1 Job Title Accountability Job Description Hazardous Area Response Team Operative HART Team Leader A4C Band Current Band 5 Plus Unsocial Hours Allowance Date August 2011 Core Responsibilities: To attend and respond to operational and potentially critical incidents including Major Incidents, incidents of a CBRN nature, structural collapse, confined space rescue, major transportation incidents, incidents requiring working at height, trench collapse and rescue, incidents involving complex entrapment. Provide immediate health input to the initial assessment of the scene to meet the needs of Ambulance and Health Services, including casualty confirmation and management. Receive incident briefings from the Ambulance Incident Commander in the absence of the HART T/L on assigned roles and instructions for managing the incident, following the deployment plan where appropriate. To provide specialist clinical support and knowledge within HAZMAT/CBRN and USAR situations. Provide immediate health input to the initial assessment of the incident to meet the needs of Ambulance and other Emergency Services. Key Result Areas: 1. Operational To provide specialist clinical support and knowledge within HAZMAT/CBRN and USAR, T66 situation, and inland water operations. Be responsible for activating as the initial Trust response to an airport alert Be responsible for activating as the Trust initial response to a T66 incident or to any lethal weapon incident where specialist training and equipment would be required to deploy safely. Be the Trust initial response to any inland water rescue requirement, wearing appropriate PPE and following specialist guidelines and legislation. To be able to deploy to any HART related operational incident and provide health input wearing appropriate specialist PPE. Supervise in the absence of the T/L, direct, coordinate and deliver life saving clinical care for patients within the inner cordon including triage (where appropriate, toxic triage), diagnosis, appropriate treatment, prior to, and during, decontamination (if contamination present) and in situations of difficult access in USAR incidents, at times being the only clinician in situ and deliver casualties into mainstream healthcare. Take on the role of Bronze Commander until relieved by T/L or a appropriate on call officer.
2 Operate specialist equipment e.g. mass oxygen delivery system, BA, PRPS, CR1, DIM and winching equipment, Safe Working at Height (SWAH) equipment and make appropriate use, based on dynamic risk assessment, of levels of PPE required. Deploy specialist vehicles and equipment as determined by the nature and type of incident. This could involve Command and Control, Prime Mover, Polaris and 4x4 vehicles. These vehicles all require specialist training to deploy safely and effectively. Collaborate with partners operating alongside the HART Team specialist and liaise with specialist agencies e.g. HPA, Fire & Rescue Service USAR, Police firearms teams to gather relevant information on scene. Estimate resources required and deliver Situation Reports to Control/Contact centre required. Access relevant databases (e.g. TOXBASE, CHEMNET, (HPA) etc.) to research and communicate to others (and wider health) regarding the symptoms, treatment, and decontamination procedures for an incident. Provide clinical support and backup to multi-agency service personnel working in the inner cordon by deploying wearing the required levels of PPE. Set up and contribute to Command & Control in the inner cordon / Hot/Warm/Cold Zones supervising the deployment of resources, casualty management and evacuation Undertake Hazard Identification monitor local environment safety e.g. weather & climate conditions, gas levels and wind direction, liaising with other available expertise to consolidate decision making Responsible for highlighting own potential training needs to better develop the role in the future. In the event of providing mutual aid in responding to a National incident, be away from home for unknown periods of time, up to 30 days. Working within the Team, ensure the readiness of PPE, clinical and operational equipment and vehicles is maintained, and routine care and maintenance is carried out to ensure a high state of preparedness. Apply the principles and practice of Dynamic Operational Risk Assessment to ensure that plans and actions are regularly updated according to the needs of the current situation, dynamic risk assessment Doc completed. To undertake any other duties associated with the role as directed by the HART T/L, Manager/Ambulance or Incident Commander. Communications: Promote HART awareness to other Ambulance staff within the Trust and among local Fire Services and T&W USAR Team, Police services and regional Firearms Teams. Comply with the required instructions, procedures and processes of the Team, and the Trust to maintain effective two-way communication. If required, represent the Trust and emergency services in public arenas and promote its image as a professional and competent service. Develop and maintain good working relationships with other emergency services, NHS Trusts and public/private and voluntary sector agencies, HPA, coastguard, RNLI, Mountain Rescue. HART personnel would communicate with: All levels of management within the Trust - Other Emergency Services including Fire and Rescue USAR Teams, Firearms teams, Police Silver and bronze command, military personnel either during or post incident.
