# data[].attributes.attachment_link.title
Scanned from a Xerox Multifunction Printer 2

# data[].attributes.attachment_link.title
Scanned from a Xerox Multifunction Printer

# data[].attributes.attachment_link.entities[].name
South East Coast Ambulance Service NHS Foundation Trust

# data[].attributes.attachment_link.entities[].name
Burntwood & District Community First Responders

# data[].attributes.attachment_link.entities[].name
West Midlands Ambulance Service Corporate Video

# data[].attributes.attachment_link.title
Behind the scenes at the West Midlands Ambulance Service

# data[].attributes.attachment_link.description
During the winter months the number of 999 calls increases. In an aim to reduce the workload on the ambulance service, some of the less serious (non life threatening conditions) are referred on to a team of dedicated paramedics known as the clinical support team.

# data[].attributes.attachment_link.title
Behind the scenes of EEAST ambulance control

# data[].attributes.attachment_link.description
Take a look behind the scenes of EEAST's emergency operations centre in Bedford to see how 999 calls are answered and how ambulance staff are dispatched to emergencies.

# data[].attributes.attachment_link.title
Integrated Risk Management Plan - Emergency Response

# data[].attributes.attachment_link.description
We have already stated our commitment to improve something now, if we believe that immediate change makes you safer, and one example of this is our response to fires in these homes. We will change.

# data[].attributes.attachment_link.readable_text
(Image: Joel Goodman / Jon Baxter)

The time it takes for police to respond to the most serious night-time emergencies has increased by up to 57% after brutal Coalition cuts, figures show.

Response times for the highest priority 999 calls between the hours of 11pm and 6am went up in 20 out of 27 police force areas between 2011 and 2014, according to statistics from the House of Commons library.

In Bedfordshire, average call-out times at night for the most serious cases rocketed from seven minutes to 11 - a 57% rise. In Cornwall, they rose from six minutes to nine minutes - a 50% hike.

The revelation comes after the Coalition made the biggest police cuts of any country in Europe.

Labour's shadow home secretary Yvette Cooper blasted: "You can't trust the Tories with public safety. 999 waits have gone up significantly for the most serious emergencies - and that means victims are being put at risk."

An inquest was told in January how a student drowned in a river after an unexplained five-minute delay in the police response. Christopher Taylor, 21, was still clinging to a branch when police were called but slipped under water soon after they finally arrived.

Coroner Maria Voisin later wrote to Avon and Somerset police to raise concerns.

The new night-time figures - released after Freedom of Information requests - show that average response times to major emergencies in Avon and Somerset jumped 10% in 12 months.

Other large increases included Essex (up 38% from 2011 to 2014), Kent and West Mercia (both 33%) and Staffordshire and Hertfordshire (29%). The average increase across 27 forces surveyed was 17% in the same period. Response times improved in just two forces. Ms Cooper raged: "This is the direct consequence of Tory police cuts."

The Coalition has already slashed police spending by 20%, costing the jobs of 34,000 officers and police staff.

Senior officers have warned the Government's current plans would see both figures double over the course of the next Parliament.

# data[].attributes.attachment_link.title
Tory cuts delaying 999 emergency police response times by 50%

# data[].attributes.attachment_link.description
The time it takes for police to respond to the most serious night-time emergencies has increased by up to 57% after brutal Coalition cuts, figures show. Response times for the highest priority 999 calls between the hours of 11pm and 6am went up in 20 out of 27 police force areas between 2011 and 2014, according to statistics from the House of Commons library.

# data[].attributes.attachment_link.readable_text
Shadow home secretary Yvette Cooper said: "When people call 999 in an emergency, they need to know help will be there fast. But instead victims are waiting longer and longer for that help.

"Two-thirds of the police forces responding to this survey have shown big increases in average response times for the most serious calls. In some of these cases, seconds matter.

"David Cameron and Theresa May said the front line would be protected but the reality is that vital response units have been heavily cut back.

"The Home Secretary needs to stop blaming the police for her decisions and start working with the police to get victims the response they need."

Of the 21 forces who replied to the request, 14 showed substantial increases over the last two years, two forces showed a significant increase in the last year, while a further two remained the same.

