The National Ambulance Resilience Unit (NARU) is now really starting to cement its position as the central place to come to within NHS ambulance services for all matters related to national emergency preparedness, resilience and response.
We have worked hard to engage properly with our key stakeholders, and the results show we have already become a valuable partner to a number of cross-Government agencies with responsibility for civil contingencies and the response to major, large-scale incidents.
Importantly, we have already become a vital central resource for all NHS ambulance Trusts and their own internal Emergency Preparedness Resilience and Response (EPRR) departments, with whom we work closely on a daily basis to strengthen ambulance resilience nationally.
Much of our work was on show in April 2014 at the excellent AMBITION event in London where we had a stand at what turned out to be one of the key events in the EPRR calendar, and we were able to showcase our work in front of many visitors. We'll be there again next year so keep 21 and 22 April 2015 in your diaries.
A brief summary
NARU works with all UK Ambulance Trusts to help strengthen national resilience and improve patient outcomes in a variety of challenging pre-hospital environments.
NARU works to support the development of properly trained, equipped and prepared ambulance responders to deal with especially hazardous or challenging situations (particularly mass casualty incidents) that represent a significant risk to public health.
Funded by NHS England, NARU also provides strategic input to Government policy on ambulance resilience issues.
The NARU Education Centre is a world-class national ambulance training facility that has just been awarded the coveted Skills for Health Quality Mark. Its activities cover:
NARU has been managed by West Midlands Ambulance Service NHS Foundation Trust since July 2011. Initially, this was on behalf of the Department of Health, and then NHS England from April 2013.
Essentially, NARU delivers the ambulance element of the NHS commitments under the UK's National Security Strategy, the National Security Council and the UK's Civil Resilience and counter-terrorism (CONTEST) strategies.
This delivers for the NHS (including, policy input, doctrine, Joint Operating Procedures, clinical, staff training, all equipment (including PPE), vehicles, pods, lighting, exercising, communications, and staff welfare and development):
The vehicle for delivery of this work primarily consists of 15 English Hazardous Area Response Teams, each team consisting of 42 staff plus a trainer and a manager. In addition, each ambulance Trust is provided with training for staff in CBRNe decontamination (approximately 200 per Trust) and MTFA (approximately 60 per Trust).
‘Importantly, we have already become a vital central resource for all NHS ambulance Trusts’
Each HART has also been provided with a bespoke dedicated base with first-rate training facilities. (NARU also supports the training and equipment element to Welsh HART and Scottish Special Operations Response Teams (SORT), but this is funded by the devolved Governments).
NARU provides subject matter experts to supply input to various NHS and Government Departmental Strategic Oversight Boards and tactical/operational working groups to ensure the NHS and ambulance sectors are represented and have appropriate input.
In addition, NARU also provides funds to ambulance services to ensure that:
Trusts are then audited periodically by NARU against the HART specification.
NARU provides subject matter experts to help develop policy, doctrine, training and capability, and ensures interoperability within the ambulance sector and across the NHS and other blue light services.
Key achievements in 2013/14
In terms of achievements, NARU has continued to improve governance arrangements, provided further in-year cost reductions and efficiency savings and has developed a significantly enhanced profile with stakeholders.
Additionally, NARU has provided credible clinical leadership to the Health EPRR community and agenda and has improved clinical standards and patient care in mass casualty scenarios. it has trained and exercised a large number (approximately 2 300) of ambulance and other staff in HART, USAR, MTFA, CBRNE and Command techniques and has significantly improved staff safety and patient care in a number of different environments.
NARU has delivered the ambulance requirements and supported the resilience objectives of NHS England, AACE and ambulance commissioners.
In addition, NARU has also provided support to the UK's CONTEST strategies and the DH and NHS England's commitments under the UK's National Security Strategy and the National Security Council, and continues to provide a wealth of subject matter expertise and leadership to stakeholders within the health community as well as across partner agencies and other Government departments.
NARU has successfully managed a number of procurement contracts, reducing costs in the process. It has delivered cost savings for new mass-casualty vehicles and is in the process of delivering more savings.
‘In addition to this work within the UK, NARU has also provided assistance and input into various international programmes’
NARU has reduced the cost of the strategic national powered respirator protective suit (PRPS) reserves and delivered huge improvements to the safety of staff in areas such as safe working at heights equipment and water rescue. NARU is continuing work in all these areas to further reduce costs for 2014–15.
During 2013–14, NARU also completed the HART audit for all English ambulance services and the Scottish ambulance service. A consequence of these audits was that in early 2014, NARU established a compliance work programme to support Trusts in the safe delivery of high-risk operations. It is essential that safety critical systems are maintained when committing staff into hazardous environments, and a key output of the programme will include a mandatory minimum set of compliance standards confirmed by external legal experts and the Health and Safety Executive. A crucial aspect of NARU's relationship with the DH and NHS England is to provide assurance that a nationally interoperable set of capabilities are being maintained.
NARU has also provided an evidence base to influence future training, decision making, staff competence and safety, and has provided an environment for Lessons Identified (LiD) to be shared and assessed.
In addition to this work within the UK, NARU has also provided assistance and input into various international programmes. This has included supporting exchange visits with the USA's Department of Homeland Security, delivering training to Gibraltar's health and ambulance service and providing support to the Indian healthcare system. This international work has provided excellent insight and experience of how other countries provide resilience capability and has shown that the NHS and NARU are world leaders in this vital area.
There was also time for celebrations as the NARU Education Centre won a special achievement award for their work training paramedics for specialist duties at the Advancing Healthcare Awards 2014, won an award at the West Midlands Ambulance Service NHS Trust awards ceremony for their dedication in organising Exercise Amber 2, and have now been awarded the Skills for Health Quality Mark for their excellence in training and education.
To find out more about NARU visit www.naru.org.uk or email me direct at keith.prior@wmas.nhs.uk.