3 Purpose of the communication could be: on scene management of an incident - giving an updates to team members or teams from other emergency services on the situation on the ground. Participate in a hot debrief post incident and a more detailed debrief at a later time. Breaking bad news. Attending court to give evidence. Personal and People Development. Personal development could be maintained by keeping up to date with changes in working practices and researching updates from JRCALC guidelines. Attend Stat. Man training as required by the trust. Attend HART recertification as required by national guidelines i.e. BA recertification, SWAH and Confined Space Working Recertification. IRU recertification, as per HART continuity Doc. Attend Guardian Exercises in the role team member or Bronze Commander as delegated by officer in charge. Attend training with other emergency services on a regular basis to help maintain skills and a close working relationship with other multi agency personnel. Enabling others to develop might include: Advice and guidance to other operational personnel. Acting as a role model to others Health Safety and Security The Operative is responsible for ensuring the H&S of all staff with H&S legislation, Trust Policies and Procedures and HART SOPS. The post holder is responsible for ensuring that all staff comply with the regulations that governs HART team working. This would include: Safe working at heights regulation, Confined space working regulation and Swift water rescue regulations as examples. The types of incident that HART staff would be responded to would include: Collapsed or unstable building or structure from either accidental or deliberate cause eg. Explosion, structural failure Patient trapped in a confined space or location with difficult access, such as: Storage tanks, vats and silos Reaction vessels, open topped chambers Subterranean environments tunnel, sewer, utility tunnels, crawl spaces, manholes, enclosed drains Combustion chambers in furnaces Ductwork
4 Unventilated or poorly ventilated rooms Large transport vehicle accidents, i.e. Railway, aircraft Caves Industrial plant or machinery Where Safe Working at Height regulations apply, such as: Side / top of buildings, scaffolding Cranes Steep ground / slopes / angles cliffs, embankments Lift shafts Industrial plant or machinery Access platforms / walkways Any situation in which rope and associated equipment is/should be used to prevent falls Any incident where patient entrapment might result in crush syndrome When requested by Fire Service Urban Search and Rescue Team When requested by Fire Service Line / Rope Access Team At the request of an Ambulance crew where it is thought that the skills, knowledge and equipment of the USAR Paramedic will assist the crew in providing care to any patient Requests from other UK Ambulance Trusts for mutual aid At the request of the Ambulance Incident Officer where it is thought that the skills, knowledge and equipment of the USAR Paramedic are appropriate to the needs of the incident Any incident where an explosion, of either terrorist or non terrorist origin, has occurred or is believed to have occurred The post holder is responsible for ensuring that all staff wear the appropriate level of PPE dependant on a dynamic risk assessment being carried out. This could range from standard fire ground kit to full BA and gastight suits. Any none compliance should be reported to HART T/L. The post holder is responsible for having safe systems of work in place along with adequate control measures to mitigate risk as far as possible. They must monitor the changing environment and take suitable measures as far as practicable to mitigate risk. Any none compliance should be reported to HART T/L. All staff are accountable to the designated H&S Officer on scene and to the H&S executive.
5 In an emergency the post holder is responsible for the evacuation of staff from unsafe or unstable structures if it is felt that the safety of staff becomes compromised. The post holder has a responsibility for alerting all team members if there are any changes to plans or arranged RVP when the team are responding to a firearms or other significant event where staff safety is could be compromised. The post holder is responsible for giving tactical advice to the Ambulance Incident Officer on the incident and the H&S issues of deploying teams into potentially dangerous environments or hot zone working within the incident ground. Quality The post holder is responsible for ensuring that all staff adheres to the Trust Policies and procedures. They are responsible for ensuring HART SOPs are followed and report any none compliance to HART T/L. Working as an effective and responsible team member maintaining the quality of own work and that of the team. Assist and give advice to trainee members of staff on how to maintain the quality of their work and that of the team. Assessment and Treatment Planning To autonomously assess and diagnose within the skills of the post, individual patient needs to ascertain how to treat in accordance with Joint Royal Colleges Ambulance Service Liaison Committee (JRCALC) guidance, Health Profession Council (HPC) and local Ambulance Service critical procedures. This will include the triage of patients in order to prioritise individual needs. This could be within hot zone working and may involve toxic triage, triage sieve and triage sort. Interventions and Treatments Plan, deliver and evaluate interventions and/or treatments when there are complex issues and/or serious illness. Critical decisions need to adapt to a changing environment and exposure to chemicals. Interventions and treatments may relate to physiological and/or psychological functioning and might include: - advice, explanation and reassurance to patients, relatives and other emergency staff. - Application of procedures unaided i.e. within a USAR/HAZMAT environment, using nightingale dressings, blast bandages, celox gauze or cat tourniquets or multi patient oxygen delivery systems as necessary. - Responsible for advanced life support within an IRU/ USAR or T66 environment. This could be as part of post toxic triage at a CCP set up by the HART team. - Current ROLE and Traumatic Cardiac Arrest guidelines set by JRCALC (2006) may not be applicable in a USAR environment due to time, space and safety considerations. "If in the JUDGEMENT of the USAR Paramedic it is appropriate to adhere to the JRCALC guidelines to recognise life extinct then compliance is advocated" managed.
