Why I’m a Dignity Champion

Dignity in care and me

Alan Clark MBE

“From tiny acorns mighty oaks grow”

Looking back all my life I have in one way, or another interacted with people. As a ten-year-old working in a local grocery shop on Saturday’s, when an elderly customer saw a discount sign and commented that it was some time since she had had peaches and cream, would have loved to buy some but couldn’t afford them. That weekend my wage were a large tin of peaches and cream which I took to her house on the way home.

In later life, whilst in hospital a Chaplain asked if I was “A Christian” back then my response was “If you mean do I go to church the answers, no, but if you mean do I help others in need the answer is yes”

At 0800 hours on the 22nd of March 1976, at twenty-five I Joined the London Ambulance Service (LAS). Back then you had to be at least twenty-five and experienced work/life to be considered, unlike today. In 1985 I was selected to join a pilot scheme which brought was now called Paramedic’s into London and the 56th person to qualify nationally in 1986. I retired on 31st December 2012 and on 31st December 2022 voluntarily deregistered with the HCPC, meaning I can no longer use the word Paramedic, but that does not mean losing my skills and knowledge to the betterment of others. During my service, I lost track of how many times I was asked, “do you really know what you are doing, Josh does do that on Casualty.”

Over the years, I had witnessed many occasions when those I was dealing with were at time treated as a commodity and not a person. On many occasions I would find myself at odds with colleagues both in and out of hospitals over actions or comments made, which now would and do generate complaints and rightly so over “attitude.” The same applies to my experience as a Team Leader in the ambulance service with newly qualified staff straight out of university. Having gone straight from school through sixth form college to university and qualified with little “on the road experience” due to the way the course is planned, the complaint rate for “attitude” increased.

One of the difficulty areas is for Psychiatric Patients in crisis who removed under “Section” under the Mental Welfare Legislation. I have always tried to persuade those in need to walk out in a dignified manner, rather than be removed carried, shouting, kicking, and screaming police or ambulance staff under direction of the RSW. I always had in mind that these patients would be coming back home to live among neighbours who would remember what happened and may view the suffer in a different light, which could make future life difficult especially for those with recuring psychiatric needs.

I became aware of a “new” campaign in 2006, which was then underwritten by the then Department of Health (DoH). The office of which was based in Wellington House which was opposite the LAS Headquarters in Waterloo Road SE1. I signed on as a” Dignity Champion” and made a number of visits to the office and became a defacto Dignity Champion for the LAS, albeit unofficially to start with.

At the time the DoH was funding the campaign and I managed to get the LAS to distribute the “Aide Memoir” cards distributed to over 5,000 staff with their payslips in 2000. I also managed to make in in road to what was then Chingford, Wanstead, and Woodford PCT (CWW) and became part of a National Primary Care Development Organization One Year Pilot scheme looking at alternative ways of treating, initially elderly fallers in relation to Standard Six of the National Service Framework (NSF) for the Elderly, who had no major problems at home rather than transport to hospital. This but eventually opened up to all age fallers looking to identify early signs/symptoms of a long-term illness. Of the twenty UK wide pilot schemes CWW was initially the only one with a direct Paramedic/direct Dignity input. The scheme was initially restricted to the London Borough of Waltham Forest, but I managed to persuade the London Borough of Redbridge to establish a parallel provision.

At a meeting held in St Thomas’s Hospital, attended also by a double amputee female from the Seven-Seven bombing. I was asked by the then Ambassador Sir Michael Parkinson about how Dignity fitted in with my work. I explained that we do our best to treat those in need whilst trying to maintain dignity for such as this lady because most incidents are in the public/media gaze. My biggest issue is they can inadvertently get in the way, however and even bigger issue is “Social Media”, bystanders or perpetrators filming incidents on mobile phones which are then posted to the world without restriction. Such as an attack at Leytonstone station or the bullying footage of a girl in West London. The broadcast media have added to this by requesting such members of the public to send in footage which is then broadcast. That said I do understand that such footage can help in investigation and securing a conviction. It is the flouting of the DIGNITY of those involved without consent and in contravention of GDPR legislation that further annoys me.

As a Safeguarding lead for Adults in the LAS, I was able to maintain a Dignity Profile in house and the wider Health and Social Care economy. And was a member of a local committee set up to review events/actions/complaints under Standard One of the National Service Framework for Older People – “rooting out age discrimination” and Standard Two – “Person Centred Care” so became a “Dignity in Care and Older Persons Champion”.

On one occasion after talking to a hospital colleague who was extremely distraught that her elderly mother’s operation had been postponed for the fourth time, having been “nil by mouth” on each occasion, I made a telephone call to a colleague in CWW and raised a concern. The following week my colleague found me and said thank you! Apparently, my telephone call generated a care planning meeting and the operation had happened two days after my call.

I have one regret, that I never followed up a conversation with a Chaplain who was a Home Office Interpreter for the Hearing Impaired and learnt BSL (British Sign Language). Many times, when answering calls to the ambulance service, you have people who take time to speak to you if at all. On one occasion A gentleman was not responding to any questions. As at last resort I place two finger over my left ear, the sign for deaf, at which point he sprang into life, signing madly. I then had to explain that I did not know BSL. Luckily, he could lip read. However, remembering the previous conversation I was aware that at times medical staff have little concept of a hearing-impaired person understanding of questions which for the majority are not a problem.

On arrival at the Emergency Department, I handed over what information I had been able to obtain and suggested asking for a BSL interpreter as the gentlemen was deaf. At which point a doctor said, “We don’t need and interpreter, he can read” At which I said, “Are you Sure?” The doctor replied, “What do you mean?” I asked the doctor “How he head leant to read?” The doctor replied, “I sat on my mother’s lap while she read to me”. I said “So you could hear! How do you know this gentleman was not born deaf?” The doctor made no comment got up and walked off.

At times as a champion you need the strength to ask questions of those who can, or believe they can, change the world. Towards the end of an early meeting at Richmond House, I asked a Minister for Continuing Care. “In relation to ambulance target times, can you please explain why, if an ambulance arrives in nine minutes and the patient survives it is seen as a failure, but if an ambulance arrives inside eight minutes and the patient dies, statistically that is a success?” His response was to get up and walk out.

In my wider life, I was able to bring an understanding of Dignity into First Aid Training as the First Aid Lead for the RAF Volunteer Reserve Training Branch, commercially as a freelance trainer and latterly as an Area President and occasional trainer for St John Ambulance.

As an Area President I have close working relationships with local community groups and local authorities at all levels but particularly the Mayoralties which is another opportunity to champion and keep Dignity to the forefront of people’s minds.

From “tiny acorns, mighty oaks grow” from a small group there are now, at time of writing 161,726 registered champions standing up for individuals or groups to be treated with Dignity on an individual basis.

Along may it be so with ever increasing numbers.