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NHS learns lessons of war from Afghanistan surgeons
Territorial Army medical personnel who have served in Afghanistan are now using
key techniques they learned there to help save lives in the NHS.
Adam Brooks works a red, gooey gel into his hands and rubs them hard under the
warm flow of water. A consultant trauma surgeon at Queen's Medical Centre hospital
in Nottingham, he is also a Lieutenant Colonel in the Territorial Army, and spent the
summer treating battlefield injuries at Camp Bastion, in Helmand province.
"Here we are looking after people from motor vehicle crashes, while there we were
looking after people who have been hit by roadside bombs. "But they are all injured
and they need a similar sort of approach," he explained. "The experience I have had,
that we have brought back to Nottingham, is saving lives. "We're improving people's
care," he said.
Shortly after talking to me, Lt Col Brooks begins a six-hour operation to remove
cancerous tissue from a patient's liver. It is very different from bomb and bullet
wounds, but even here, lessons from Afghanistan can make a difference.
"Some of the techniques we have learnt and developed within the military can be
transposed across, even to the elective, non-trauma work I'm doing - specifically
looking at how we transfuse blood, the volumes that we use, and the products
that we use," Lt Col Brooks said.
David Willis, a paramedic who has served in Afghanistan, Iraq and Northern Ireland
during the troubles, has also learned similar lessons. He said: "We use a lot of warm
blood products and keep our patients warm, even in the heat of Afghanistan, and it
helps their recovery. "So hopefully we'll take that on board and keep our patients
warm here too - even on a hot summer's day."
Moira Kane, matron on A&E and two other wards at George Elliott Hospital in Nuneaton,
Warwickshire, served alongside Lt Col Brooks in Afghanistan. She commanded the
emergency department at Camp Bastion during operation Panther's Claw, when fighting
was at its most intense. She said it gave a massive boost to her abilities to lead and
organise her teams. "The doctor spends six weeks out there, and they said that was
equivalent to about five years within an average NHS trauma unit. "It's probably about
the same for us. It is incredible. "But you get these soldiers in at eight to 12 at a time,
whereas here, if someone comes off a motorbike, you get only one patient," she said.
The steep learning curve is also underlined by Duncan Phimister. Now retired, he
commanded 202 Field Hospital - Moira Kane's unit - during its last Afghan tour.
"There are casualties coming into the hospital and it is almost pandemonium the first
couple of times because there is such a deluge of really severe casualties. "But you
can see people growing, developing, and dealing with these situations as if they are
normal almost within a few weeks," Mr Phimister said.
During her time at Bastion, Moira Kane did not have a single day off. She said it had
been hard to adjust to work back in Nuneaton. "It's a little frustrating initially, because
there you have a military ethos and a rank structure, so if you ask for something to be
done it invariably gets done. Within the NHS, that is not quite so.
"I can't demand staff do something - though they sometimes think I do, I'm sure,"
Moira said.
Medics say blood transfusion lessons have enhanced their work for the NHS
Roughly about 100 NHS staff have passed through Camp Bastion this year, at
times making up two-thirds of the medical personnel there.
Peter Barrett, chairman of Nottingham University Hospitals NHS Trust, said reservists
were a valuable resource which the NHS was not doing enough to make use of.
"These are very special people. "The teamwork, the skills, the environment in which
they work gives them enormous benefits to the NHS when they come back and I think
we're patchy about picking that up," he said. "The reservists are quite reserved
themselves in blowing their own trumpets when they come back.
"Often they just want to keep their heads down and get on with the day job. I think
we have got a lot to learn really. We should celebrate what they have experienced
and use those experiences."
In Nottingham, Mr Barrett has introduced an annual veterans' dinner, and a "welcome
back" interview where staff returning from deployment share the experiences and
training they have received. "We can then put that into their job plans for the future
and their promotion prospects or their work within teams," he said.
Elsewhere, medical practitioners are organising their own events, so the key skills
being brought back home can be shared more widely.
