Flagging Addresses

Notes On Assaults 1 Notes On Assaults 2 Notes On Assaults 3

(You can click through to Flickr to see the notes that I've added to my notes)

Just some notes that I made before going on Radio 5 Live to talk about this story.

Donal MacIntyre devoted part of his radio programme to it (and you can download and listen to it here, I don't know how long it will last).

So I got on the radio and said a few words (here for a few days – the section starts 1:03 in and again I suspect it only lasts a few days and won't let nasty foreign types listen to it).

But I didn't get a chance to say as much as I wanted to. But I have an audience here – so here goes…

Sadly we don't tend to flag addresses for people who are just verbally abusive to us, as I said in the radio segment, I'm working next Friday, Saturday and Sunday nights and I fully expect to be sworn at on every one of those shifts. If I were to fill in forms for that sort of abuse I'd never get any work done. Instead we fill in the forms for those people who have either physically abused us, or have acted in such a way that there is a high chance of them physically abusing people in the future.

We fill out the form, explaining why we are flagging it as a dangerous address and then fax it off to Control (using the hospital fax machine, our station doesn't have anything so high tech as a fax machine…)

So the dangerous addresses are flagged by people who have actually been there. And trust me, if someone dies as a result of a delay by us waiting for the police, the person initially flagging the address will get some serious questions asked.

The flagged address system is a warning system, it informs and compliments our 'at scene' risk assessment. Sometimes we ignore it, sometimes we wait for the police. It all depends on the situation. If someone is reported as not breathing then we'll probably go in, if they are calling because someone in the house is drunk then we are more likely to wait for the police. An example of when it was right to enter the address is this one, while in this example it was right for me to wait outside for police assistance.

It's that sort of risk assessment that we make all the time, often without consciously thinking about it.

The address is reviewed every six months, taken off the register if there have been no further reports, at least that is how it was explained to me.

So why are people violent towards us? Obviously drink and drugs play a huge part, mostly drink. But I think that there is a more subtle thing in action here.

When I wear my uniform people do as I say, they don't see me as a slightly overweight bloke – they see me as a figure of authority, that I know what I'm doing and that it is in that person's best interests to do as I suggest. Conversely, the uniform dehumanises me – it makes me a 'thing' rather than a person and it's much easier to hit someone if you think about them as just being a 'uniform' rather than a living, thinking, feeling human being.

A lot of arguments are started because of the raised expectations of people to be looked after by the state, they don't want to wait for their treatment and they want an instant cure – this is why I would suggest that actual violence against staff is higher in A&E departments, although they do have security guards posted there now.

The dangers for ambulance staff have only increased – there are more solo responders now, and they go into situations where the police would turn up mob-handed. While solo's aren't supposed to be sent to assault cases on their own, I know that I attended a fair share of such things – often waiting ages for a proper ambulance to arrive. I remember one stabbing I was sent on and it took forty minutes for the ambulance to arrive. I'm just glad that the assailant didn't return to finish off the job he'd started.

The other huge danger is Call Connect.

Due to “call connect”, the government's new way of measuring the “success” of ambulance trusts, we are finding ourselves going into houses without any idea of the possible dangers. Once we are out of the ambulance, there is no way for control to contact the crew.

The new 'Airwave' radios have been delayed, so there is still no way for Control to contact us once we are out of the ambulance. We are often sent calls that just give the address.

An example,

I'm sent a call to a house I'm just driving up to – no further information is given. If I'd got out of the vehicle then I would have been met by a house full of drunks, one of whom had been cutting herself open with a kitchen knife and was arguing with the other occupants. Thankfully I don't give a damn about the government's ORCON target so I waited until more information came down – then waited for the police. If I hadn't done that there was a good chance that I wouldn't be here today writing this post.

To be honest, I would be very surprised if an ambulance person isn't killed in service before the end of next year.

Edited to add that I found the Unison's comments in the original BBC story particularly unhelpful, seeming to care more for the people who hit us than the members of their own union, then realising that there was a fence that they had to go and sit on.

24 thoughts on “Flagging Addresses”

  1. What i didn't add before is that radios and mobile phones do not work everywhere. There are significant black spots around the UK so shouting help will be more useful than having a radio. Not even AIRWAVES (tetra) is the answer. I does reduce the number of black spots but they're still not sat. phones/radios. Deep in a valley with large hills/mountains either side negates the abilities of many cordless communications systems. Even in the concrete jungle comms. are still hit n miss.

  2. The police around my way aren't too impressed with them and I think that may be the reason for the delay.Also, by going digital when you get a 'dodgy' signal you hear nothing – at least with VHF you can filter out noise with the human brain (which is pretty well suited for discerning patterns in noise, but of course 'digital' means 'better')

  3. Seems you've got to rely entirely on your own judgement for whether to enter a call or not. Which is fine completely unfair. Just…look after the newbies, the ones that may not have a fully developed sixth sense yet!

  4. Sorry, what is the meaning of the “rune” (like an inverted peace symbol) at the end of your third page of notes?Andrea

  5. Whilst radios are useful they are not the answer to someone attacking you.If i have a chance of running from an assailant my breath will be taken up on… oh yes… breathing not trying to scream down a radio that will send help too too late. Even just being able to press a HELP button won't have the police on the doorstep in 1 minute.

