First Responders Policy

First Responders Policy Ref. No. OP/046 Title: Community First Responders Policy Page 1 of 37 DOCUMENT PROFILE and CONTROL Purpose of the documen...
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First Responders Policy

Ref. No. OP/046

Title: Community First Responders Policy

Page 1 of 37

DOCUMENT PROFILE and CONTROL Purpose of the document: is to be an overarching policy which directs all relevant staff to more detailed policies/procedures. It should therefore be read in conjunction with all of the policies/procedures listed in this document. Sponsor Department: A&E Operations – Emergency Operations Centre Author/Reviewer: Ambulance Operations Manager – First Responders. To be reviewed by September 2015 Document Status: Final Amendment History Date *Version 02/10/12 3.2 26/09/12

3.1

06/09/12

2.4

30/08/12

2.3

06/08/10

2.2

18/06/10

2.1

31/03/10 24/12/09

1.7 1.6

13/02/09

1.5

14/01/09 18/11/08

1.4 1.3

12/11/08

1.2

31/10/08

1.1

03/10/08

1.0

Author/Contributor IG Manager

Amendment Details Document Profile & Control update Ambulance Operations Manager Minor amendments following – First Responders approval IG Manager Document Profile & Control update Ambulance Operations Manager Updated implementation plan, – First Responders amendments including updating of Standard Operating Procedures Ambulance Operations Manager Revised monitoring section and Head Records Management and addition of Appendix 5 Ambulance Operations Manager Additions to sections 4.5, 7.3, and Head Records Management 13.3, Imp. Plan Monitoring, and App.1. Ambulance Operations Manager Amendments Ambulance Operations Manager Following feedback and early review Head of Records Management, Minor amendments, formatting, Records Manager number sequencing Ambulance Operations Manager Amendments Head of Records Management Amendments & Ambulance Operations Manager Head of Governance Amendments following CGC ratn. Head of Governance Amendments following SMG approval Ambulance Operations Manager – CFR Management, CFR Programme Manager, Head of Governance, Medical Director

*Version Control Note: All documents in development are indicated by minor versions i.e. 0.1; 0.2 etc. The first version of a document to be approved for release is given major version 1.0. Upon review the first version of a revised document is given the designation 1.1, the second 1.2 etc. until the revised version is approved, whereupon it becomes version 2.0. The system continues in numerical order each time a document is reviewed and approved.

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For Approval By: ADG CQSE CGC SMG Ratified by Trust Board (If appropriate):

Published on: The Pulse The Pulse LAS Website LAS Website Announced on: The RIB The RIB

Date Approved 14/09/12 18/06/10 12/11/08 08/10/08

Date 04/10/12 (v3.2) 08/10/10 04/10/12 (v3.2) 08/10/10 Date 09/10/12 10/10

EqIA completed on 22/03/10 Staffside reviewed on

Version 3.0 2.0 1.0 1.0

By Governance Co-ordinator Governance Administrator Governance Co-ordinator Governance Administrator By IG Manager Governance Administrator

Dept GCT GCT GCT GCT Dept GCT GCT

By First Responder Steering Group By Staff side Representative

Links to Related documents or references providing additional information Ref. No. Title Version Saving lives: Our Healthier Nation (DH 1999)

HS001 HS005 HS007 HS011 HS012 HS016 HS017 HS018 HS020 HS021

Taking Healthcare to the Patient: Transforming UK Ambulance Services (DH 2005) The Role and Management Of Community First Responders (Healthcare Commission 2007) Health and Safety Organisation – Policy Statement Manual Handling Policy Personal protective Equipment Procedure Incident Reporting Procedure Violence Avoidance and Reduction Latex Lone Worker Policy Stress Management Policy Hand Hygiene and Care Policy Slips, Trips and Falls Procedure First Responder Steering Group Terms of Reference Standard Operating Procedure: Confirming availability with the Emergency operations Centre Standard Operating Procedure: Equipment Standard Operating Procedure: Recording and reporting

1.2 2.2 2.1 4.1 3.4 2.0 2.1 2.0 1.3 1.1 3.0 2.0 1.0

Document Status: This is a controlled record as are the document(s) to which it relates. Whilst all or any part of it may be printed, the electronic version maintained in P&P-File remains the controlled master copy. Any printed copies are not controlled or substantive. Ref. No. OP/046

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1.

Introduction

First responder schemes and public access defibrillation are widely recommended strategies to achieve more rapid defibrillation and thereby provide definitive treatment for victims of sudden out-of-hospital cardiac arrest. In July 1999 the Government set out a White Paper entitled „Saving Lives: our healthier nation‟. This paper focused on public access to early defibrillation and announced the government‟s intention to invest £2 million in siting Automated External Defibrillators (AEDs) in busy public places and training people in their use. The experience in London demonstrates that siting AEDs at high footfall locations can result in very short collapse to defibrillation times and a significant improvement in survival. AEDs are now more commonplace, although there are still many more opportunities for increasing access to defibrillation for those suffering an out-of-hospital cardiac arrest. Whilst siting an AED at a high footfall location creates the greatest opportunity for a life to be saved by any single device, only 20% of sudden out-of-hospital cardiac arrests occur in a public place, therefore the provision of early defibrillation for cardiac arrest patients in their own homes remains a challenge. Volunteer responder schemes have existed for many years in rural locations where it is more difficult for an ambulance response to reach the patient in time to resuscitate them successfully. More recently these schemes have been started in urban environments, thus improving the chances of these patients receiving an early response. All volunteer emergency responders working in association with the London Ambulance Service (LAS) either directly or through partner organisations, will be included in this policy.

2.

Scope

This policy is intended to be an overarching policy which directs all First Responder Schemes linked to the London Ambulance Service NHS Trust. Anyone who responds on behalf of the London Ambulance Service with an AED as an unpaid volunteer, will be included in this policy. It should be read in conjunction with all of the policies/ procedures listed in this document.

3.

Objectives 1. To describe the purpose of First Responders within the LAS 2. To define the role of First Responders 3. To describe the different types of First Responders 4. Operation and control of First Responders

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4.

Responsibilities

4.1

The Chief Executive has overall accountability for having an effective Operational and Risk management system in place and an effective system of internal control within the Trust. The day to day responsibility for risk and operational management is delegated to Nominated Directors.

4.2

The Medical Director has delegated responsibility for managing the strategic development and implementation of clinical management, clinical governance, and including infection prevention and control.

