Case
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Case
Study 2: Ambulance Control Centres
This
article was published in the
Emergency Services Times in 2001
A
new Control Centre on-line in twelve months.
The
Welsh Ambulance Service NHS Trust was created in 1999 by
amalgamating five Ambulance Services across Wales. A priority
for the new organisation was a review of Control Centres
for EMS and PTS services. The Trust had inherited five different
systems with no common agreement on strategy other than
“something had to be done”. The developed strategy
was to reduce the current eight Control Centres to three.
The
Trust adopted an incremental approach to the rationalisation
process in order to reduce operational risks and take advantage
of partnerships where practicable.
The
first project in the strategy was the rationalisation of
the three North Wales Controls onto a single site. The Trust
decided to appoint an external Project Co-ordinator to lead
the project, but utilise internal technical skills and experience.
This would improve and promote co-operative working within
the Trust and identify technical solutions which could be
applied on a Trust-wide basis in the longer term. Ash House
Management was appointed as Project Co-ordinator in April
2000. The decision to use a Project Co-ordinator rather
than a Project Manager resulted in an inclusive project
which was managed and developed from within. In addition
to co-ordinating the project, the consultant was also tasked
with achieving the Outline Business Case and the Full Business
Case.
The
Project Board set a timetable of May 2001 for transfer of
the EMS Controls. This was a critical completion date because
transfer during the busy summer months, a time of increased
workload and staff holidays, created unacceptable risks.
The PTS Control was to be transferred in September 2001.
The
Outline Business Case was presented to the Trust Board in
May 2000 and the Full Business Case in July. A TETRA compatible
radio system, which had been included in the O.B.C., was
replaced in the F.B.C. with refurbished analogue equipment
following specialist NHS advice.
The
FBC identified a redundant building in the ownership of
the North West Wales Trust and their technical staff were
commissioned for the building and services design. The re-use
of NHS property for this project was opportune and enhanced
by the high quality technical support from the host Trust.
Risk
management was a key activity throughout the project. Risks
were evaluated and assessed at each stage, particularly
of communications issues. Project information was shared
across teams by Updates which were produced on a regular
basis.
The
project was conceived as a set of modular units plugging
into the Control infrastructure, with the construction and
services contract being designed and tendered prior to agreeing
equipment, telecoms, radio and IT specifications.
The
linking of the project elements was key, as the construction
contract, which included the electrical and CAT6 installation,
was tendered in October and began on site in December. Radio
and Telecoms requirements were not defined until December,
and the final radio scheme approved in February. Due to
the modular nature of the project, the full integration
of systems caused few problems and target dates were met.
The
Project Board managed three Project Teams – Staff
(transfer issues, rotas, approval of internal layout and
decoration); Environment (building design, services, ventilation,
furniture); and Communications (Radio, Telecoms, I.T.).
The
Staff Team was led by the Director of Personnel and comprised
solely of operational staff. This allowed staff concerns
to be aired openly while management were invited in by the
Team as appropriate to inform and support debate. During
the course of the project, the Trust underwent a major internal
reorganisation resulting in staff grades and job descriptions
for Control staff being changed on a national basis.
This project represented an additional upheaval for staff,
and the new Control, although mid way between the existing
EMS Controls, meant a 26 mile journey each way for some.
Throughout the project, the Staff Team were actively involved
in the decisions of the other teams. Maintaining positive
commitment from the staff throughout was identified as key
to the success of the project.
The
existing building used for the new Control had a mono pitch
roof with high level windows, which were retained and supplemented
by a high level extract system and low level chiller units.
Air conditioning was originally planned for the project,
but was re-evaluated at the tender stage, and a heat reduction
strategy adopted instead. The effect of this strategy was
to reduce heat output from equipment by investing in low
energy CPUs and flat screens. This low energy solution avoided
the closed atmosphere of air conditioning and provided an
improved working environment, as well as resulting in considerable
financial savings.
The
design of the project was “loose fit” with the
ability to accept change in the future with minimum disruption
a specified requirement. Simplicity was a keynote. All electrical
power supported by the UPS was structured beneath the raised
floor. Desking consisted of modular units on a spine to
support structured cabling, with CPUs housed in free standing
units for easy access/renewal.
Rationalising
building use is relatively straightforward but bringing
together disparate I.T. systems and coding structures required
an understanding of the issues and a willingness to reach
a common goal by technical staff across the Trust.
The
determination of the I.T. elements of the communications
specification was particularly complex because not only
was it specifying the technology for the North Wales Control
Centre, it was also evaluating and determining a communication
strategy for the whole of Wales. The systems adopted had
to have the ability to link with other Control Centres in
Wales with the introduction of TETRA. The Trust standard
became MIS Alert, with a strategy to migrate to common modules
and coding systems across the Trust.
The
modular approach zoned the equipment room for Telecoms,
Radio and I.T. thus avoiding system conflict. A single terminal
cabinet for the structured CAT6 cabling was the focal point
for I.T. and Telecom links to the Control Room. System security
was enhanced by separation of Telecoms circuits, duplicate
radio units and I.T. servers separately located. With the
advent of TETRA and the development of common systems across
the Trust, the long term strategy was that major failure
could be overcome by transferring responsibility to another
Control Centre. Fire suppression systems were considered,
but following H & S concerns, further investment was
made in fire detection and duplicate backup services.
The
decision to retain the analogue Radio units until TETRA
did pose some technical concerns, solved by NTL who provided
refurbished units – operational and standby - in the
new Control linked to existing units in the former Controls
via digital BT kilostreams and multiplexers. System security
for mast and radio sites which were remote were enhanced
by the introduction of Zetron alarm units which monitored
building entry and mains power failure and relayed status
to the new Control. From the new Control, staff could disable
or able voting cards in remote equipment in the former Controls.
An Audio monitor was installed in the Control Room to provide
an intercom facility to any of the remote sites.
Fallback
in the event of radio failure was via land lines to a number
of fixed mobiles in ambulance stations. This automatic system
would provide talk-through and avoided the cost of a new
mast which would be redundant following the introduction
of TETRA.
During
the commissioning stage the focus was on the preparation
of the staff for the new Centre, the transfer from MIS Assist
to Alert, and training on the new telecoms system.
By mid
May 2001 the Control, following thorough commissioning and
intensive staff training and checking and rechecking of
systems, was open, with the west of the zone transferred
first, followed three weeks later by the east.
The
transfer of the PTS Control was potentially the most difficult
aspect of the scheme. The majority of the staff in the PTS
unit had exceptionally long travel distances to the new
Control Centre, and chose alternative employment to the
transfer. This element was treated as a separate project
and achieved in early September.
This
was a low cost/high benefit project which has laid the foundation
for the further rationalisation of Controls across Wales.
For a unit of the complexity of a Control Centre, the project
was achieved in a very short timescale. It demonstrates
how Trusts can engage consultants to supplement in-house
teams, add value to projects and retain ownership.
John
Bottell, the Chief Ambulance Officer, said “When we
began this project we did not wish to abdicate responsibility
to a project manager, but we did need continuous co-ordination
throughout, particularly as we were planning major upheaval
within the Trust. Using a Co-ordinator to organise the project
from within proved to be a successful solution for us”.
Case Study 1 Case
Study 2 Case Study 3
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