This Article
was published in the December 2001 edition of the Emergency Services
Times.
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".
For further
information telephone 01352 750300 or
Complete the contact
page.
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