4.3

The Director of Operations has overall responsibility for core A&E Ambulance Operational Services

4.4

The Assistant Director of Operations has delegated responsibility for managing risks associated with community first responder schemes, and has responsibility for the development of operational strategy in order to meet national performance and clinical targets.

4.5

First Responder Steering Group meets quarterly and has responsibility for deciding how First Responders operate and manage any changes or improvements in accordance with the Terms of Reference (Appendix 1). Membership of this group includes representatives from A&E Operations, the LAS Patients Forum, Staff Side representative, Management Information, IM&T, Control Services, Training, Medical Directorate, Communications, Programme Management, Logistics, Human Resources, Patient and Public Involvement and Legal Services. It reports through to the Clinical Quality, Safety and Effectiveness Group.

4.6

The Ambulance Operations Manager (AOM) – First Responders has responsibility for the process of developing and establishing First Responder schemes throughout the LAS operational area and in the utilisation of first responders from partner organisations.

4.7

Ambulance Operations Managers (AOMs) and Duty Station Officers (DSOs) have responsibility for the day to day delivery of core services and any associated risks associated with community first responder schemes, including local induction emanating from both the LAS and its partner organisations

4.8

LAS First Responder Co-ordinator is the member of the Complex management team that leads on local issues relating to First Responders and their Co-ordinators in the Complex operational area. There will be one at every station Complex area that has first responders operating within their operational area. This would usually be a Team Leader or Duty Station officer. They will supervise the local induction process and monitor compliance in relation to operational documentation, use of equipment, disposable items and general conduct

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4.9

Volunteer First Responder Co-ordinator is a member of the responder scheme and is responsible for ensuring up to date records, arranging meetings, training and accurate contact information liaising closely with the LAS first responder co-ordinator on all aspects.

4.10 Training Officers from either the LAS or partner organisation must have a specific qualification to provide training for appropriate voluntary groups. At the end of the training course the students must be assessed by a different qualified training officer.to the one carrying out the training. 4.11 LAS Team Leaders have the responsibility for supporting clinical practice of front line staff and volunteer responders. They will also provide feedback on the Clinical Performance Indicator (CPI) audit that they take from the LAS Patient Handover Record (LA4H). 4.12 Emergency Operations Centre (EOC) staff are responsible for identifying suitable incidents and activating the responders to these. 4.13 Operational Staff are responsible for the day-to-day delivery of core services. This includes Paramedics, Emergency Medical Technicians, A&E Support, Control and Patient Transport Services staff. 4.14 First Responders are responsible for following the guidelines issued by the LAS and reporting any changes to their capability to fulfil the role of First Responder safely 4.15 It is the responsibility of all staff and volunteers to identify risks and to highlight these to the appropriate manager, via the Risk Reporting & Assessment Procedure. Employees also have a responsibility to cooperate with managers and to contribute to the process of identifying areas of developments and reducing risks.

5.

Definitions

5.1

First Responders

First Responders are volunteers who provide emergency life support to patients as part of the London Ambulance Service response. First Responders will be activated to emergency calls when a patient‟s condition is sufficiently serious that their attendance may have a beneficial impact on the patient‟s outcome. They will not be activated to patients with minor conditions that will not be improved by the attendance of an individual with emergency life-saving skills. First Responders consist of three main types: 5.1.1 Emergency Responders Emergency Responders are those that work or volunteer for established organisations and who respond to selected emergency calls as part of their Ref. No. OP/046

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existing duties (e.g. City Police, Royal Air Force, Airport Fire Crews and other emergency services, voluntary aid societies, etc). These organisations may have their own emergency transport arrangements, and may well provide both the equipment and the training required, if this meets the required standard. Training will be to the IHCD First Person On Scene (FPOS) Intermediate standard or equivalent nationally recognised qualification. 5.1.2 Community First Responders Community First Responder (CFR) schemes consist of groups of local people who volunteer to share the provision of a single responder within their local area. These responders will be recruited, trained and equipped by the LAS or partner organisations and may respond in their own private vehicles at normal road speeds. Training will be to the IHCD First Person On Scene (FPOS) Basic standard or equivalent nationally recognised qualification. 5.1.3 Establishment Based Responders Establishment Based Responders (EBR) are staff who work for organisations that host static defibrillator sites, such as London Heathrow Airport and rail stations, and are trained to provide emergency life support. Staff involved in these schemes will operate within walking distance, use equipment provided by the LAS and are trained by LAS instructors. The actual responders are selected by the relevant establishment. These responders engage in their normal activities within the establishment until an emergency medical incident occurs on the premises. They then act according to their levels of training on behalf of the establishment and the Trust.

6.

Recruitment of Responders

6.1

The method of selection and recruitment of First Responders will depend on the type of responder being recruited, however all new volunteers will be required to have an enhanced Criminal Records Bureaux (CRB) check, satisfactory references and be able to demonstrate competence in the skills required for undertaking the role.

6.2

Emergency Responder organisations will also be responsible for the recruitment of members to the individual schemes. The criteria for recruitment of new members will be agreed by the LAS and where practical LAS staff will engage in the recruitment process.

6.3

The recruitment of Community First Responders is to be open to anyone who can demonstrate the required competencies and there will be no selection process to limit numbers taken on. Any recruitment techniques used will be designed with this in mind. All volunteer responders will be interviewed to assess their suitability before being accepted onto a scheme, Standard Operating Procedure: Recruitment and becoming operational (Appendix 6).

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6.4

Establishment Based Responders will by definition be recruited from within the existing workforce of the host organisation which will be responsible for their selection based largely on their role within the organisation and their capacity to respond when required.

6.5

All Community First Responders and Emergency Responders are required to have an enhanced Criminal Records Bureau (CRB) clearance before they operate as a responder. This check will be done by the LAS except when the responders become members of a partner organisation that already has an established capability for undertaking CRB checks.

6.6

Before they are permitted to undertake an operational shift on behalf of the London Ambulance service, all Community First Responders must meet the requirements specified in the Standard Operating Procedure: Recruitment and becoming operational (Appendix 6).

7.

Training and Induction of First Responders

7.1

First Responders will be trained either by the LAS or by another organisation to a nationally recognised standard that is acceptable to the LAS. The level of training and induction will depend on the specific role that the First Responder is undertaking.

7.2

Depending on the nature of the scheme Emergency Responders may already be qualified to an acceptable standard in terms of their clinical skills. The extent of training will depend on the type of response being provided, but will be a nationally recognised qualification that meets or exceeds the Institute of Healthcare Development (IHCD) First Person On Scene (FPOS) Intermediate qualification. Training will be provided if the qualification is not current or cannot be validated to an acceptable standard. All Co-Responders will undergo induction in relation to the role and their interaction with the ambulance service.

