Break the chain

Break The Chain

The current health crisis has created unprecedented demands on everyone in all walks of life, a situation that the majority of us have never previously experienced. The virus is not focusing solely on the elderly or infirm, it can infect the young, the super-fit and because it is invisible to the naked eye, it is impossible to see it in order to walk around it. We can however take precautions to limit the risk to ourselves, our families, our friends, neighbours, patients and our NHS colleagues.

Unison has been in consultation with the Trust in order to identify ways that we can jointly tackle the Covid-19 situation and ensure that while providing the much-needed responses to the public we are able to maintain our own safety.

Dynamic Activation Points (DAPs): In line with the Government restrictions, a high number of businesses are closing until such time that restrictions are removed. In light of this Unison has considered the impact that these closures and restrictions may have on the DAPs that we have agreements with.

We have considered the need to maintain and support the deployment of ambulances in order to achieve quick responses in areas that historically have taken longer to reach. Unison is recommending a number of temporary changes to the current agreement in respect of DAPs for the duration of the Covid-19 restrictions.

1. Crews being deployed to DAPs which are no longer functioning as a result of Covid-19 should be given sufficient time to use the facilities at their current location before mobilising.
2. If they are already mobile, and the crew need the use of facilities, they are to be allowed to stop on route or divert off route to nearest facilities, before continuing to stand by at a DAP which has no access to facilities.
3. Once the crew are at the DAP if they require the use of facilities they must be allowed to leave and use the nearest available facilities.
4. The crew must only be deployed to a DAP that has no facilities for a maximum of 45 minutes, unless the crew are willing to remain there. Otherwise at the end of the 45 minutes they must be sent to a response post or base standby.

The ventilators that are carried on our ambulances are being withdrawn and will be taken to Barton Mills from where they will be provided to NHS Hospitals that are critically in need of them. A ventilator will be provided to every LOM vehicle, Critical Care Vehicle and HEMS. Our ambulance clinicians are well skilled and trained in manual ventilations with Bag -Valve-Mask and should the need for a ventilator arise, the nearest LOM will deliver it to the crew. This action is being mirrored by all other ambulance services.

The Government has issued guidance for people that have high risk underlying health conditions and it includes a list of these conditions. Concerns have been raised in respect of members who have underlying medical conditions which are not currently included in the document particularly when the members have more than one condition which together may present a significant high risk. These conditions include Hypertension, AF, CFS and a BMI above 40.Until the Guidance is updated, it is recommended that members who have concerns regarding their existing medical conditions, should contact their own GP to seek advice as the GP will have full access to their medical notes and will be best placed to provide the advice on any actions to be taken.

If members undertake alternative working duties due to underlying medical conditions it is most important that they discuss this fully with their manager and risk assess the areas they might work in and how they can maintain appropriate social distancing. Remember, even at work there is the potential to make contact with contaminated surfaces, so the message is clear. Follow the basic IPC procedures and if you are unsure about the safety of a surface, clean it before handling it. Break the Chain.

A series of Action Cards covering different topics have been produced and Unison has requested similar action card for “Members of staff who have a family member that has high risk underlying health conditions, living in the same household”.

The transmission of Covid-19 can be thought of like a row of Dominos: as one topples forward it contacts the next which topples forward until the entire line have fallen over (been infected). By restricting our movement, reducing our social contacts and by following IPC guidance, we can remove a lot of the Dominos, limit the number that are falling but most importantly ensure the greatest number of Dominos remain standing and NOT infected. Break the Chain.

Large stocks of PPE and Hand Gel are now being delivered. The gel may be in large containers so DON’Tthrow the small hand sized containers away as they can be refilled from the large ones; it also reduces plastic going to landfill. The hand gel is very effective at killing invisible bacteria, but after several applications it can start to affect the skin, so wash your hands with soap and water when possible, and the application of moisturiser on your hands is beneficial too. If you have an empty small container, consider keeping moisturiser in it. Break the Chain.

Some members have asked for advice with regard to travelling to and from work. The best advice is to take a change of clothing (such as tracksuit) and a plastic bag with you when go to work. Leave it in your locker. When your shift has finished, change out of your uniform and put it in the bag and seal it. Get cleaned up and travel home in civvies. This will ensure that the interior of your car does not get infected by your (possibly) contaminated uniform. When home, leave the uniform in the plastic bag to one side. At the end of a few shifts, if possible, empty all the uniform items into the washing machine and launder at 60>. This will work for some and maybe not for others, depending on the pattern of your shifts. You may come up with your own system depending on your circumstances. The key point is maintaining your IPC practices, limiting the potential for spreading any contamination, and above all else Break the Chain.

There has been a lot of discussion and concerns regarding Fit Testing of respirators. The only members of staff that are required to maintain a clean face are those employed within HART, all other employees have been allowed to adopt “self-expression” which is understandable. However, this is an extraordinary situation which the country is facing and individuals stand a better chance of getting a proper seal in a respirator if they are clean shaven.

The area from the bridge of the nose, passing the cheeks to the chin are where respirator seals are made or fail. Broad flowing handlebar moustaches, beards, mutton-chop sideburns and general stubble will not support a good seal. Some members of staff may have religious or medical reasons why they are not clean shaven and this is understandable; however, in the interest of IPC and personal safety, it might be prudent for others to consider being clean shaven, at least during the present situation. If you wear a respirator and get a good seal, you will Break the Chain.

Unison has also recommended that it would be beneficial if members knew what size Tyvek overall they should select when needed. The suggestion has been that one of each size should be made available at bases for staff to try on over their uniform. This would prevent selecting an incorrect size which might otherwise restrict movement, tear or be discarded as not suitable; reducing stock levels. The correct size will Break the Chain.

The Trust has taken steps to increase the number of call takers to ease the pressures in AOC’s and reduce the waiting time for callers. Out on the road, more ambulances are being provided to increase our response capability, more VCO’s have been recruited to work alongside & with our MRO’s who are cleaning and decontaminating our ambulances. NES /PTS staff will also be working more closely with the emergency ambulance crews to help meet the needs of our patients.

I will be taking part in weekly updates with the Trust and as soon as we have more information it will be made available to you. Keep safe and Break the Chain.


Jeff Pittman

East of England Ambulance Service

Unison Health and Safety Officer

SPOC Covid-19