Territorial Army medical personnel who have served in Afghanistan are now using
key techniques they learned there to help save lives in the NHS.
Adam Brooks works a red, gooey gel into his hands and rubs them hard under the
warm flow of water. A consultant trauma surgeon at Queen's Medical Centre hospital
in Nottingham, he is also a Lieutenant Colonel in the Territorial Army, and spent the
summer treating battlefield injuries at Camp Bastion, in Helmand province.
"Here we are looking after people from motor vehicle crashes, while there we were
looking after people who have been hit by roadside bombs. "But they are all injured
and they need a similar sort of approach," he explained. "The experience I have had,
that we have brought back to Nottingham, is saving lives. "We're improving people's
care," he said.
Shortly after talking to me, Lt Col Brooks begins a six-hour operation to remove
cancerous tissue from a patient's liver. It is very different from bomb and bullet
wounds, but even here, lessons from Afghanistan can make a difference.
"Some of the techniques we have learnt and developed within the military can be
transposed across, even to the elective, non-trauma work I'm doing - specifically
looking at how we transfuse blood, the volumes that we use, and the products
that we use," Lt Col Brooks said.
David Willis, a paramedic who has served in Afghanistan, Iraq and Northern Ireland
during the troubles, has also learned similar lessons. He said: "We use a lot of warm
blood products and keep our patients warm, even in the heat of Afghanistan, and it
helps their recovery. "So hopefully we'll take that on board and keep our patients
warm here too - even on a hot summer's day."
Moira Kane, matron on A&E and two other wards at George Elliott Hospital in Nuneaton,
Warwickshire, served alongside Lt Col Brooks in Afghanistan. She commanded the
emergency department at Camp Bastion during operation Panther's Claw, when fighting
was at its most intense. She said it gave a massive boost to her abilities to lead and
organise her teams. "The doctor spends six weeks out there, and they said that was
equivalent to about five years within an average NHS trauma unit. "It's probably about
the same for us. It is incredible. "But you get these soldiers in at eight to 12 at a time,
whereas here, if someone comes off a motorbike, you get only one patient," she said.
The steep learning curve is also underlined by Duncan Phimister. Now retired, he
commanded 202 Field Hospital - Moira Kane's unit - during its last Afghan tour.
"There are casualties coming into the hospital and it is almost pandemonium the first
couple of times because there is such a deluge of really severe casualties. "But you
can see people growing, developing, and dealing with these situations as if they are
normal almost within a few weeks," Mr Phimister said.
During her time at Bastion, Moira Kane did not have a single day off. She said it had
been hard to adjust to work back in Nuneaton. "It's a little frustrating initially, because
there you have a military ethos and a rank structure, so if you ask for something to be
done it invariably gets done. Within the NHS, that is not quite so.
"I can't demand staff do something - though they sometimes think I do, I'm sure,"
Moira said.
Medics say blood transfusion lessons have enhanced their work for the NHS
Roughly about 100 NHS staff have passed through Camp Bastion this year, at
times making up two-thirds of the medical personnel there.
Peter Barrett, chairman of Nottingham University Hospitals NHS Trust, said reservists
were a valuable resource which the NHS was not doing enough to make use of.
"These are very special people. "The teamwork, the skills, the environment in which
they work gives them enormous benefits to the NHS when they come back and I think
we're patchy about picking that up," he said. "The reservists are quite reserved
themselves in blowing their own trumpets when they come back.
"Often they just want to keep their heads down and get on with the day job. I think
we have got a lot to learn really. We should celebrate what they have experienced
and use those experiences."
In Nottingham, Mr Barrett has introduced an annual veterans' dinner, and a "welcome
back" interview where staff returning from deployment share the experiences and
training they have received. "We can then put that into their job plans for the future
and their promotion prospects or their work within teams," he said.
Elsewhere, medical practitioners are organising their own events, so the key skills
being brought back home can be shared more widely.