7.3

Community First Responders will be trained and assessed as competent to a level that is nationally recognised for this role. The minimum standard for Community First Responders will be the IHCD First Person On Scene (FPOS) Basic qualification. Other nationally-recognised First Responder qualifications will be accepted, such as the St John Ambulance Community First Responder Qualification, if they meet or exceed this minimum standard. All Community First Responders including those of partner organisations will undergo induction in relation to the role to include operational preparedness and their interaction with the ambulance service, as specified in the Standard Operating Procedure: Recruitment and becoming operational (Appendix 6). The First Responder Coordinator is responsible for ensuring that all aspects of training and induction are completed within 6 months of recruitment. Recruits do not become Responders, are not permitted to respond, and their ID card will not be issued, until all compulsory components have been completed and their individual file contains documentary evidence to demonstrate that

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this is the case. Completion of training and induction is recorded in the individual files and a central log is held by the First Responder Coordinator to enable follow-up of those who do not complete the specified training and induction. Recruits who fail to complete their induction will have a note to this effect in their file and will not be permitted to operate as a First Responder. 7.4

Establishment Based Responders will normally have already been operating in a first aid capacity in their own work environment. Additional Emergency Life Support skills will be provided and assessed to the standard required by the LAS. Induction of these personnel will take into account the extent to which they continue to operate in their normal work environment.

7.5

A training file will be kept on every responder by either the LAS; as for other operational staff within an operational complex area; or by the partner organisation. Each training file will include a record that confirms the level of competence of the responder and the date this was achieved. Files kept by partner organisations must be made available for inspection by the LAS if required. In addition the LAS will hold a master list with details of all responders including their skill level, with qualifying and requalifying dates.

7.6

First Responders are required to attend relevant post qualification courses, seminars, workshops and meetings to maintain clinical skills and ensure continuation of qualification. As a minimum they are required to be re-assessed annually against the standard to which they are qualified to practice, this proficiency check meeting should take place on or before the anniversary of their joining date or the date of their last reassessment.

8.

Scope of Practice

8.1

First Responders will provide an initial response to serious or lifethreatening emergencies in addition to the normal ambulance service response. They will be activated to red and amber calls in their area according to their skill levels and national guidelines.

8.2

When responding a First Responder must be equipped with an Automated External Defibrillator and be trained in its use.

8.3

A First Responder‟s scope of practice will be limited to the extent of their training and the equipment with which they are provided. First Responders who work outside of their prescribed scope of practice will be subject to the disciplinary procedure of the organisation of which they are a member. LAS will be informed of the outcome of, and if necessary assist in, the disciplinary investigation.

8.4

First Responders who are medical professionals with a higher level of ability are advised that if the clinical care they provide exceeds that

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defined by their responder role, they are personally responsible and liable for their actions. 8.5

First responders will pass the clinical responsibility for a patient to the first member of LAS operational staff that arrives on scene, unless the skill set of the first responder requires that they accompany the patient.

8.6

First Responders have neither the skills nor the experience to decide that a patient does not require treatment at, or conveyance to, hospital. These decisions can only be made after the attendance of a member of LAS staff with a skill level of Emergency Medical Technician (EMT3) or above.

9.

Activation of Responders

9.1

First Responders will be activated in accordance with the Standard Operating Procedure: Activation and Airwave Radio Procedures (Appendix 5). The availability of First Responders will be agreed in advance by means of a detailed monthly rota submitted to the LAS so that when a suitable emergency incident occurs, the Emergency Operations Centre is aware of which responders are available to be activated. This will also apply to Community First Responders whose rotas will be submitted monthly by the CFR Co-ordinators. Establishment Based Responder schemes are designed so that at least one responder will be available throughout the normal operating times of the host organisation. Emergency Responders will make themselves available in the same way as either CFRs or EBRs depending on the nature of the scheme.

9.2

Community First Responders will confirm that they are available for activation in accordance with the Standard Operating Procedure: Booking, Commencing and Ending a CFR Shift, confirming availability with the Emergency Operations Centre (Appendix 2)

9.3

When an emergency incident has been identified by dispatch staff in EOC, which is both within the operational area of a responder scheme and within their scope of practice, then the EOC will activate the on-call responder using the agreed communication channel.

9.4

There will be active monitoring of a responder for the duration of the incident by EOC and operational management staff, to maintain their safety and ensure their welfare.

10.

Use of vehicles

10.1

First Responders who will use a vehicle to respond, are required to demonstrate that they have an appropriate driving licence and that the vehicle is insured for them to drive, has a current road fund licence and a valid MOT certificate if required.

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10.2

Community First Responders must not use or display blue lights and sirens and will not be permitted to contravene traffic regulations when responding.

10.3

First Responders that are using a car to respond must display the agreed identity markings for their scheme (e.g. magnetic panels).

10.4

Every care should be taken when parking to avoid endangering the volunteer responder, the patient and members of the public. If the location of the patient necessitates parking in a no parking or restricted area and a penalty notice is incurred, it should be forwarded together with the patient PRF number to the First Responder Co-ordinator who will forward this to the AOM – First Responders to instigate an appeal to the issuing authority.

11.

Equipment

11.1

First Responders responding to calls will use equipment issued by the LAS or partner establishments. This will be strictly within the guidelines and procedures detailed within the initial training, and in accordance with the Standard Operating Procedure: Use, storage and replacement of equipment (Appendix 3).

12.

Health and Safety

12.1

First Responders are required to comply with the relevant LAS Health and Safety policies and procedures available on the „Pulse‟, and those of their respective partner organisation where applicable.

13.

Support and Feedback for First Responders

13.1

First Responders will receive support from the LAS in the same way as for paid staff. This applies for both immediate and follow-up support which could be in addition to that provided by the volunteer‟s partner organisation.

13.2 The Community First Responders‟ Co-ordinators meet quarterly in a group that includes both themselves and LAS First Responder Co-ordinators. These meetings are chaired by the AOM – First Responders and are intended primarily to provide a two way communication link with CFRs across London giving opportunities for issues to be raised and for briefing on changes and other information relevant to the operation. 13.3

First Responders are required to be re-assessed annually for their competence to undertake the role. This assessment will be conducted under the same structure that provided their original qualification. A failure to display an adequate level of competence will preclude the First

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Responder from acting as a first responder until they have been given further training. If then, on re-assessment, they still fail to meet the required standard, they will be withdrawn from the scheme. 13.4

First Responders will receive feedback and support from LAS Team Leaders using the Clinical Performance Indicators (CPI) designed by the Clinical Audit & Research Unit. This audit will be based on the documenting of care provided via completion of the LAS Patient Handover Record (LA4H) in accordance with the Standard Operating Procedure: Recording and reporting (Appendix 4). The data obtained is used to support practice and any stand-out results are flagged up during the process, documented and feedback is provided to the individual responder.