    And the crazy idea of having solid bulkheads between the cab and saloon should be quashed asap.

    Again, as per, that's down to money.

    In one set of vehicles we can centrally lock-down the ambulance… it's in the front. Not much bleedin' use if both of you are in the back with the pateint and trouble arrives outside.

    And, as was said on the RADIO, flagged addresses only highlight half the assault issues.

  6. Indeed – I don't wear a stab vest because it'll only slow me down as I run away (and I only have to run faster than my crewmate…*grin*).It's just that we were promised them in October, but as they don't work right the radios have been put back indefinitely.

    (The radios were a recommendation of the 7/7 999 response inquiry)

  7. Tom,I'd happily time you running to the J2 fitters and back both with and without the vest on 🙂 PLenty of good reasons to wear them and of course not to wear them but that's not one!

    All the best


  8. Out of interest do you flag addresses these days for other reasons eg the asthmatic who cant talk during an attack beyond asthma & address being given etc or epileptic who doesnt respond to normal drugs

  9. The surprising part is that you don't have personal radios. Imagine going to an incident and you get stabbed (hopefully it never happens).What do you do? Run outside and call from the ambulance? (assuming you can run)

    Use the house phone? (assuming they didn't spend the phone money on drugs and it's cut off)

    Run to the nearest telephone box (in a few years there won't be any)

    Crazy Mr Fawlty, crazy.

  10. Yes, we flag addresses for people with tricky clinical conditions – and example of one would be a child with a degenerative disease that is not for resuscitation.We also have some sickle cell patients that have specific treatment protocols and the occasional instruction on dealing with a tricky COPD.

  11. Well, the *real* reason is that it makes me realise how much weight I've put on since being fitted for it.But it does make a nice body-warmer on those long cold winter nights – you remember nightshifts don't you DSO?


  12. Sorry if this seems a little basic – but is it not DRABC?i.e. – assess the Danger to self and others before moving onto the all important (R)ABC.

    When will people not realise that whilst ambulance crews are lifesavers (along with the the rest of the emergency and armed services) they are all HUMAN like the rest of us.

    Maybe the government should do an advert similar to the drink responsibly campaign.

    Control 1 takes a call to an assult (pans to view of situation and the attacker is still running a rampage at the scene and crew dispatched)

    Ambulance crew get to to scene dressed in superhero-medic uniforms who then run to assist the patient only to be stabbed and left bleeding on the floor – no superhero outfit just a paramedics uniform.

    Then a message stating (something way more prolific than I can come up with) but along the lines of how the HELL are you meant to help people if you are injured or hurt!?

    Maybe people will realise that you aren't the bad guys and you don't judge and that you are there merely to help save someone's life – even if that person has killed someone or has been the victim of a violent crime?!

    Grrr – Bloody media and government targets – this ones really got my goat.!!!!

  13. I've listened to the podcast. and my first thought is that I don't really understand what the segment was aimed at?They inform the listener that there is such a flagging list, the implications, and imply that you may be on it becuase of a former occupant of your address? they also point out that you can respond to the trust and have the result removed.

    Donal does not seem so concerned that ambulance crews are being attacked, he doesn't mention the lack of equipment you've discussed above. Thankfully some of his callers at least mention the stab vests, and onetext suggests that abusive people should not get treatment at all.

    The angle of the show seems slightly outraged that these people may not be treated when they call 999, and concerned that there's no centralised system for balanced recording and monitoring of addresses (which would naturally involve central staffing, cost, much more paperwork, and doubtless a new governemnt database which they'll leave on a train)

    I have to side wholeheartedly with the ambulance crews here. Bottom line they should not put themselves at risk if they know from experience that persons at an address may be abusive. As you point out Tom, the crews can use their own judgement to go in without backup in some siutations.

    The radio show suggests that there may be a problem where a former occupant of an address was abusive, and a new patient having recently moved in is denied an ambulance. I would guess the chances of this are miniscule, and many of these addresses will likely be council accomodation, occupied by the same family for years.

  14. You ARE WITHOUT DOUBT too valuable to put yourselves at risk. If only people would recognise that. Please be careful out there. OK And to be totally selfish I MAY NEED YOU with life threatening asthma attack next in line after those dodgy calls and you're no use to me or others if all crews are injured.

  15. You're so right about Call Connect – it's a dead/seriously injured ambulance person waiting to happen. In my service, solo responders are sent to everything, and since call connect the amount and quality of the information we get has got worse and worse – after all, once control have sent a resource, why bother wasting time finding out what that resource might find?Oh yes, and they've been talking new radios since I joined the NHS and that's long before 7/7 (and longer than I care to remember). I'm not holding my breath waiting for Airwave.

  16. Down in Gurt Western, we used to flag every trachyotomy patient in the county, so crews would be prealerted to take trachy care equipment with them to calls.Cheers


  17. Yeah but I've also heard that we're not going to be given personal radios, so we still won't be able to use the radios to call for help when we need to – only if we're in the vehicle.

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