:: Figures provided by Labour revealed that in the last year, between 2012 and 2013, response times increased by:

16.4 per cent in Norfolk

10.1 per cent in Kent

19.2 per cent in Hertfordshire

38.9 per cent in Bedfordshire

12.5 per cent in Devon and Cornwall

7.9 per cent in the West Midlands

In the last two years, between 2011 and 2013, response times increased by:

50 per cent in Devon and Cornwall

15 per cent in Hertfordshire

29.3 per cent in Bedfordshire

28.4 per cent in Cheshire

31.4 per cent in Kent

10 per cent in South Wales

9.1 per cent in Sussex

14.5 per cent in South Yorkshire

8.6 per cent in Northants

7.1 per cent in West Mercia

# data[].attributes.attachment_link.title
Police 999 response times getting slower

# data[].attributes.attachment_link.description
Shadow home secretary Yvette Cooper said: "When people call 999 in an emergency, they need to know help will be there fast. But instead victims are waiting longer and longer for that help. "Two-thirds of the police forces responding to this survey have shown big increases in average response times for the most serious calls.

# data[].attributes.attachment_link.readable_text
Official Statistics

Statistics on response times by fire and rescue services in England and severity of fires.

This publication and accompanying data tables were released on Thursday 7 August 2014 by the Department for Communities and Local Government. The publication focuses on trends in average response times in England.

Statistics in this release are the latest figures available for England and relate to periods up to 31 March 2014.

The key points are:

in England the average response time to fires in dwellings in 2013 to 2014 was 7.4 minutes, unchanged from 2012 to 2013 and 2009 to 2010

the average response time to other building fires in 2013 to 2014 was 8.1 minutes; this is 18 seconds longer than in 2012 to 2013 and 12 seconds longer than in 2009 to 2010

over the 10 years from 2003-04 to 2013-14, response time to both dwelling and other building fires increased by 1 minute and 27 seconds (23%) on average

meanwhile the average severity of fires and numbers of casualties decreased due to implementation of fire safety and prevention policy

# data[].attributes.attachment_link.title
Fire incidents response times: England 2013 to 2014

# data[].attributes.attachment_link.description
Official Statistics Statistics on response times by fire and rescue services in England and severity of fires. This publication and accompanying data tables were released on Thursday 7 August 2014 by the Department for Communities and Local Government. The publication focuses on trends in average response times in England.

# data[].attributes.attachment_link.readable_text
People living in East Anglia face some of the longest waits for an ambulance, according to new research.

The NHS sets a target that 75% of life-threatening calls are responded to within eight minutes.

However, 999 callers in the CM0 postcode in Maldon, Essex will have a median waiting time of 38 minutes while those in Norwich's NR23 will usually wait around 28.

The areas surrounding London such as Watford, Cheshunt and St Albans generally wait fewer minutes for an ambulance than their neighbours in the capital.

The research was compiled via freedom of information requests by digital agency Totally Communications to produce an interactive map that allows you to see how quickly ambulances have been responding in your postcode over the last few years.

It unsurprisingly shows that there is a sharp divergence between fast ambulances getting to the scene in rural areas compared to those in urban ones.

That divide is particularly stark in Wales and Northern Ireland where people in the countryside may have to wait up to 15 minutes more than those in towns and cities.

NHS England used to described all life-threatening calls as "Category A", however, that was split into two different measures called Red 1 and Red 2 in mid 2012.

Since then there has been a significant decline of standards since with the percentage of calls being responded to falling below 70% across both of these measures in December last year.

However, there has been considerable improvement in Scotland over the same period with the 75% target almost being met in 2012-13. There was a slight decline in 2013-14.
Topics

# data[].attributes.attachment_link.title
Find out speed of ambulance response times in your UK postcode area

# data[].attributes.attachment_link.description
People living in East Anglia face some of the longest waits for an ambulance, according to new research. The NHS sets a target that 75% of life-threatening calls are responded to within eight minutes. However, 999 callers in the CM0 postcode in Maldon, Essex will have a median waiting time of 38 minutes while those in Norwich's NR23 will usually wait around 28.

# data[].attributes.attachment_link.readable_text
Ambulance services help many people with serious or life-threatening conditions. They also provide a range of other urgent and planned healthcare and transport services.

Ambulance services should ensure that patients are given the appropriate level of care.

Who will treat you?

