Your comments about the ambulance service not being able to respond to "incidents off the road" are incorrect and misleading. Ambulance HART teams have off road capabilities and have responded successfully to many casualties in scenarios as described above. To state that a call to the police is more advised than a call to the Ambulance service is at best negligent. The ambulance service have an excellent working relationship with mountain rescue and Fire and rescue service line rescue teams, and are in a better position to deploy the necessary rescue personnel. I would advise you to do your research more thoroughly in future before you commit to print your misinformed information.

This sort of information should surely be processed at the 999 Joint Control Centre or by the Ambulance Service. If the Ambulance Service are informed that a casualty is located on say Ben Macdui, they are not going to dispatch an ambulance to that location, and would ensure that the caller is referred to the Police via the 999 Control Centre.

Keith, you may well be correct in your area but it has always been accepted practice in mountain accident situations where Mountain Rescue is required to dial 999 and ask for the police who will deploy the appropriate resources.

If you ask for the Ambulance service they will deploy a road ambulance first and only once their personnel are on site and they need more help will MR be requested. This can often mean a delay long delay in effective treatment being given to the casualty. If the casualty is some distance from a road the ambulance crew don't even have suitable footwear or clothing to get there in rough terrain or bad weather.

Also, it takes eight people to carry a stretcher over rough ground and MR are often required to assist even with air ambulance rescues.

The advice to call the police is sound.

Oh cobblers. What a badly researched story. I agree ambulance services do not have the same capabilities as mountain rescue teams for patient recovery from a mountain side, but you will be hard pressed to find an ambulance clinical who does not venture away from “a public road” when needed. It’s all about team work. If you are injured in the mountains, a call to either the Police or Ambulance via 999 will ultimatly result in the same rescue response.

Agree with Lakeland Paramedic. If there have been delays
it is only because the control room operator didn't do their job properly and immediately inform the correct ES.
It should not matter which 999 service one calls.

Keith, have you ever worked or encountered a HART team? Mark Leyland is absolutely correct, whilst paramedics are, on the whole, outstandingly good at their job, most will not be equipped or capable of travelling off road for any distance away from the vehicle whilst loaded with all the kit they may need plus navigating an upland area especially at night. HART teams may well have off road capabilities but the do not have the search expertise, local knowledge, technical knowledge, fitness levels, stamina or experience anywhere near that of a trained MR team, they do have their place but trudging across the UK's upland areas are not it.

HART teams are not primarily designed for mountain rescue work, and have far longer mobilisation times. To task them to MR work is wrong, especially as it leaves their core areas unmanned. The legal responsibility of the police for mountain rescue is quite clear. Same goes for people asking for ambulances for beaches, not coastguard - it just builds in time, doglegs, and often prolongs extraction times.

A couple of years ago we came across a walker with a bad ankle injury on moorland near the Cat and Fiddle. Luckily we were only 100 metres from a layby on the main road and were able to carry her there. In the meantime a call was made to 999 and a request for an ambulance was mad as the casualty was on a main road. The controller who dealt with the call wanted a POST CODE despite explanations that we were on an isolated layby on a main road with no nearby buildings. Even after giving a map reference and explaining the location with respect to a nearby juntion with another main road, they continued to demand a Post Code.
Eventually after many minutes were wasted, they agreed to send an ambulance ot our location.

Mark. I am a HART team member.

Mark

I agree with you on some points but the fact that you say HART Teams do not have the fitness levels, technical knowledge or stamina of an MRT then you are talking rubbish. You are obviously biased or have no idea of HART duties and training. I work with both and as many MRT are largely unregulated in minimum fitness levels and set their own training levels, I have worked with many obese members from MRTs. Now they dont always go on the hill but it does disprove your ridiculous point. HART teams have minimum entry requirements and constant CPD a lot higher than that of an MRT. RAF MRT would be the exception to this.

Im not saying that HART should be preferred to MRT or vice versa but I think that people on this post need to calm down stop puffing up their chest and realise that we are all here to get the same result!!

Kieth good job.

Keith (and everyone else who wants to bicker), I think that you will find that in the UK, the police have primacy over such incidents involving rescues. They will then devolve responsibility to the most appropriate service. For such incidents in the mountains, that will usually involve the ARCC. That is why phoning the police is the correct course of action. One would hope thought, that the ambulance service would alert the police for a co-ordinated response. Whilst HART can respond to a number of different incidents, this type is not what HART is about. Best left to those who train regularly in those environments.

