Improving Patient Care at Major Incidents

08/07/2008

South Central Ambulance Service NHS Trust (SCAS) was established in 2006 following the merger of four ambulance trusts in the counties of Berkshire, Buckinghamshire, Hampshire and Oxfordshire. This area covers approximately 4,600 sq miles with a resident population of around four million.

The Challenge

SCAS wanted to improve the way that personnel communicated, both with HQ and with other colleagues whilst responding to major incidents. Although traditional radio-based communications, basic mobile phones and dial-up modems used with laptops had served the organisation adequately, it was clear that this level of technology would no longer be sufficient to deal with the increasing demands on the service from terrorist threats, industrial incidents, higher traffic volumes and the effects of climate change such as flooding.

A key requirement was to improve access to the Computer Aided Dispatch system, based at SCAS's Wokingham HQ. This would be essential to improve business continuity, incident management and the delivery of a more effective response to enhance patient care at major incidents. It was also important that, as a Category 1 responder, any proposed solution would help achieve interoperability with other blue light services enabling SCAS to share information and meet its responsibilities under the Civil Contingencies Act.

The Solution

SCAS had already commissioned a new vehicle and started talking to potential suppliers. It quickly became apparent that Excelerate Technology was the only company with experience of working with the blue light services and could also demonstrate a track record of successful solutions and implementations. It presented a full portfolio of modular solutions that would meet SCAS's requirements and provided some additional recommendations that would further enhance the end solution.

After going out to tender, Excelerate Technology was awarded the contract to equip the new mobile Incident Command Unit (ICU) with a comprehensive suite of cutting edge voice, data and video transmission technologies. The installation and commissioning process was completed in less than four weeks.

The ICU is fitted with a 95cm satellite dish that provides a resilient stand-alone broadband connection for high-speed data, voice and video communications within four minutes of arriving at serious incidents regardless of location. The satellite network is managed by Excelerate Technology in real-time from a Network Operations Centre based at its headquarters at St Mellons, Cardiff. From here, network performance is monitored to ensure that available bandwidth meets the current requirements with additional bandwidth instantly provided to meet operational requirements at any time.

In terms of voice communications, SCAS continues to use VHF and UHF radio communications, but this capability can now be expanded through use of the Excelerate Communications Management System (ECMS) which provides satellite and GSM-based VoIP (Voice over IP) PBX switching functionality. Two VoIP handsets are used by Silver Command to make and receive calls that are seamlessly routed through the HQ's telephone network. As backup and to provide increased resilience, these handsets can also use GSM networks to make VoIP calls. ECMS also enables different voice devices including UHF and VHF radios, GSM and VoIP phones to be patched into each other as well as providing real-time voice recording of all voice communication

Ruggedised, touch-screen PC terminals which enable STEPS (Strategic Emergency Planning Software), GIS, email, instant messaging and other specialised applications to be run. This gives personnel in the ICU access to the same critical incident information as if sitting at a workstation at HQ. All such applications are current in real-time using the satellite links to ensure that vital operational decisions can be made using the latest, up to date information. To further enhance data communications, a wireless network has been installed to enable tactical advisors using laptops to access treatment plans or information from STEPS anywhere within a 100 metre range of the main ICU.

STEPS provides location-based intelligence about an area, buildings, infrastructure, assets and threats overlaid with operational collateral that allows faster and more informed management of incidents and the automatic sharing of information in real time to improve communication. It integrates with the CAD log which acts as a conduit for all information received both from the public and from personnel at the scene. All data is time and date stamped for debriefing and evidential purposes.

STEPS also enables the delivery of a multi-agency response during major incidents. It would allow personnel from all three blue light services to share and update emergency plans that can be viewed remotely in real-time using the on-board satellite links to keep every level of the command structure informed wherever they are located.

A CCTV camera supplied on an extendable, hydropneumatic 5 metre mast allows SCAS to transmit pictures into the ICU for viewing on a large screen monitor by silver command staff operating at the scene of an incident. Images are stored on a video server and streamed via secure satellite links to a secure video server for online access in virtual real-time by authorised personnel including Gold Command at HQ as well as strategic and tactical commanders based at other locations. This enables strategic decisions to be made based on what is seen to be happening without the usual reliance on Sky TV news. The vehicle is also equipped with an externally mounted 37” touch-screen monitor to enable personnel to be quickly briefed on the incident management strategy.

Commenting on the contribution that Excelerate Technology has made throughout the project, he added: “From the start, we were impressed by Excelerate's professional and knowledgeable approach. The level of service far exceeds what was promised and the company has become a close partner in helping us to deliver improved patient care at every incident.”

SCAS is maintaining its lead in pioneering the development and application of innovative communications solutions for emergency planning and management applications. It is a driving force in helping the Royal Borough of Berkshire become one of the first regions to achieve true interoperability across all blue light services with sharing of information between Category One responders well on the way to fruition.

As a direct result of the first project, SCAS ordered a smaller Forward Command Vehicle that is again equipped by Excelerate Technology with a mobile satellite platform, VoIP and wireless. It is used to provide a rapid response at major incidents as well as providing all necessary command and control facilities at smaller incidents. Both vehicles are now also regularly deployed at major events such as Royal Ascot, Royal Weddings and large scale exercises.