Lincolnshire Integrated Voluntary Emergency Service

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Lincolnshire Integrated Voluntary Emergency Service is a registered charity[1] staffed by volunteers providing prehospital care services across Lincolnshire, UK. The Lincolnshire Integrated Voluntary Emergency Service (or LIVES) operates alongside the East Midlands Ambulance Service to provide clinical and critical care skills as well as immediate medical responses in the form of first responders. LIVES operates under the national prehospital care co-ordinating body BASICS (British Association for Immediate Care).

LIVES logo

LIVES is a registered provider of healthcare with the Care Quality Commission[2]

History[edit]

LIVES is one of the oldest prehospital care schemes in the United Kingdom.

During the 1970s two doctors in Lincolnshire, Dr Michael Cooper from Nettleham and Dr Richard Harper-Smith of Tetford, devised the LIVES concept. An open meeting was convened, attended by over one hundred local doctors enthused by the idea of the service. As a result of this meeting, LIVES was born. The Lincolnshire Integrated Voluntary Emergency Service. The original objective of the scheme was to provide expert emergency medical assistance for road traffic accident victims and other trauma cases throughout Lincolnshire. Originally LIVES had no funds and joining doctors bought their own equipment. In the following years several companies and institutes gave money which was spent on establishing a radio-communication system to improve the efficiency of callout. A mixture of telephones and two way radios were introduced with transmitters at Nettleham and Fulletby.

In 1974 Dr Mike Cooper became ill and resigned from the Chair whilst Dr Richard Harper-Smith took over, the position confirmed at the 1975 AGM. Dr Mike Cooper died in 1976.

In 1980 further transmitters were installed at Barton, Boston and Sleaford employing 3 part-time operators. Communications remained limited and additional transmitters were provided by charitable contribution to a total of seven. Each transmitter was then connected to the control room at the County Hospital by landline. These alone cost £10,000 a year in rental.

During the 1990s Lincoln County Hospital declared that as a result of a modernisation programme it was not possible to continue letting LIVES have a room at the Accident and Emergency Department. The radio system became obsolete and expensive to run. An invitation from the Lincolnshire Ambulance Service to base LIVES Control within the ambulance control centre was accepted and LIVES control was moved to the ambulance headquarters at Bracebridge Heath. This move greatly improved the efficiency of LIVES callout and still operates to this day as part of the computerised automatic dispatch (CAD) system.

In 1999 the Chief Executive of the Ambulance Trust invited LIVES to establish a First Responder Service for suspected heart attack victims. It was envisaged that this would enable an equality of service to be extended across the rural areas within the County. LIVES saw this as an extension of their existing service and readily agreed to participate. This then became the LIVES "First Responder Scheme".[3]

In 2008 Dr Harper-Smith received an MBE for his work with LIVES.[4]

Current[edit]

LIVES headquarters is situated within a dedicated office unit at Birch Court, within the Boston road industrial unit in Horncastle, Lincolnshire. Administration is undertaken by dedicated staff who are responsible for the 98 First Responder groups. In addition to this they provide administrative and logistical support for the 75 medical personnel involved with the charity.

The Horncastle War Memorial Centre, the headquarters for LIVES
The old LIVES headquarters at the War Memorial Centre

Clinical director Dr Yvonne Owen heads the management team.

LIVES responders attend approximately 1,000 incidents a month, totalling in the region of 12,000 incidents per annum. LIVES medical staff attend on average 100 of the most serious incidents each month.

LIVES is registered with the Care Quality Commission.

Volunteers[edit]

Doctors

LIVES doctor volunteers are tasked to respond to the most serious of incidents throughout the county. LIVES doctors bring specific critical care skills to the prehospital environment, enhancing current roadside care. LIVES doctors employ specialist airway management as well as surgical skills and are able to utilise specialist drugs and resuscitation techniques. LIVES doctors come from a variety of backgrounds but are typically from general practice or specialise in critical care areas. Current LIVES doctors hold, whilst new recruits are encouraged to work towards, the coveted Diploma in Immediate Medical Care (Royal College of Surgeons of Edinburgh).

