Dr Peter Holden
Role: GP, pre-hospital emergency doctor and GPC negotiator
Locations: Practice in Matlock, Derbyshire, emergency work in East Anglia and the East Midlands, and GPC work in London
Hours worked per week: 70
In an average week, I spend three days at my practice and two days working for the GPC. On the days I work a shift for the air ambulance team, an earlystart is required. I put on my flying kit in the dark before driving the 100 miles to Huntingdon from my home. I first developed an interest in pre-hospital emergency medicine in the 1980s when I noticed a lack of expertise in the field. After a long campaign, the GMC recognised it as a subspecialty in 2012.
At RAF Wyton, my paramedic and I conduct the checks on our rapid response car. I load it with a defibrillator, two trauma bags, a ventilator bag and oxygen, and put a duplicate set into the helicopter. Then I pre-draw anaesthetic drugs and put them in my pocket.
The mobile phones are on and handheld radios are functioning, so I inform Control that ‘Medic 250’ is now available by land. From now until the end of the shift we are ready to leave instantly.
The helicopter crew arrives. There is a team briefing between me, the paramedic, the air observer and the pilot. We review the weather forecast and any issues concerning the aircraft, crew or local airspace. We go through an aircraft emergency drill, then declare ‘Helimed 66’ available by air or land. From now until we clock off, we have to be able to get airborne within two minutes of a call.
The paramedic and I run through a simulation of an emergency scenario on a training mannequin. Then it’s the day’s scheduled task – today we check the trauma bag, confirming that every item is functional and in date. Other days, we may wash the car or helicopter. Whatever the work, it’s much more fun than preparing for a CQC inspection. On some shifts we have done a job by 10am, but sometimes we do nothing all day.
The phone rings. There are two people trapped in a car after crashing into one of the deep ditches that run alongside local roads. It’s more than 15 minutes’ drive so we fly. I take the details while the pilot cranks up the aircraft.
Our head-injured semi-comatose patient crashed his car 70 miles from the nearest neurosurgeon, but within half an hour he is anaesthetised for airway and neuroprotection, and within an hour and 45 minutes he is at Addenbrooke’s. This kind of work is a high point of my month. I’m privileged to be making a difference at the most critical time of a patient’s life alongside the finest colleagues.
The helicopter lifts off from the hospital. Just two minutes into the nine-minute flight back to RAF Wyton, we get another call. We only have one trauma bag, but there is only one casualty, so we accept.
We take the patient to Addenbrooke’s, but we’re out of kit so can’t do any more jobs. Back at RAF Wyton the late-shift team is waiting. We hand over radios, pagers and keys, exchange the usual banter, and they sportingly agree to sort out the trashed kit bags for us.
I finish the paperwork and set off for home, not bothering to change clothes. I stop for supper at a service station.
On the second leg of the journey, I see red lights, white lights, then red lights again on my side of the dual carriageway. I turn on my blue lights and the idiot tailgating me drops back rapidly. Some 300 metres down the road, I find a lorry in the middle of an illegal U-turn, stuck, with a van smashed into its unlit side.
I sedate and extricate the van driver, then hand over to a GP from the East Midlands Immediate Care Scheme, who escorts him to hospital in Peterborough. I’m not in surgery tomorrow – I need to work on the dispensing paper for the GPC that I didn’t get done today. I arrive home at 11.30pm.