Graham, agree with your final paragraph. Such a nonsensical argument.

Let's all get along, and speaking from previous experience as an MRT, (RAF and Civilian) member. It usually works well.

Firstly this piece contains very sound advice, regardless of what the HART team members or paramedics say.

I've seen this exact issue time and time again. Of course it doesn't always work this way, but it does often enough to make it a problem.

You call 999 and ask for an ambulance. The normal two person crew or a fast response car is is dispatched to the rural location and they do a great job of reaching the casualty, often at some risk to themselves as they are usually not clothed or equipped for the conditions. These guys and gals are superb, they go out on a limb to reach and treat the casualty.

However, it is often only then realised that they can't evacuate the casualty and extra resources are needed.

At this point the Police get involved and call on more resources, like MR, SAR Helicopters or Air Ambulance. Note I cannot recall EVER hearing of a HART team deployed into hills for this - I am sure it must have happened, but if so no news has reached me.

All this is avoided if the person who calls 999 asks for Police first. They will then get a response from a variety of resources as appropriate, which will include an Ambulance paramedic crew and maybe a Mountain Rescue or Lowland Rescue team.

If you are interested in what HART teams are for (Keith I know you are a member of one) then see the definition here
http://en.wikipedia.org/wiki/Hazardous_Area_Response_Team

NWAS description here
http://www.nwas.nhs.uk/our-services/managing-major-incidents/hazardous-area-response-team-(hart)/
One very small mention of Mountain/Cave rescue. Which I have never seen in action.

Both of these descriptions explain why HART came about and what their function is.

I agree this is an initial ambulance control tasking problem, but until that can be fixed the only answer is to go to the Police first as they have primacy on Land Search and Rescue.

I don't often do this, but I will have to sign as Anon as I am too close to this to risk identification.

This thread has become the most childish bickering. MRT are clearly the experts in this area. The problem surely lies with dispatch. HART have some very highly trained (very keen) individuals, but come on reall? Mountain rescue? Another ridiculous attempt to justify your role. (PS my Dad's bigger than your Dad)

Keith, Well done, and as I said the paramedics I have come across do an excellent job. But as a HART team member, unless you're carrying different kit to the HART vehicles I've seen then you have no chance of effecting a rescue on the hill in poor conditions. A short stretcher carry off as far as I'm aware needs a minimum of six people, a long one, many more. That's after any technical rope work has been put in place and de rigged and that's after whoever is being rescued has been located, which may take many hours.

Graham, I based my comments on what I've seen, yes there are members of rescue teams that carry a bit extra, but its doubtful you will see them very far out. MR teams are well aware of their skills and where best to put them, and do it extremely well. A mountainside or an upland bog is no place for a HART, its as simple as that.

This isn't about puffing up chests its about letting those with the knowledge and experience do what they do, and have been doing for many years.

Good morning
I came across this "discussion" by accident whilst researching other material and felt the need to add two rather saliet points.
As a lifelong outdoor pursuits enthusiast and member of MRT both RAF and civilian my understanding is that HART teams were introduced to opertate along side other emergency service in order to bring thier medical skills to casualties faster. For example accompanying Fire and Rescue crews into a "hot zone" or cave rescue going underground. I imagine this would work well but only in cooperation with other experts whose resposibilty would be the HART teams safety whilst in transit. Why would this not be the case during fell or mountain rescues?Assuming of course the HART teams level of equipment and fitness levels are sufficient.
My second point concerns availability. To achieve the above would require HART teams be available as widely as MRTeams which I am guessing would be totally cost prohibative. What we need is cooperation and coordination of all our "emergency" services to enable "teams" to effectivly operate in wild country.

After 30 years in the Rescue world . I would say that the general premise of the article is correct . I.e. in most mountainous regions of the UK, asking for Mountain Rescue rather than the Ambulance service leads to a quicker and more effective rescue . There is lots of evidence to corroborate this .
To state that calling the Police/ MRT rather than the Ambulance is "negligent" is frankly rather silly and shows a limited knowledge of the subject.

As has been said chest puffing does nobody any good .

It would also be well to remember that not all MRT's are equal and nor are HART's .

