other road userswho may be placed at risk due to the lack of familiarisation driving and also the unacceptably reduced training time in some areas.
Unison Health & Safety Officer