Typical of the prehospital equipment carried by LIVES doctors, including advanced life support equipment, life saving drugs and monitoring
Typical of the medical equipment carried by LIVES doctors, 2010

Registered Paramedics

LIVES paramedics are drawn from operational front line positions throughout the ambulance service and volunteer in their spare time. They are typically activated to provide a response within their home locality to incidents specifically requiring paramedic skills.

Registered Nurses

As well as holding specialist critical care and advanced life support skills in their own environments, LIVES nurses are expected to hold the Prehospital Emergency Care Certificate (Royal College of Surgeons of Edinburgh).

First responders

Form a large proportion of the immediate emergency response. First reponders undertake accredited courses at the LIVES headquarters before going operational. Once operational and on duty they can be activated to incidents by ambulance control within a defined area, providing valuable emergency cover in otherwise hard to reach areas. There are currently three levels of trained first responder:

  • Level 2 Utilising basic life support skills with airway adjuncts, oxygen use and fully automated defibrillators.
  • Level 3 Further training in paediatric care. Activated to a wider scope of incidents.
  • Level 4 Specific on scene safety training. Use of entonox and other medications for immediate care.

Operational impact[edit]

The 2004 ScHARR report[5] undertaken by the University of Sheffield Medical Research Unit investigated the utility of the service:

  • LIVES activity is increasing over time as the number of schemes also continues to increase. Up to 25% of ambulance service category A calls now receive a LIVES response and for 80% of these calls the LIVES response arrives first on scene
  • LIVES improves response time performance by 35% in the rural areas where they provide a service thus contributing to the provision of an equitable service for life-threatening category A calls
  • The return to spontaneous circulation rate of patients in cardiac arrest is 20% for cases attended by LIVES and receiving defibrillation. Response times to these cases are considerably shorter than the first ambulance service response
  • Users of the ambulance service who receive a LIVES response show a high level of satisfaction with the LIVES service

The NHS Improvement network recognises the significant contributions made by LIVES volunteers:[6]

"This has been an innovative way of using locally available resources, at minimal cost, to improve patient outcomes for life threatening conditions in an environment where continued annual increases in demand for emergency ambulance services produce further pressure on already stretched resources"

A 2011 independent review by the University of Sheffield speaks highly of the service:[7]

LIVES training[edit]

LIVES training is the external training arm of the LIVES charity. LIVES training offers a number of FAW and prehospital care courses. LIVES training is both HSE Approved (58/03)[8] and IHCD (5231) registered.[9]

Educational Commitment[edit]

LIVES personnel have a strong educational commitment and ethos. In addition to regular meetings and sessions, LIVES personnel are involved in multiple educational activities, including the promotion of prehospital care amongst medical and nursing students. LIVES doctors and nurses have delivered lectures and presentations to local universities and at national conferences.

A number of LIVES personnel hold instructor status with BASICS and teach on nationally recognised and accredited BASICS courses.

LIVES has amongst its volunteers the BASICS educational facilitator as well as members of the BASICS educational board.

References[edit]

  1. ^ "Lincolnshire Integrated Voluntary Emergency Service (LIVES)". The Charity Commission(UK) Registered Charity 1098364. 
  2. ^ "Entry for Lincolnshire Integrated Voluntary Service". Care Quality Commission. 
  3. ^ "LIVES Website". The Lincolnshire Integrated Voluntary Emergency Service. 
  4. ^ "Queens Birthday Honours List". London: The Independent newspaper. 2008-06-13. Retrieved 2010-05-07. 
  5. ^ "Evaluation of the clinical and Ambulance Service operational impact of the Lincolnshire Integrated Voluntary Emergency Service (LIVES)" (PDF). University of Sheffield School of Medical Research. Retrieved 2009-12-20. 
  6. ^ "Saving LIVES in Lincolnshire". The NHS Improvement Network. 
  7. ^ "A review of emergency medical responses in Lincolnshire". The University of Sheffield. 
  8. ^ "HSE Website". Health and Safety Executive. 
  9. ^ "LIVES training". Lincolnshire Integrated Voluntary Emergency Service. 

External links[edit]