13.5

There is an established system for all LAS staff, both paid and voluntary to provide feedback on any aspect of First Responders. This system includes an official LAS form (LA 30) and an e-mail account that can be accessed both internally and externally. All feedback is viewed by the AOM - First Responders, the Communications officer and the First Responder Administrator and, if appropriate, actioned by the AOM.

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IMPLEMENTATION PLAN Intended Audience Dissemination

All staff

Communications

New Policy to be announced in the RIB and a link provided to the document. Will be discussed and disseminated at First Responder Co-ordinators meeting. Available on the „Pulse‟ to all staff and first responders. Annual update and skills assessment for all community first responders. This assessment will be conducted under the same structure that provided their original qualification, and responders will be assessed against the same standards.

Training

Available to all staff and external first responders on the Pulse

Monitoring: Aspect to be monitored

Frequency of monitoring AND Tool used

Individual/ team responsible for carrying out monitoring AND Committee/ group where results are reported

Committee/ group responsible for monitoring outcomes/ recommendations

How learning will take place

Duties (Section no. 4) including; Documenting care (Section no. 13.4, Appendix 4)

Quarterly audit utilising the Clinical Performance Indicators

Clinical Team Leader reporting to Ambulance Operations Manager

First Responder Steering Group reports to Clinical Quality, Safety and Effectiveness Group

Direct feedback by Clinical Team Leader to First Responder

Scope of practice (Section no. 8)

Continuous utilising informal and formal feedback systems (LA30) As required utilising the Disciplinary procedure for the organisation

All volunteers, staff and managers

Ambulance Operations Manager reports to First Responder Steering Group

Individual feedback and group bulletins

Senior managers for the relevant organisation

Ambulance Feedback, Operations sanctions or Manager reports dismissal. to First Responder Steering Group

Actions to be taken when voluntary responders work outside of their scope of practice (Section no. 8.3)

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Emergency operation centre procedures (Section no. 9.2, Appendix 2)

Reviewed annually unless procedural change takes place beforehand

EOC managers

Ambulance Operations Manager reports to First Responder Steering Group

Clinical Quality, Safety and Effectiveness Group

Storage of equipment (Section no. 11, Appendix 3)

Continuous utilising informal and formal feedback systems (LA30)

All volunteers, staff and managers

Ambulance Operations Manager reports to First Responder Steering Group

Individual feedback and group bulletins

Reviewed annually unless procedural change takes place beforehand Reviewed within first 6 months of recruitment process utilising SOP 10

AOM – First Responders and senior managers for the relevant organisation

First Responder Steering Group reports to Clinical Quality, Safety and Effectiveness Group

Issue of replacement SOP

First Responder Co-ordinator

Ambulance Issue of Operations replacement Manager reports SOP to First Responder Steering Group

Continuous utilising SOP 10

First responder Co-ordinators, AOM – First Responders and senior managers for the relevant organisation

First Responder Steering Group reports to Clinical Quality, Safety and Effectiveness Group

Induction Minimum content of local induction and timescales for completion (Section no. 7.3) How the organisation records that all new voluntary staff complete local induction and follows up those who do not complete local induction (Section no. 7.3)

Training Selection arrangements including those required of stakeholder organisations (if appropriate) (Section no. 6, Appendix 6)

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Minimum standards of voluntary responder staff training which reflects national guidelines (Section no. 7)

Reviewed annually unless procedural change takes place beforehand utilising National Governance Framework for Volunteer Responders

AOM – First Responders and senior managers for the relevant organisation

First Responder Steering Group reports to Clinical Quality, Safety and Effectiveness Group

Feedback to AOM – First Responders and senior managers for the relevant organisation

How often proficiency checks of voluntary responders should take place (Section no. 7.6)

Reviewed annually unless procedural change takes place beforehand

Confirmation of requalification monitored by administrator, either LAS or partner organisation annually

Ambulance Operations Manager reports to First Responder Steering Group

Feedback to First responder Co-ordinators and senior managers for the relevant organisation

When proficiency check meetings with voluntary responders should take place (Section no. 7.6)

Annually on or before anniversary of joining or last proficiency check

First Responder Co-ordinator

Senior managers for the relevant organisation report to Ambulance Operations Manager

Responder suspended until proficiency is demonstrated .

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Appendix 1 London Ambulance Service NHS Trust First Responder Steering Group Terms of Reference The Steering Group‟s function will be to monitor First Responder activity throughout the London Ambulance Service NHS Trust and ensure that First Responders are an integral part of the LAS Service operational activity. This will be achieved through review, monitoring, remedial / corrective action, initiation and proactive planning. The Steering Group will regularly review implementation of the First Responder strategy. The Committee will encourage the Trust to engage with members of the public to contribute towards the provision of a voluntary emergency response to our patients. Functions Utilising a network of managers and leaders to co-ordinate and advise on the methods to achieve the greatest effectiveness and efficiency in the utilisation of First Responders. Sharing information on First Responder activity, raising concerns and learning from examples of good practice. Acting as an internal discussion forum to verify issues and trends requiring action through First Responder activities and the influence of the Steering Group. Reviewing key activity within the First Responder Strategy and informing project approaches so that problems are easily identified and resolved. Managing risks that threaten the implementation of the Trust‟s strategic approach to First Responders. The First Responder Steering Group will meet quarterly and be chaired by the Ambulance Operations Manager. A quorum for each meeting will be a minimum of five members. The Group reports through to the Clinical Quality, Safety and Effectiveness Group.

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Membership 

Ambulance Operations Manager – First Responders (Chair)



Administrator – First Responder Department



Deputy Management Information Manager



Logistics Manager



Communications Administrator



Staff Side Representative



Head of Legal Services



Ambulance Operations Managers



Distribution Manager - EOC



Training Officer



Duty Station Officers



Senior HR Manager



Patients‟ Forum Members



Community Defibrillation Officer



Patient & Public Involvement Manager



Senior Clinical Advisor



Project Manager - IM&T

The Steering Group will take particular responsibility for: Identifying methods for Trust staff to engage and involve the public and the voluntary sector in providing a voluntary emergency response. Promoting the interests of First Responders within the Trust. Co-ordinating reports on First Responder activity across the Trust. Monitoring the effective implementation and demonstrating outcome measures from First Responder developments in the Trust Ensuring that the Trust continues to meet external standards for First Responders.