What we do need to do is respect each other and use the skills and capabilities of all to effect the best result for the casualty.

All I will add is that I am both a Paramedic from a very rural part of the UK, and work regularly providing clinical advice in the control room of one of the UK's largest ambulance services.

This article is written by a misinformed and naive contributor.

When the call for assistance reaches the EOC, we plot the address... if it is anywhere that we feel an ambulance cant reach (and bear in mind that we mobilise more than a million each year, so we know fairly well where they can and cant get to), we will immediately alert the police and MRT. This often happens before the caller has even hung up.

Experienced Para ,
Unfortunately what you describe does not happen consistently across the UK and in some areas never .
It would be great if it did but does not .

I doubt if the person who wrote the article is misinformed or naïve , just dealing with the reality of their area.

Myself and colleagues regularly have to call for help with incidents on our remote area.

There is still a lot of confusion as to the best service to call for help.

I tend to call police for mountain rescue, and coastguard for medical issues (as there is a sea-journey involved and they can mobilise a lifeboat or helicopter). The twice I asked for ambulance it caused a lot of confusion and delay, with very little information being relayed back to me as to how help was arriving (helicopter or lifeboat - this information was necessary so we could meet crews and transport them to the patient).

It would be really useful if the services could get together and produce a guide for people so they knew the best number to call when in remote areas. I am leaning towards calling police for any incident here.

999 what's your emergency?

I'm up a fecking mountain, I've cocked up. Please send someone to get me off. I don't care who as long as they are quick.

Job done

As both an ex MRT member and ex NHS ambulance service who now runs a medical services company I would like to say the following.

MRT - Mountain Rescue

HART - Hazardous Area response Team

Coastguard - Like Ronseal does what it says on the tin.

On several occasions I have had to call 999 for incidents but in the mountains and in rural and urban areas.

When I have called 999 in the mountains asked for either police or mountain rescue (for other walkers not myself) I have given basic information and OS grid and the call has lasted no more than 2 - 3 minutes. Conversely when I have called for ambulance back up at events or RTC's and, as stated in a previous comment, I didn't have a postcode because a road junction isn't a house or building, it has taken 5/6 minutes to get a location and then even after being told that clinicians (either Tech or Para) are on scene the call has still taken over 10 minutes to complete.

It is all about using the resources correctly and unfortunately those that aren't as long in the tooth as some can only follow a computer screen and as such are unable to think outside the box and shortcircuit the computer to get the correct responses deployed in the minimum amount of time.

Yea cause ambulance are really equipped for the mountains in their green jump suit and biker boots. Then they wouldn't go to far incase they missed a meal break.

i am very much an urban paramedic. i have a fair bit of mr experience and am still a fairly keen winter mountaineer. the coordination of rescues in upland areas in the uk is a slick, professional system co ordinated by arcc kinloss at the request of the police. they have proven systems to rapidly mobilise helos and or mrts in the immediate locality. in the interests of rapid mobilisations, leap frogging ambulance control makes perfect sense. if i,n honest i was a member of a scottish mrt for a good many years primarily as it was a chance to use hard learned mountaineering skills which neither your average paramedic ambulance or hart operative has. its a no brainer.

hi guys -sorry to invade this weird argument.. and sorry if i missed it..but...

thankfully, i have not need any of these emergencies services in the past (touch wood for the future) but exactly what is the correct information to give following the 999 call ?

OS map number and grif ref ?
postocde ?
trace my phone via GCHQ ?

thanks
G

I can assure you that whilst technically correct ambulance control is perfectly capable of requesting mountain rescue and most certainly would not wait for an ambulance crew request

F:#k it just send in the fire service!!

I can give at least four examples in Scotland where Police have created delay in mobilising MRT or SAS SORT (HART) have deployed at the same time as MRT and SORT have actually got the casualty off the hill and left the scen before MR have arrived.

The UK SAR document was written without the input of SAS and is currently being reviewed because of this.

Bottom line is MR are experts in this type of scenario but mobilisation of SAS and MR should be concurrent with each other to benefit patient care - SAS are pre-hospital professionals with the majority of MR as pre-hospital volunteers. Start working together and stop this crap about its my ball you not getting to kick it.

PS - not the best researched or balanced article either.

You'd mobilise the SAS!!!

I've only twisted my ankle on Catbells, not invaded the Lake District with an invading army.