Spotlight on HMCG’s Clinical Governance Team
Responsible for overseeing clinical skills and the training of casualty care instructors, the Clinical Governance team is vital to standardising HM Coastguard medical care for the Coastal Rescue Service. We spoke to the team to understand more.
The Clinical Governance Team deliver, maintain and update the Coastguard Emergency Responder Casualty Care course, or ‘CERCC’. CERCC is delivered by around 75 instructors across the United Kingdom, who then train circa 3000 volunteer Coastguard Rescue Officers.
Through a newly implemented annual revalidation process, the Clinical Governance Team has been provided with increased face-to-face engagement, offering a greater insight and opportunity to reinforce what standardised good practice looks like.
The team can now evaluate and understand, in real time, the challenges of operational delivery of care and rapidly support changes in national pre-hospital care practice and innovations. Key to this are planned quality control visits from members of the Clinical Governance Team, to assure and support the quality of care being delivered.
“Through annual revalidation, we have the opportunity to gain more feedback than ever before,” says Paul Browne, HM Coastguard’s Clinical Governance Lead.
“As an experienced healthcare professional, our Clinical Tactical Lead engages with stakeholders to form a crucial link by attending skills and drill sessions and exercises across the UK.
They’ll really delve into the feedback provided, engaging with all, from our CROs to the Chief Officers Group, to improve our CERCC training and service.”
“They’ll also have clinical input into all sorts of different things, from the Coastguard Rescue Service, to Search and Rescue, Maritime Operations and to some extent Aeronautical Operations.”
The Clinical Governance Team is also responsible for work to draft, develop and provide quality assurance across all content supporting casualty care. For example, HM Coastguard’s Casualty Care Check Card resource of flash cards, used by coastguards to rapidly assign appropriate care strategies to casualties ‘on the ground’.
Paul adds: “Traditionally, HM Coastguard only delivered basic “carpet” first aid, before we set up formal clinical governance and appointed a Medical Director.
“Since these advancements, our quality of training has improved considerably, with notable developments, such as the introduction of Patient Report Forms, which are reviewed by our working group and Clinical Tactical Lead.”
The newly created Clinical Tactical Lead role will offer a higher level of clinical advice and oversight, working with HM Coastguard’s Medical Director Dr Paddy Morgan.
Dr Morgan says: “HMCG Clinical Governance supports all areas of HMCG business delivery from the coast to the co-ordination centres and maritime environments.
“The aim is to ensure the highest level of care is consistently delivered to our casualties in the remote and austere situations they find themselves in, irrespective of where that is in the UK, whilst ensuring the wellbeing of our people responding.”
“The Clinical Tactical Lead is a key role in the clinical governance system, ensuring there is consistent, high quality, and up to date standards of Casualty Care delivered by HMCG responders.”
The Medical Director has direct input into several processes and implementations across the service and wider UKSAR partners, from UK Second-Generation Search and Rescue Aviation programme (UKSAR2G) to resuscitation, submerged casualty procedures, clinical risk management, and interaction with external partners.
The Clinical Governance Team also oversees and reviews the performance of the Telemedical Assistance Service, which provides HM Coastguard with specialist medical advice for vessels at sea and support for offshore incidents requiring clinical direction and/or prioritisation of medical evacuation.
Integral to the development of clinical governance for operational delivery of casualty care by the Coastal Rescue Service has been the benchmarking of CERCC to level D on the Faculty of Pre-hospital care’s Pre-Hospital Emergency Medicine (PHEM) framework, says Naomi Davies, UKSAR Liaison and Clinical Governance Manager.
“There's great work going on through the UKSAR Medical Working Group to look at how we're benchmarking our UK search and rescue standards against pre-hospital emergency medicine framework (PHEM) and looking at how we line up It's recognised across the health sector and helps to better professionalise our work, alongside other emergency services.”
“Every time you look at something, there is usually a clinical component to it. For example, when you're undertaking rescue, our personnel need to make sure that that casualty pathway is delivered effectively.
Naomi adds: “From procedure to the post-incident, from the ‘what do we do’ to the ‘how did it go’ at every level, there is usually clinical involvement, and we engage very well at the strategic level with the other departments, including standards, training, resources and equipment.”