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Appendix 2

Ambulance Community First Responders

S.O.P. 1 Standard Operating Procedure: Booking, Commencing and Ending a CFR Shift, confirming availability with the Emergency Operations Centre Version 7: August 2012

For review: August 2013

Background The purpose of this SOP is to stipulate the procedure for individual CFRs to book shifts with their units, for unit coordinators to book shifts with LAS and for commencing and ending each shift. The standard model of booking shifts requires the compilation of an advanced monthly rota by each local team and its submission to LAS monthly in advance by each CFR Unit Coordinator. However, it has been the practice for LAS to accept late bookings of shifts in an effort to accommodate those CFRs who may find themselves available at short notice. However, with the welcome significant increase in the number of CFRs, this is administratively more complex for coordinators and less effective for the dispatchers. All CFR units who do not do so already should be moving towards monthly advanced booking and move away from last minute booking. The introduction of Airwave means that those teams using it will have a simplified facility for commencing and ending their shifts.

Booking Shifts All CFRs are required to book their shifts with their unit coordinator or the unit rota coordinator authorised by the unit coordinator in advance using a procedure devised by the unit. The unit coordinator will pass the unit‟s rota to the LAS First Responder Department in advance to book in with the Emergency Operations Centre (EOC) system.

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Booked shifts must be carried out in full unless there is a very good reason to standdown as we are offering a resource on the system by booking the shifts. Authorisation for additional shifts may only be given by the unit coordinator If the CFR is unable to cover their shift they should first attempt to find alternative cover from their qualified CFR colleagues and then gain authorisation for the change from their unit coordinator Changing times for start and end of shifts may only be authorised by the unit coordinator The purpose of these procedures is to support the clinical and operational governance requirements of SJA and LAS in order to ensure: Effective deployment of CFRs by EOC Widest possible cover of shifts and best utilisation of equipment Access to all shifts for all CFRs in each team There is no inadvertent overlap of shifts Adequate time for the passing of equipment from CFR to CFR at shift changes SJA know when their volunteers are on call in order that they are able to maintain their welfare Ad-Hoc booking with the EOC desk using the Airwave radio will not be permitted. Members will not extend shifts without consulting their unit coordinator by text or e-mail. If they are requested to extend their shift by EOC and they are able to comply, they may do so only is they are aware that there are no unit shift rotas following on (bearing in mind the time it takes to pass the kit around). The unit coordinator must be notified at the earliest opportunity by text or e-mail.

To confirm availability at shift start If a LAS mobile telephone is in use The CFR should telephone the appropriate sector desk using the correct number from the table below. This call should include the call sign (e.g. FR01) and confirm shift times (e.g. 1100-2300). If Airwave radio is in use Turn on the Airwave radio as stated in the Airwave SOP. A text message “Your call sign is FR??” should on the Airwave display in uppercase Press and hold 7 on the radio keypad. It should confirm that the Green Mobile request has been sent. Although it is not essential to do so, CFRs may wish to have voice contact at a convenient time at the start of their shift with EOC by initiating an Airwave point to point call with EOC

Becoming unavailable at shift end Action If an LAS mobile phone (not Airwave) is in use: there is no requirement to confirm unavailability at the end of the shift. If the Sector desk has been advised of the correct shift time, the CFR will automatically show as unavailable on CTAK at this time. Ref. No. OP/046

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Action if Airwave radio is in use: If the sector has been advised of the correct shift time, Airwave should send a text out as soon as the shift ends saying “Your call sign is fr??” in lowercase (may take a minute or so to come through). Should you not receive call EOC and confirm that the shift is at an end.

Sector Telephone Numbers (for use with a LAS mobile phone only) Call signs FR02, FR04, FR13, FR14, FR15, FR18, FR27 FR01, FR06, FR07, FR10, FR12, FR16, FR17, FR20 FR79, FR80, FR87, FR88, FR89 FR71, FR74, FR76, FR77, FR83, FR84, FR85 FR31, FR32, FR41, FR42, FR44, FR45, FR46, FR48, FR49

Sector South East South West North West West North East

Telephone number South Area Controller 9228 7900 2101 West Area Controller 9228 7900 2151 East Area Controller 9228 7900 2121

Back-up Telephone Line If there is a need to contact the control room urgently and there is no response on the Sector desk telephone, then the Operations Centre manager (OCM) should be contacted on 9228 2346.

Restriction on the use of numbers These telephone numbers can only be dialled from the ECA mobile telephone provided by the Service.

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Appendix 3

Ambulance Community First Responders

S.O.P. 2 Standard Operating Procedure: Use, storage and replacement of equipment. Version 3: March 2012

For review: March 2013

Background Ambulance Community First Responders (CFRs) are provided with specific operational equipment by LAS and SJA as laid down in the current Kit list and will be appropriate for use on the categories of patients CFRs are trained and dispatched to provide care for. In order to ensure safe and effective patient care in accordance with the clinical governance standards and procedures of LAS and SJA, all items are supplied fit for purpose, in good condition, in date and they meet all current guidelines and standards for design, manufacture and calibration where appropriate. Use of equipment CFRs shall only use the equipment provided by the SJA and LAS for the purpose. Under no circumstances may CFRs carry or use their own equipment or consumable items. The equipment shall always be stored and carried in the bags specifically provided by St John Ambulance or the LAS. The equipment must be packed in accordance with the attached guide. At the beginning of every shift CFRs must check that all items of equipment are complete and functioning correctly, and that all consumable items are within their „use by‟ date and are still sealed in their original packaging. Storage of equipment The equipment must be kept securely at all times; either in the immediate possession of the CFR, locked in the luggage compartment of their response car or kept in another secure location between shifts.

