Welsh Ambulance: Paramedics say job is soul destroying

"Absolutely soul destroying" is how one paramedic describes his job.

Over the past few months, BBC Wales has been contacted by employees from the Welsh Ambulance Service who paint a dire picture of a service under immense pressure.

Ambulance waiting times have climbed and climbed throughout the pandemic. The impact that has on patients is well known - but what about those on the other side?

Anonymous workers have given BBC Wales a rare insight into the stress and anxiety of working for a service under strain.

'I'm now on antidepressants because of the ambulance service'

Mark, who did not want to disclose his real name or show his face for fear that he would lose his job, described the stress of his shifts with a radio strapped to his chest, hearing "red calls waiting, red calls waiting".

"That is the potential of somebody's life waiting in the balance - and you can't get there. It's absolutely soul-destroying. We wouldn't treat animals this way, why are we treating humans?", he said.

Mark said the job has always come with pressure and anxiety.

But over the course of the pandemic that has intensified and he has "never known as many people looking for other jobs as they are at the moment".

The stress has become so bad that he is now on antidepressants.

Drafting in the army to help

To help the service cope with the additional pressure of the pandemic, the Welsh Ambulance Service Trust brought in support from the army at various points throughout the pandemic.

The military re-joined the service for the third time in October 2021. By the end of this month, they will be leaving.

But their involvement has not been without controversy.

Paramedics usually work with another paramedic partner when they are sent out in ambulances to attend patients in need.

With the arrival of the military, they have instead often been paired with them.

But the military cannot blue-light drive, and are not usually clinically trained either, so some paramedics say it has actually added to their workload and made their jobs more stressful.

Jason Killens, chief executive of the Welsh Ambulance Service, said: "Whilst I recognise that bringing the military back for the third time to help us across winter and the third wave of the pandemic was unpopular for some of our people, on balance we do believe it was the right thing to do.

"It was about providing the best care we possibly could to as many patients as we possibly could in a very busy and extremely pressured time."

'Russian roulette with people's lives'

The paramedics who spoke to BBC Wales have strong views about working with military staff.

Mark described how "soldiers can't blue-light drive an emergency ambulance" and so when he gets to a time-critical patient with a military partner, he is faced with a difficult choice.

Either he can "sit in normal road speed traffic" attending to the patient while the soldier drives or he has to wait for a different paramedic to turn up and blue-light the patient.

Another anonymous paramedic - who wishes to be known as John - said people are going off with stress "purely because they do not want to work with people who have no clinical training".

In a survey by the GMB union of its members, some paramedics echoed those views.

One said the extra "stress and pressure" of working with military "makes you more tired and more likely to make a mistake".

Another described it as "playing Russian roulette with people's lives".

"Waiting for an accident to happen," said a third worker.

Looking through the results of the GMB's survey, there are a lot of similar views - but not all are negative.

One staff member said: "The military personnel I've worked with have all been professional and worked to their abilities."

While there were a lot of negative views, only 32% of the union's members replied (out of about 1,100), so it could be that those who were unhappiest were also the most eager to get in touch.

For the staff BBC Wales spoke to, working with the military was not the problem. They said the real issue for them was the fear of what would happen to those who criticised the policy.

Mark described it as "bullying".

"If you raise any concerns like staff have done working with military, they take you for capability and disciplinary proceedings," he said.

This issue appears a number of times in the GMB survey, with a number of staff claiming they would be "threatened with disciplinary action".

The ambulance service denied this had ever happened.

John said: "If I'm raising a concern, management shouldn't be threatening to refer me to the registering bodies, they should be having a professional conversation."

Mr Killens was asked if staff who do not want to work with the military face disciplinary action.

He said he was not aware of "any cases where staff have been disciplined or reported to their professional body for raising concerns".

When asked why staff seemed to think otherwise, he said: "We've got the anxiety caused by the pandemic and we've had to change a lot of stuff in the last two years.

"Those and other things come together to create an environment for some of our people where they find it difficult to rationalise."

But after the interview with Jason Killens, the BBC heard a recording from a meeting of managers late last year which suggests the threats were real.

A manager is heard to say: "If they've got a lack of confidence of whatever, we support them through capability policy.

"If they're refusing point blank, it'll be 'thank you very much, you can go home, and we'll see you in seven days for your disciplinary'... obviously you'll couch it better than that but he's asking you guys to have those difficult conversations and if anyone refuses, feed up the names."

It is that threat that some staff said has made them afraid to speak out.

GMB officer Nathan Holman said: "Whether it's going to happen or not it's the fact that the threat is there.

"There is a clear culture of bullying: If you do not comply with what we tell you, we will punish you."

Mr Killens said that he and the Welsh Ambulance Service did not condone bullying.

Moving to England is 'the last thing I want to do'

Soon the military will be leaving the Welsh Ambulance Service - so will everything go back to normal?

The ambulance workers who spoke to BBC Wales do not seem to think so.

John said it had made him decide he did not have a future in the service.

Despite being born and brought up in north Wales, he has been looking for jobs in England - in the North West and West Midlands ambulance services.

He said: "It's the last thing I want to do but needs must."

Mark has thought about leaving too, but he said: "That would mean uprooting my whole family and moving them, which I can't do to the children."

He said that what he sees as a "bullying culture" in the service would not go away when the military leaves, but that he felt he did not have any options other than staying for now.

Asked if there was a bullying culture in the Welsh Ambulance Service, Mr Killens said that, through an organisation-wide "listening exercise", they had heard examples of people "who feel they've been bullied in the workplace".

He said: "There is no place for that in our organisation, and if we see evidence of that, of deliberate evidence, we'll tackle it."

In a statement about the recording of a managers' meeting obtained by BBC Wales, after the original interview with Mr Killens, he added: "There was no plan to discipline colleagues for refusing to work with the military, a position set out by me personally in a written commitment to trade union partners in November 2021.

"Any comments that suggest otherwise did not, and do not, represent the organisational position.

"Indeed, we have not forced anyone to work with the military if they object, recognising that these staff members are relatively few in number.

"Through a process agreed with trade union colleagues, we have endorsed individual work plans for around 100 staff who have come forward with reasonable concerns.

"It remains the case today that no member of staff has been subject to disciplinary action or a Health and Care Professions Council referral for choosing not to work with the military, and while we recognise that there was apprehension among colleagues when we re-enlisted the military, we went above and beyond with trade union partners and staff to understand and allay any concerns.

"We remain proud and grateful for military support through one of the toughest chapters in our history, and despite the concerns raised by our people, maintain that this was the right choice to make in the interests of patients.

"The reality is that, without the support of our military colleagues, the service we would have been able to provide to people in Wales would have been significantly worse than the already challenging environment means it has been.

"We're grateful also for our own dedicated, professional and hard-working teams who have continued to deliver services as best they can."