6 The HART Operative can be, as a practitioner, responsible for the care of patients who may have been extricated from prolonged entrapment with crush syndrome or multiple injuries. - carry out manual treatments i.e. airway management, chest decompression of entrapped patients. - The administration of medications, fluid or analgesia. - The ongoing monitoring of the patient and the environment especially in low oxygen or noxious environments. Take appropriate action when required without seeking permission or advice. - Restoration of circulation within a CRBN/ HAZMAT /USAR or T66 environment - supporting and supplementing body functioning within the inner cordon or other hazardous environment. Other Duties The above is only an outline of the tasks, responsibilities and outcomes required of the role. The post holder will carry out any other duties as may reasonably be required by their line manager. Confidentiality The post holder will be expected to maintain the complete confidentiality of all material and information to which they have access and process. Equality and Diversity Ensure compliance with equality and diversity legislation and display active commitment to the need to ensure equality of opportunity and the benefits of diversity. When in contact with colleagues, patients, visitors, volunteers, contractors and people from other organisations, ensure that they are treated with respect and consideration and their dignity is maintained Infection Control It is your responsibility to adhere to infection control policies in order to promote cleanliness and reduce infections. Hand hygiene must be undertaken correctly to prevent the spread of infection. Personal protective equipment must be used in accordance with NEAS policy. You must contribute to the cleanliness of the work environment and keep it clutter free and tidy. You must also attend all mandatory training and updates to ensure you receive training appropriate to your role. Data Protection The post holder must, if required to do so, process records or information in a fair and lawful way. They must hold and use data only for the specified, registered purposes for which it was obtained and disclose data only to authorised persons or organisations. Corporate Governance The post holder must, at all times, act honestly and openly and comply with relevant corporate governance requirements, employment legislation, standards of business conduct, codes of openness and accountability. Equal Opportunities The post holder must comply with and promote Equal Opportunities and accordingly must avoid any behaviour which discriminates against colleagues, potential employees, patients or clients on the grounds of sex, marital status, sexual orientation, age, race, colour, nationality, ethnic or national origin, religion, political opinion, trade union membership or disability.
7 Health and Safety Under the Health and Safety at Work Act (1974), it is the responsibility of individual employees at every level to take care of their own health and safety and that of others who may be affected by their acts at work. This includes co-operating with the organisation and colleagues in complying with health and safety obligations to maintain a safe environment and particularly by reporting promptly and defects, risks or potential hazards. Flexibility The Trust is currently working in a climate of great change within the NHS. It is therefore expected that all staff will develop flexible working practices to be able to meet the challenges and opportunities of working within the new NHS. Risk Management Support the implementation of the Trust s Risk Management Strategy. Help the Trust meets its risk management obligations by being aware of hazards and risks within their work environment and working with the Risk Officers for the reduction and removal of unacceptable risks. To advise on the inclusion of business and financial risk within the appointed risk appetite framework for inclusion on the overall Trust Risk Register as appropriate. Personal This job description outlines the duties as currently required but may be amended to reflect future developments in the service and the impact of new technology on the role. Appropriate training will be provided to support essential additional skills required.
8 PERSON SPECIFICATION JOB TITLE: HART Operative DIRECTORATE: Operations Essential Qualifications State Registered Paramedic (Academic/Professional Experience 3 Years operational ambulance experience Evidence of Continuing Professional Development Evidence of working in a multi-agency environment Knowledge, Skills and Abilities Proven clinical skills and a commitment to delivering high standards of patient care. Ability to make sound clinical decisions often at short notice. Ability to maintain high standards of clinical care and health and safety, even in stressful and challenging situations. Understanding of the Trust s risk management system and ability to undertake Dynamic Operational Risk Assessments and manage risk in accordance with these procedures. Demonstrate effective written, verbal and listening communication skills. Understanding of and demonstrable commitment to Equal Opportunities and Diversity, both as a colleague and as a provider of a service to the public. Desirable Experience of Incident Management. Experience in using selfcontained breathing apparatus or other respiratory protection. Currently qualified as CBRN Special Operations Response Team member. Experience of working at height and in confined spaces.
9 Physical Requirements Core Behavioural Competences Special Requirements Essential Ability to work effectively at height and other areas of difficult access. Ability to work effectively in enclosed, confined spaces. Capable of swimming 100 metres. Ability to handle sensitive, stressful and traumatic incidents effectively, knowing when to use tact, diplomacy and assertiveness. Ability to remain calm and resilient under pressure and support others in this respect. Ability to work as part of a team and be supportive of others. Be self-disciplined and conscientious. Open to change, flexible and adaptable. Ability to establish efficiently an appropriate course of action to accomplish a goal. Being self confident and have the ability to develop self, motivate others and instil a sense of capability in others. Maintain a professional image at all times To be part of 24/7 response unit working unsocial hours. Low level of absence due to sickness in the last two years. No outstanding disciplinary sanctions. Have a satisfactory CRB enhanced disclosure check. Occupational Health clearance. Able to attend and pass pre-employment fitness test and maintain a specific level of fitness including being able to work at heights and in confined spaces. Able to attend and pass Desirable
10 Essential pre-employment training on the required dates and achieve the standards required for the role. Hold a valid UK driving licence with Class C1 and no more than 3 penalty points. Flexibility required surrounding shifts and time away from home, including the requirement to attend residential training courses to achieve required standards. Desirable