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When responding to a call, all equipment must be kept inside the securely closed bags, and these shall be transported in the luggage compartment of the CFR‟s car, to prevent it becoming a hazard to the occupants of the vehicle in the event of a sudden change of direction, speed changes or accidents. Replacement of Consumable Items Consumable (single patient use items) may be replaced by the operational LAS personnel at the scene of an incident or by arrangement at the allocated LAS ambulance station. The only exception to this is the CPR pocket mask which should be drawn from a unit spares supply kept in accordance with unit procedure. Defective Equipment Oxygen: contact the allocated LAS ambulance station, report the defect to enable completion of the appropriate defect report to be undertaken by the LAS staff and draw a replacement cylinder AED: notify the SJA Duty Officer immediately to arrange an operational replacement with the SJA London Division CFR management team. AED and Oxygen bags: will be replaced by the SJA CFR management team

Spares Bag and Contents Ambulance Community First Responders (CFRs) are provided with specific equipment by LAS and SJA as laid down in the current CFR Kit list and subject to the conditions laid down in this SOP. Consumables are generally replaced on scene by LAS crews and other items are available from CFR unit stocks drawn from SJA London District or local LAS Complex stores. However it is appropriate for the on call CFR to have a small quantity of spare equipment in accordance with the attached inventory with them in the boot of their car when attending calls to cover for situations when replacement consumables are not readily available. Container and storage and transport of equipment CFRs shall carry the spares including the oxygen cylinder in the bag provided by SJA which shall be kept securely at all times. When responding to a call, the spares shall be kept inside the securely closed bag, and transported in the luggage compartment of the CFR‟s car, to prevent it becoming a hazard to the occupants of the vehicle in the event of sudden change of direction, speed changes or accidents. The bag remains in the car whilst the responder is attending the patient.

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Spares Bag Inventory Item Spares Bag Airway and Breathing CD or ZD Oxygen Cylinder

Qty 1

Source SJA London District

Notes

1

LAS local Complex

CD or ZD according to availability

Non Rebreathing Mask 2 LAS local Complex Nasal Oxygen Cannula 2 LAS local Complex OP Airway size 4 1 LAS local Complex OP Airway size 3 1 LAS local Complex OP Airway size 2 1 LAS local Complex Spare suction canister 1 SJA London District Large gauge suction catheter 1 SJA London District Narrow gauge suction catheter 1 SJA London District Pocket mask 1 SJA London District Oxygen connecting tubing for 1 SJA London District pocket mask Personal Protection and Infection Prevention and Control Box Nitrile Gloves Small 1 LAS local Complex Box Nitrile Gloves Medium 1 LAS local Complex Box Nitrile Gloves Large 1 LAS local Complex Box Nitrile Gloves XL 1 LAS local Complex Disposable Aprons 2 LAS local Complex Box of Protective Masks 1 LAS local Complex Orange Clinical Waste Bags 5 LAS local Complex Hand Sanitizer Gel 1 SJA London District Vomit bags 2 SJA London District Splash Spectacles 1 SJA London District Container of hard surface wipes 1 LAS local Complex Defibrillation Razors 2 LAS local Complex Pair Defibrillation Electrodes 1 LAS local Complex Dressings and Bandages Large Sterile Dressing 2 SJA London District Medium Sterile Dressing 2 SJA London District Small Sterile Dressing 2 SJA London District Woven Triangular Bandage 2 SJA London District Small Pack self adhesive 1 SJA London District dressings Patient Comfort Single use adult HP blanket 1 SJA London District Foil blanket 1 SJA London District Koolpak Cold Compress 1 SJA London District Other Equipment Size D Torch batteries 3 SJA London District Documents SJA Call Record Forms 10 SJA London District Resuscitation Council AED 2 SJA London District Event Forms SJA Fatal Incident Forms 2 SJA London District Pad of LA4H 1 LAS local Complex

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Appendix 4

Ambulance Community First Responders

S.O.P 3 Standard Operating Procedure: Recording and reporting Version 7: March 2012

Review Date: March 2013

Background In the best interests of our patients, to ensure confidentiality for them, to maintain best practice in clinical governance and to comply with the requirements of the law, Community First Responders (CFRs) operating on behalf of the London Ambulance Service (LAS) shall record and report their operations strictly in accordance with this standard operating procedure (SOP). There are no exceptions. LAS Patient Handover Form (LA4H) Form LA4H is used by the CFR for taking the call from the LAS Dispatcher and as a handover from to the on scene LAS crew. The LA4H Patient Handover Form shall be completed by the CFR for every occasion on which the CFR is activated, even if the call is subsequently cancelled. Completion of this form generates three copies, which shall be distributed as follows. Bottom white copy: to be handed to the responding LAS crew in order to provide a record of the patient‟s condition and treatment to aid the clinical management of the patient. This shall be executed even if the CFR has had little time to gather information and the form is incomplete. Top white copy and the yellow copy: On completion of the call, the form shall all be completed with as much information as the CFR has been able to gather and sealed in the envelope provided and returned to the Duty Station Officer (DSO) at the nearest ambulance station within 72 hours of the shift end. The LAS DSO will forward the top white copy to the LAS management information department where it is retained as part of the patient record. The yellow copy will be reviewed by a local LAS Team Leader at the ambulance station so that feedback can be given to the CFR unit coordinator in accordance with locally established practice. The form must not be copied or retained by the CFR or the CFR unit in any way or under any circumstances. Every effort shall be made to maintain the confidentiality of these Ref. No. OP/046

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documents whilst they are being handled as they inevitably contain patient identifying details. The combination of „date‟ and „CAD ref‟ which must be included on every form creates a unique identifier to enable the form to be linked with other patient details should this be subsequently required. SJA Call Record Form This form shall be completed by the CFR following every activation, even if the call is subsequently cancelled. It is normally completed when the CFR has completed the call and left the scene. It shall be handed to the unit coordinator after the event in accordance with a procedure to be agreed by the unit. The unit coordinator will collate all the unit call record forms each month and either send them to John Newman at London District HQ, 63, York St. London W1H 1PS or scan and create electronic copies to send to [email protected] within two weeks following the end of the month. When completed correctly, there is no patient confidential information on this form so if each unit wishes to retain a copy for debriefing, training and unit records they may do so. SJA Fatal Incident Form In the event that a CFR is activated to a call where the patient is dead or dies or where there has been no return of spontaneous circulation on scene (ROSC), the SJA Fatal Incident forms shall be completed. This shall apply even where the call has been cancelled after dispatch or where the LAS crew are first on scene, manage the resuscitation attempt and the CFR does not become involved with the patient, for example where circumstances may dictate that the CFR best undertakes another task such as to care for the patient‟s spouse or partner whilst the LAS crew are undertaking the resuscitation attempt. The abbreviated Fatal Incident Initial Notification form shall be completed by the CFR and forwarded to SJA National HQ within 24hours in accordance with the instructions on the form. The London District Duty Officer must be advised by telephone (08448802311) on completion of the call to enable support for the CFR to be initiated if necessary and for details to be taken to enable the District report to be made to NHQ. Resuscitation Council UK – AED report forms Where a CFR has used the SJA Unit AED on a patient, the Resuscitation Council (UK) AED Event Form shall be completed as soon as possible following the event. It shall be passed to the unit coordinator in accordance with a procedure agreed within the unit. Top white copy and blue copy: the unit coordinator will collate all the unit forms each month and send them to the SJA CFR Programme Director at London District HQ, 63, York St. London W1H 1PS within two weeks following the end of the month. Ref. No. OP/046

