Being a BASICS Doctor in Edinburgh

I am a GP at a large practice based in a town in southwest Scotland, and I also work as a doctor in the Emergency Department in our local district general hospital. Like dozens of other doctors, nurses, and paramedics across Scotland, I have the privilege of being a responder with BASICS Scotland.

BASICS responders have additional skills and can provide pre-hospital emergency care to patients delivering time-critical interventions to improve outcomes. This is a different route from doctors who undertake additional qualifications as part of their medical training (usually in anaesthesia/intensive care/emergency medicine) and work as part of helicopter emergency medical service (HEMS) teams based in major cities. BASICS responders are usually based in rural locations where challenging geography and a lower population density means that there is limited access to pre-hospital emergency care.

Responders can be tasked by the ambulance service to attend emergency calls where there is going to be a delay in an ambulance response, or where additional skills or simply another pair of hands might improve the outcome for the patient. Doctors can volunteer as responders with BASICS Scotland if they have undertaken a Pre-Hospital Emergency Care Course (PHECC). However, doing the course does not automatically get you working as a responder. This is also based on where you live and what resources are already available, as well as how you get on with your PHECC. In addition, doctors generally need to have a certificate of completion of training (CCT) in a relevant specialty. This is normally general practice, emergency medicine, or anaesthetics/critical care – although any background would be considered. In certain circumstances, doctors towards the end of their training can be considered if they have appropriate supervision.

What does a Pre-Hospital Emergency Care Course involve? PHEC courses are run by BASICS Scotland and are certified by The Faculty of Pre-Hospital Care at The Royal College of Surgeons of Edinburgh. They run over three days and are split into medical emergencies and trauma care. The course is very hands-on from the start and assumes a good knowledge base from the manual provided before the course. The course is not just for doctors, but also allied health professionals, including paramedics and nurses, who can gain new skills to use within their scope of practice. The course can feel quite different from hospital-based emergency care courses which are based on team working. Although there is a focus on team working and non-technical skills, a big focus of the course is how to manage a situation when there is no team. Only you.

What kit do I need? All the equipment needed to work as a BASICS responder is kindly donated by the Sandpiper Trust. The Sandpiper Trust was founded in 2001 following the death of 14-year-old Sandy Dickson. The trust was founded by his mother, father, and aunt, who recognised that when accidents happen ambulance services can’t always be there immediately, and they made it their mission to work tirelessly to ensure that other families do not have to go through what they experienced. Sandpiper provides responders with the ‘Sandpiper Bag’ – a unique approach to packaging emergency medical equipment, as well as automated external defibrillators (AEDs). They also supply the technology required to connect responders with the Scottish Ambulance Service to allow tasking.

What kind of calls might you go to and how often? The frequency of calls varies between responders. Personally, I try to be available whenever I am at home, and with this, I attend on average one call every few months. Some responders who live in areas with denser populations and limited ambulance cover might be asked to go out more often. Since I started responding in 2017, I have been first on scene at an anaphylaxis where the ambulance arrived 45 minutes after me, as well as a medical cardiac arrest at the side of a rural road where my assistants were a relative and a delivery driver. I have also backed up a crew at a traumatic cardiac arrest following a motorcycle crash, where the patient sadly died. The motorcyclist was from outside the area, but months later his wife tracked me down by phone to my GP practice. She took comfort in being able to speak to someone who was with her husband when he died. I find the role massively rewarding and interesting.

I am also in the privileged position to volunteer as an instructor on PHEC courses where I get to work with the amazing team at BASICS Scotland and meet doctors, nurses, and paramedics from across Scotland working in all sorts of roles.

OK, I’m interested. Now what? Get on a PHEC course. Visit the BASICS Scotland website to find out more.