We chose the picture above to be the banner for the Control page as it not only shows the highly capable and caring Sid Farmer who was an absolute joy to work with in both operations and the control room; but it shows a concentration and focus that is applied by the dispatch team when they live out each and every response always looking out for the patient and the responding crews.
This section will tell the story of how the world of modern dispatch has come into being. It will chart the development of the control room from the first electric wire, the introduction of the 999 system, the revolution enabled by radio, control room conveyor belts, the first computer aided dispatch systems right through to the modern systems we take for granted today.
Importantly, it will focus on its people and how things have changed. It will recall days before pre-arrival advice was ever offered and recognise that the control team are an integral part of the ambulance family and its history.
The advent of the public telephone 999 system in 1936 started to improve how emergency services could be called.
However; it is hard to imagine how an Ambulance Service was controlled in a world with few telephones and no mobile radios in ambulance vehicles. Once the initial ambulance was dispatched there were no easy way to pass or receive a first report if other assistance was required, standby messages alerting hospitals of serious illness or injury were none existent and valuable minutes in preparing the receiving medical teams were lost.
Crews would be required to contact the control room once they were at hospital to update the control on progress and the much awaited “clear” status. If there was an outstanding call the crews would be passed the call; if not they would be asked to return to base and in essence they would be uncontactable until they got back on station. In fact prior to the implementation of mobile radio systems in the 1950’s crews could easily be driving past serious calls totally oblivious to the poor patients plight.
Quirky local “arrangements” were in place and a nice example of this was when Liverpool crews cleared at Walton Hospital, during shop opening times, they were asked to return via County Road, Walton on their way back to Lower Breck Road or Westminster Road Ambulance Stations. If a call came in when they were on the way back the Control Room would telephone a local butcher who would hang a signal out on his butchers statue indicating for the crew to stop and speak to the Control for details of the call. What this is also a reminder of is the great community spirit that was thriving after the war.
City of Liverpool Control Room - Mid 1960's
“As a young cadet in 1979 I vividly recall walking into the Lower Breck Control for the first time. There was a “space age wow” when you were introduced to the private world of the Ambulance Control.
It still seems like yesterday and we now look back at it with a slight giggle and think how did they do that job with very little technology. There were no computers; call details were meticulously handwritten, then placed on a slow conveyor belt seemingly oblivious to the chain of survival clock. Radio systems were affected by weather conditions and known blackspots, the most important part of the equipment was a working pen to write the incident on the paragon machine, there was no automatic telephone number or address recognition (you had to be able to spell Phythian Street). Voice recorders did not exist which to the more experienced ambulance officer was sometimes seen as a blessing. The telephone automatic call distribution system was a caring Ambulance Officer by the name of Jimmy Corness who used to run out and shout “answer those lights”.
However; it was the first Control Room to centralise local Control Services and it was absolutely considered “Space age technology”. It was held as a beacon of best practise across not just the United Kingdom but throughout Europe. I recall there was a great team atmosphere around it and it oozed wanting to care for the patients who needed the Ambulance Service.
The mobile phone was not even dreamt of and calls were received from red public payphones and party lines and sadly no structured pre-arrival survival advice was offered to callers.
However; despite the lack of technology, the Ambulance Control Team in 1979 were highly professional in their roles and displayed the qualities that we all expect of an Ambulance Service. These infectious qualities included; the caring nature of ambulance staff; the wanting to help people who are ill or injured; an absolute dedication to duty; the ability to manage crisis; a pride in what we do; discipline; leadership: teamwork; the skilled art of banter; the striving to improve and last but not least having the ability to believe in patient care and always bring it back to that”.
Conveyor Belts were the pre-runner of what is know known as horizontal dispatch on Comuter Aided Dispatch Systems
Mersey Metropolitan Control Room - Lower Breck Road Opened in 1976
“Stay on the line and I will tell you exactly what to do to help the patient”
The famous phrase associated with the Medical Priority Dispatch System developed in the USA by the fantastic Dr Jeff Clawson. Mersey Regional Ambulance Service was the first Regional Service to implement the system in 1996. The pioneering instructor was Ray Lunt who undertook a massive training programme to train all of the Control Team as Qualified Emergency Medical Dispatchers.
One of the first trained was an EMD by the name of Sarah Tasker who within days of qualifying as an EMD took that dreaded 999 call of a baby that had drowned in the pond. Sarah calmly followed protocol and uttered the words for the first tine in Merseyside "Stay on the line and I will tell you how to help your baby" and then followed a text book protocol driven resuscitation accompanied with a rapid paramedic response of Pete Ditcham. Pete took over the resuscitation and evacuated the baby to Leighton Hospital. Thankfully after a long resuscitation effort a return to spontaneous circulation was achieved and the baby survived with no neurological deficit.
From that day on it became unthinkable that such cases would not receive such dispatch life support. Any members of the Control team who were reluctant to change never faltered once that lived the tape recording of that call.
The photo above was taken in 1997 and is significant in that this is now the developing world of Emergency Medical Dispatch in which we see a team proudly wearing the qualification of Emergency Medical Dispatcher having qualified with the International Academy of Emergency Medical Dispatch. To the trained eye you will see AMPDS card sets on the desks which means that the CAD system is supporting the use of ProQA which is the integrated software to aid prioritisation of calls. Importantly, this is the dawn of the age when it is no longer acceptable not to provide survival instructions prior to the arrival of responding units and the norm of promoting and providing CPR instructions within seconds of the 999 call being made started to increase cardiac arrest survivability.