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Green copy: there is no patient confidential information on this form so the green copy may be retained at the unit for debriefing, training and unit records. Local Operating Procedures for implementation of this Standard Operating Procedure CFR Unit Team Call sign Unit procedure for LA4H handling

Unit procedure for SJA/LAS Call record form handling Unit Procedure for Fatal incident Reporting

Unit Procedure for AED event form

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Appendix 5

Ambulance Community First Responders

S.O.P. 8 Standard Operating Procedure: Activation and Airwave Radio Procedures Version 1: June 2012

For review: June 2013

Background This SOP defines the standard LAS protocols for using Airwave radio which are applicable to CFRs. Its purpose is to ensure that CFRs make appropriate and professional use of Airwave at all times to protect their safely, the well-being of their patients as well as the safely of other Airwave users. Airwave Radio Sets 1. Airwave sets shall not be carried other than for the purpose of booked CFR shifts and duties 2. Airwave sets must be kept secure at all times. At no times should Airwave sets be left unattended in a car, outside or at the scene of a call.

Airwave Protocol 1. CFRS shall only use formal LAS radio protocol as defined in this SOP. Inappropriate, informal use or offensive language will be subject to disciplinary proceedings. 2. For the safely of CFRs and the LAS, all Airwave transmissions are subject to recording. Similarly Airwave sets are also potentially subject to ambient (silent) listening by EOC within the strict policy and criteria laid down by LAS.

Basic Airwave Operation To Switch-on the terminal – press the Mode button, enter the 4-digit PIN and press the Green Button. (Caution: handset locks after three incorrect PIN entries) To Switch-off the terminal Press and hold the Mode Button until the terminal displays “Switching Off”.

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Always use Point-to-point (ie one to one) mode unless instructed otherwise by Emergency Operations Control (EOC). Do not change the Talk Group (i.e. channel) already set on your radio unless instructed by EOC.

Receiving an Airwave point-to point call form EOC The Airwave set will vibrate, bleep and display “individual call” Press the Press to talk (PTT) button, wait for 1 second before speaking. Identify yourself “Foxtrot Romeo go ahead over” The call-sign number should be given as the individual numbers e.g Foxtrot Romeo Two Five (not twenty five) If you understand the message given to you by EOC confirm with “Foxtrot Romeo received over” If EOC asks the CFR a question then answer “Foxtrot Romeo affirmative over” to reply “yes” or Foxtrot Romeo negative over” to reply “No”, Add a brief explanation to back up your response only if you feel that is required.

If EOC calls you, for example to cancel an assignment to a call, then at the end of their message they may state the current time followed by their initials expressed using the phonetic alphabet. For example if the EOC controller was called John Smith this would be expressed as Juliet Sierra. This information should be noted for inclusion on the LA4H form. The CFR should then acknowledge receipt the message by providing their initials phonetically. For example “FR , message received, over” If EOC asks you to “Report” the CFR should (when on scene) risk assess the situation and if feasible and safe to do so assess and report the condition of the patient(s) to EOC using the standard point to point call protocol defined above.

If you are unable to fully understand any message from EOC, for example because of unfamiliar terminology or poor reception, always ask EOC to repeat or to clarify their message. If a name or location is difficult to understand then ask EOC to spell it. Never guess the content or meaning of a message that you have not fully understood.. CFR Initiating a normal point to point call with EOC “Press and hold the “1” key until “DELIVERED RTS” is displayed (RTS = request to speak) Your request is queued. When EOC are ready to speak to you the radio will vibrate, bleep and display “Individual Call”. Press the Press to talk (PTT) button, wait for 1 second before speaking. Ref. No. OP/046

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Identify yourself “Foxtrot Romeo over” Important Note: When (as normal for a CFR) you are in point to point mode please DO NOT use the PTT (press to Talk Button) button to pass a normal message without first initiating a call using the “1” button (as described above) unless it is in extreme emergency as this broadcasts to all of the Talk Group and can stop other conversations.

Terminating a Point-to-point call All point to point calls are terminated by EOC when they believe the conversation with the CFR has ended. A point to point session also ends after 10 seconds of inactivity. When the call has ended the “Individual Call” display disappears. If ”Individual Call” is no longer displayed and you need to talk further with EOC then initiate another call sequence from the beginning by pressing and holding the “”1” RTS button as described above.

Contacting EOC with a Priority Message If you are first on scene and are very concerned about the condition of your patient and wish to update EOC (or need very urgent advice or wish to provide very urgent information about an incident) Press and hold the “#” button ”Delivered Priority” is displayed Your request is queued and when EOC are ready to speak to you the radio will vibrate and bleep. Press the Press to talk (PTT) button, wait for 1 second before speaking. Identify yourself “Foxtrot Romeo over” Always use the “#” priority facility to convey urgent information about the medical condition of your patient rather than using the emergency button In Extreme Emergency In extreme emergency only (e.g if you feel under very significant, immediate personal threat) Press and hold down the Emergency Button for 2 seconds State your location and circumstances if possible – your microphone will be in open channel for 12 seconds. If the emergency button has been pressed, EOC may use ambient listening to ascertain CFR wellbeing if the CFR does not respond to EOC calls. If the emergency button has been pressed in error then press the red button to clear. Using Hot Keys to convey change of status information Press and hold “2” to confirm you are en-route (Amber) to the scene of a call. Press and hold “3” to confirm On-scene (Red) at a call. Press and hold “7” to confirm Available on Road (Green) The display will confirm receipt of the status change. CFRs still need to record times of status changes manually for use in completing their LA4H. There is no need to call EOC to confirm Green status after a call. Ref. No. OP/046

