Lincolnshire is the second biggest county in England - so vast in fact, that it would take two hours to drive from Lincoln at one end, to Skegness at the other. This means if you were caught in a life-threatening traffic accident on a rural Lincolnshire road, the chances of survival are slim. A team of locals however are working around the clock to change that.
In 2017, volunteer responders in the area helped 21,500 patients - that’s over 55 a day - many of whom will have been in critical conditions. The job of the responders, who work for free on behalf of charity Lives, is to arrive on scene as soon as possible and do what they can to stabilise the severely injured.
There are few motorways and dual carriageways in Lincolnshire. Instead, towns and villages are connected by a network of rural roads. “If you’re in the deepest depths of Lincolnshire at night, why should you have poorer care than someone right next to a major trauma centre in London?” Dr Simon Topham, a registered GP in the area and volunteer for Lives, tells HuffPost UK. “I view it as trying to level out the health inequality that comes from rurality.”
Simon manages to juggle a frankly dizzying number of roles throughout the week. He works as an urgent care lead for Lincolnshire Community Health Services NHS Trust, an air ambulance doctor, which he does one day a week, and clinical director for Lives, for which he is paid two days a week.
In his spare time - mainly evenings and weekends - he volunteers for Lives. It’s something he’s been doing for 25 years now.
“I respond as a voluntary doctor that gets sent out by the ambulance service to attend incidents which are either people with serious illness or, more often than not, serious trauma,” he explains. “And that’s day or night. I tend to make myself available whenever I’m not at work and when I’m not too tired.”
He drives his own vehicle to the scene of accidents with a blue light and sirens –– on average, attending 12-15 incidents a month. “In 80% of the calls, I’m usually first on scene,” he says. “About 20% of them are when there are crews on scene and they’ve requested additional support from a Lives medic.” It’s not unusual for him to travel as far as 30 miles in cases where additional skills are needed that the standard road crews don’t have.
Time is always of the essence when attending crashes and while they can’t prevent initial injury (from the accident itself) they can prevent secondary injury, such as brain damage. He recently trained to deliver pre-hospital emergency anaesthetic: “So if we have a patient who has a severe head injury in a road traffic collision, and they’re not fully conscious, then I will deliver an emergency anaesthetic.” In layman’s terms, this means he puts them in a medically-induced coma.
When the patient is in this state, he is able to control their oxygen and carbon dioxide levels, tweaking them to create the best possible condition for the brain to recover. “It can mean the difference between life and death,” he explains. “It can also mean the difference between surviving an accident and surviving an accident neurologically intact with no disability.”
Lives is made up of more than 800 trained volunteers. Some of them have no previous medical experience, while others - like Simon - have many years under their belt. There are 61 medics (a team of nurses, paramedics and doctors) who volunteer for the charity and 762 community first responders who are not medical professionals but have been trained to deliver immediate care and first aid at accident scenes. Nobody is paid, it all runs on goodwill.
It would be a tough job to do in any circumstance, but doing this line of work for free takes another level of commitment. “It would be so easy to burn yourself out very quickly,” explains Simon. “I’ve made it sustainable. You’re no good to anybody else unless you’re looking after yourself.”
There are times, however, when things do become too much - especially if he has to attend a particularly distressing incident in which someone dies. Unable to turn to his family for support (due to patient confidentiality), he’s had to build up a network of friends in the same line of work over the years, who he now turns to for advice and help. He calls it his “phone a friend network”, as they understand patient confidentiality and will often be able to support him through the emotional strain that follows when he’s unable to save a life.
Last year was the charity’s busiest year ever. When pressed why, Simon replies: “There are huge demands on the ambulance service, there are so many factors.” He cites an increase in calls to 999 because people are not sure where to go for help and also acknowledges that hospital accident and emergency departments are “under immense pressure” and as a result, sometimes don’t have the capacity to take in patients arriving in ambulances. “So the ambulance is waiting with that patient and, as long as they’re waiting at the hospital, they’re not available to answer another call,” he adds.
Our ageing population is also piling on pressure and another significant factor, he says, is that not every hospital provides every service. “So for example in this massive county of Lincolnshire, there isn’t a major trauma centre at all. We’ve got three trauma units, but our nearest major trauma centres are Nottingham and Hull, both of which are out of county.”
In August this year, NHS England revealed the lives of an additional 1,600 patients with severe injuries had been saved since major trauma centres were established in 2012 – so there’s clearly a need for them.
“Increasingly there’s this demand on the ambulance service that’s getting pulled and stretched in so many different ways, and I think as an organisation Lives can be there early, make those crucial interventions, and a lot of the time there are things that - as a doctor - I will be able to deal with on scene and actually discharge the patient.” This then frees up the ambulance to attend a more critical situation.
Sometimes Simon can end up being out all night. If he travels in an ambulance to hospital with a patient, he will often end up semi-stranded there as his car will remain at the scene of the accident. It’s then up to him to find his way back, but he takes it all in his stride.
When asked what’s the most rewarding part of his volunteer work, he replies: “Making a difference - and that can be in so many different ways. If it’s going out to someone who is having their worst ever day, who has had a horrific crash, who is clinging onto life and you enable them to get to hospital alive and in a condition where they’re going to stand a chance of recovery - that’s incredibly rewarding.
“But equally if I go around to my next-door neighbour who has phoned an ambulance because they’ve had a fall and they’re stuck on the floor and they don’t know who to ring... if I go around and check that they’re ok, enable them to get up, have a cup of tea, and then discharge them without an ambulance - that’s just as rewarding.”
The doctor is incredibly humble about what he does and says when people thank him for saving their lives, which they often do, he feels a bit uncomfortable. “I’ve not done it for the thanks or the praise,” he adds. “I’ve done it because it’s the right thing to do.”
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