Protocols relating to paramedics and technicians (FOI)

Request

​A

The protocols, policies and procedures and any related guidance which apply to paramedics and technicians when they are assessing an individual’s condition following an emergency 999 call.

B

The protocols detailing the criteria to be applied by paramedics and technicians when responding to an emergency call in deciding if an individual should be transported to hospital, some other place of safety or remain in situ.

C

The protocols relating to the occasions when paramedics and technicians would engage the support of the Police Service, for example, when faced with an uncooperative individual who may be intoxicated or drugged or who may be vulnerable and a danger to themselves but is not cooperating with Ambulance Personnel. 

Response

A

The Ambulance service does not hold one overarching list of protocols, policies, procedures, and guidance which apply whenever they are assessing an individual’s condition following an emergency 999 call. Therefore Article 3 of the Freedom of Information (Jersey) Law 2011 applies. 

Protocols, policies, and procedures are not produced for every condition, injury, or illness that the ambulance teams deal with. Accordingly, it is not possible to provide a defined list. 

Instead, any assessment is guided by a range of factors, including: the presentation of the individual’s injuries; any wider incident picture; their training (whether initial training or in service training); and clinical guidelines, protocols, polices, procedures or clinical notices.

Depending on the nature of the incident being attended, there therefore may be no policies or procedures which apply, or multiple different policies and procedures may apply to a scenario. 

For example, a different list of policies and procedures can apply to a scenario involving: a mental health matter; than one about a physical injury, or one involving multiple injuries; or multiple individuals. 

Most of the clinical guidelines followed by paramedics and technicians are captured within the Joint Royal Colleges Ambulance Liaison Committee guidelines (JRCALC). These guidelines are currently held electronically and are licenced for use> It is therefore not possible to provide copies, however they are available to purchase through Class Professional Publishing at the following link. Article 23 of the Freedom of Information (Jersey) Law 2011 has therefore been applied.

Class Professional Publishing.co.uk ​

This database is produced by JRCALC for NHS ambulance services, on behalf of the Association of Ambulance Chief Executives and offer the latest, evidenced based, practice specific, guidelines for ambulance activities. 

Jersey Ambulance use JRCALC Plus, which allows it to request certain service specific changes where those are needed and agreed through our management and Medical Director.

Whilst Jersey Ambulance paramedics and technicians have online access to the guidelines, the guidelines or a list of the same are not held within the meaning of the Freedom of Information (Jersey) Law 2011 and so it is not possible to provide a list of them. Therefore Article 3 of the Freedom of Information (Jersey) Law 2011 applies.

The Service has the following Clinical Notices on the JRCALC App that are owned by the Service:

• Clinical Practice Update
• Mental Health Network Contacts
• Use of the Braun Thermoscan 6000 Tympanic Thermometer
• Use of Cirrus 2 Nebuliser
• SoJAS Clinical Awareness – National Patient Safety Alert regarding synthetic opioids.

B

As noted above, due to restrictions on the Government’s ability to provide a list of protocols found within JRCALC it is not possible to provide a complete list of protocol’s that may apply when deciding whether an individual should be transported to hospital. The scope of JRCALC specific guidance on a condition can offer red flag advice as well as safety netting advice if discharging into the community.

Health and Community Services hold certain policies which cover Ambulance Personnel. The following additional polices are held within the HCS intranet which might apply to this question:

• Acute Wound management for Ambulance Staff
• Resuscitation Policy and Guidance
• Consent to Care and Treatment March 2023
• Jersey Multi-agency Unified Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) 16 Years and Over Policy
• Planned Home Birth Guideline
• Safeguarding Children, Young People and Adults at Risk Policy June 2022 
• Policy for the Pre-Hospital Early Recognition & Management of Acute Sepsis.

C

Again, it is not just policy that is used to inform decisions in regard to contacting the Police. Staff receive training and there are judgements to be made based on training and guidance as well as any policies in place. The following policies are in place:

• Place of Safety Joint Protocol 
• Violence and Aggression at Work Policy

Articles applied 

Article 3 - Meaning of “information held by a public authority” 

For the purposes of this Law, information is held by a public authority if – 

(a)     it is held by the authority, otherwise than on behalf of another person; or 

(b)     it is held by another person on behalf of the authority. 

Article 23 - Information accessible to applicant by other means  

(1) Information is absolutely exempt information if it is reasonably available to the applicant, otherwise than under this Law, whether or not free of charge. 

(2) A scheduled public authority that refuses an application for information on this ground must make reasonable efforts to inform the applicant where the applicant may obtain the information. ​