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Responding to General Broadcasts from EOC to your Talk Group General broadcasts are used by EOC to seek LAS resources where a call is being held waiting for suitable resources to become available. CFRs are permitted to offer themselves for assignment to a general broadcast call only if the broadcast does not specify a specific type of resource being sought it is confirmed that the call fits within the scope of type of calls that CFRs are permitted to attend the location of the call is within a realistic distance to the current location of the CFR. The general broadcast will normally include instructions on how to offer yourself for assignment – e.g. by pressing the priority “#” button. Your request is queued and when EOC are ready to speak to you the radio will vibrate and bleep. Press the Press to talk (PTT) button, wait for 1 second before speaking. Identify yourself “Foxtrot Romeo Re the general broadcast for the call in ,Foxtrot Romeo is available if the call is suitable for a Community Responder, Over”

Other Potentially Useful Numeric Keys (press but do not hold down) “2” to Inhibit Transmit (eg where circumstances at the location of a call requires sensitivity in relation to potential radio noise) “8” to Invert Screen display (press again to revert) “9” Display Size (press again to revert) “*” key lock (take care not to confuse with the “#”priority key) In normal use, avoid using the following keys “4” Trunked (which takes you into open mic), “5”Gateway and “6” Back to Back as these change the mode of operation. Battery Charge the battery before and after a shift as required. Check the battery charging light comes on. A fully charged battery should last 12 hours Always hand over your Airwave with a fully charged battery. Change to the spare if required. Radio Signal Low / No signal indicator LED flashes quickly 4 * red continuously Audible tone repeated every 30 seconds Check signal-strength scale (right of screen) In the unlikely event of requiring to urgently contact EOC in an area where there is no Airwave reception then revert to use of the LAS mobile phone if being carried. If not Ref. No. OP/046

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being carried, and in case of a real emergency, dial 999 on a non service phone and asked for the ambulance service, When EOC reply then identify your call-sign, CAD number and explain the reason for making contact in this highly exceptional way. If Instructed to Change the Talk Group Do not change the talk group unless instructed to do so. Only if instructed:Press Mode button Type new talk group number Press PTT

If an CFR Airwave Set is Lost or Stolen Lost of a Airwave potentially constitutes a high financial loss and a significant security risk and hence will be subject to full investigation by LAS / SJA. In event of a loss or a suspected loss of an Airwave set, the Unit Coordinator, EOC and the SJA CFR Director should be informed immediately. EOC may then elect to “stun” (disable) a lost Airwave set for security reasons which itself involves a very significant cost.

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Appendix 6

Ambulance Community First Responders

S.O.P 10 Standard Operating Procedure: Recruitment and becoming operational Version 2: May 2012

Review Date: May 2013

Background St John Ambulance (SJA)/ London Ambulance Service (LAS) Community First Responders (CFRs) are generally recruited from members of the public and enrolled as SJA volunteers with the specific role of CFR. Some current members of SJA decide that they would also like to undertake the role of a CFR. This SOP describes the process whereby new recruits shall be effectively enrolled to ensure they are quickly enabled to go into operation whilst assuring the strict governance standards of SJA and LAS for the safe and effective care of patients. Steps in the joining process and subsequent progression

Receiving enquiries: The recruit responds to a recruitment campaign or proactively enquires about becoming a CFR to [email protected]

Establish the basic CFR criteria are met: The CFR Management team responds by asking for basic information to establish that the recruit meets the basic criteria: resident in London; current clean driving licence for two years; has a car and is willing to respond solo from home in it. Information Session – COMPULSORY before any further steps. Conducted by senior LAS CFR AOM and SJA Programme Director. To be booked by recruit with [email protected] Registration Session – COMPULSORY for those who meet the criteria. Booked with: [email protected]. Conducted by: SJA LD Volunteer HR department and CFR Management team. Ref. No. OP/046

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Purpose: I. To complete enhanced CRB checks and take references and photographs II. Conduct suitability interviews May take place at any time after the information session, before the recruit is accepted for the CFR training programme Training session – COMPULSORY. Takes place after the information evening and interview. Three day course to be booked by recruit with [email protected] culminating in formal assessment using skills test 29 Operational Preparedness Session – COMPULSORY, 3 hour session that provides practical revision of the recording and reporting procedures and introduces simple radio procedures and practical use of the Airwave radio. Continuous assessment for competence is undertaken throughout the course and recorded on the appropriate skills test form. Observer shift with LAS – STRONGLY RECOMMENDED, one shift with an LAS solo responder or ambulance crew booked by the CFR Unit Coordinator with their designated local LAS officer who designates specific crews. This may only be undertaken when the formal joining process has been completed; i.e. enhanced CRB disclosures cleared and references received at which time the SJA London District ID card is issued Operational Shifts – COMPULSORY, The CFR is then required to book on operational shifts and to undertake at least one full solo shift per month

Unit meetings - COMPULSORY, the CFR is required to attend not less than one unit session at which they undertake hands on practice of basic core CFR skills in a scenario context

Annual Revalidation - COMPULSORY, the CFR is required to revalidate their core CFR competences every year in a formal reassessment conducted by approved assessors and recorded on a current skills test 29

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Interview to be conducted at Registration Session Interview of: ___________________________________________________________ Date: ________________________________ Time: ___________________________ Likely CFR Unit: ________________________________________________________ Has completed a CFR Information evening (date): ___________________________ Interviewer: ____________________________________________________________ Interviewers recommendations:

1. Have you had any contact with St John Ambulance before? (If yes please elaborate)

2. Have you had any contact with LAS before? (If yes please elaborate)

3. What specific aspects of being a CFR most motivate you to want to volunteer in that role especially?

4. Please tell us about any personal experience of dealing with injuries or ill health

5. Have you any first aid/medical experience? If so please provide brief details

6. How will the commitment to volunteer for St John Ambulance fit in with your life, and what support do you have from other people?

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7. How do you feel about the expectation that you will be responding on your own?

8. How do you feel about coping with stressful situations? Give examples of how you managed / coped with pressurised situations

9. How did you feel about meeting strangers and engaging with them? Give examples of how you do this.

10. Please tell us what other volunteer activities you have taken part in? What was your role? What were the issues for you?

11. Please indicate your availability and thoughts on your personal potential. (Explain about the probation period – requirement to participate actively in at least one meeting monthly- undertake at least one solo shift per month. Is their commitment more or less than six months?)

Have you any questions for us?

Concluding Statement to the candidate – either Thank you: It seems that following this discussion we agree that CFR volunteering is not for you. Would you like us to arrange for you to have discussions about other SJA alternatives? OR Thank you: We agree that you are a suitable person to commence CFR volunteer training. Please take the following action: 1. reflect on our conversation and the commitments you are making and if you decide to go ahead 2. book your self on to the recruit training course and operational preparedness module as soon as possible by sending an email to [email protected] NB: if the person does not have access to email, agree a specific alternative.

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