Depending on the situation the ambulance service can dispatch the following units:

an ambulance

a rapid response vehicle (car, motorbike or bicycle)

a doctor

an air ambulance

a community first responder (CFR) and volunteers

a patient transport service (PTS)

a combination of the above

Ambulance crews
Ambulance crews can include a range of medical staff, such as emergency care assistants and paramedics. Crews are highly trained in all aspects of emergency care, from trauma injuries to cardiac arrests. An ambulance is equipped with a variety of emergency care equipment, such as heart defibrillators, oxygen, intravenous drips, spinal and traction splints, and a range of drugs.

Patients will always be taken to hospital when there is a medical need for this. However, paramedics now carry out more diagnostic tests and do basic procedures at the scene. Many crews also refer patients to social care services, and directly admit patients to specialist units such as major trauma centres or stroke units. Paramedics also administer a wide range of drugs to deal with conditions such as diabetes, asthma, allergic reactions, overdoses and heart failure.

A rapid response vehicle (car, motorbike or bicycle)
These units are often sent ahead of an ambulance as they are quicker at getting through traffic or large pedestrian areas. This is important in situations where every second counts.

Air ambulance
Air ambulances deliver emergency care, especially in rural areas and where road access is a problem. They can be an effective way of getting better and faster access to hospitals, are valuable in transferring patients between hospitals and are dispatched by NHS ambulance services where there is a need. Air ambulances operate as independent charities. However, the cost of some clinical staff on air ambulances has been met by the NHS.

Community first responders (CFRs) and volunteers
Many local ambulance services run volunteer responder schemes. Volunteers receive medical training and are expected to provide emergency care alongside ambulances or until an ambulance can be on site. They are often trained to use defibrillators, provide CPR and are able to give oxygen treatment. The volunteers have to provide their own cars and usually don't have blue lights.

Non-emergency patient transport services (PTS)
If you have a hospital appointment you usually need to make your own transport arrangements. However, under certain circumstances a non-emergency patient transport service (PTS) can be arranged. Transport can and should encompass a wide range of vehicle types and levels of care consistent with the patients' medical needs.

PTS services are commissioned by Clinical Commissioning Groups (CCGs) and it remains up to local CCGs to decide how these services are managed. To find out if you are eligible for PTS speak with your GP, your hospital team or contact your local CCG.

Handling 999 calls

Any 999 call to an ambulance service is prioritised into two categories to ensure life-threatening cases receive the quickest response:

1. Immediately life threatening

A. Red 1: 75% of Category A Red 1 calls (the most time critical, where patients are not breathing or do not have a pulse) to be responded to within 8 minutes

B. Red 2: 75% of Category A Red 2 calls (still serious, but less immediately time critical, like strokes or fits) to be responded to within 8 minutes. The clock starts ticking up to 60 seconds after the clock for Red 1.

C. A19: 95% of Category A calls to be responded to within 19 minutes.

2. All other calls - For conditions that are not life threatening, response targets are set locally

Figures from NHS Digital show that in 2013/14 ambulance trusts dealt with an average of 16.1 emergency calls per minute. You can find the full report about ambulance services in England on HSCIC's website.

# data[].attributes.attachment_link.title
NHS ambulance services - emergency and urgent care - NHS Choices

# data[].attributes.attachment_link.description
Ambulance services help many people with serious or life-threatening conditions. They also provide a range of other urgent and planned healthcare and transport services. Ambulance services should ensure that patients are given the appropriate level of care.

# data[].attributes.headline
Gold  - silver - bronze command structure.

# data[].attributes.subject
Gold  - silver - bronze command structure.

# data[].attributes.attachment_link.readable_text
The generic command structure, nationally recognised, accepted and used by the police, other emergency services and partner agencies, is based on the gold, silver, bronze ( GSB) hierarchy of command and can be applied to the resolution of both spontaneous incidents and planned operations.

The terms gold, silver and bronze are used in the police service. However, the hierarchy of the terms strategic, tactical and operational may differ in some departments, agencies or organisations.

GSB structure

This structure provides a framework for delivering a strategic, tactical and operational response to an incident or operation. It also allows processes to be established that facilitate the flow of information, and ensures that decisions are communicated effectively and documented as part of an audit trail.

Most incidents and operations are resolved by using a simple GSB command structure, with the responsibilities and accountabilities of each commander clearly set out in command protocols. The command structure is role not rank specific and allows for flexibility.

It is essential that everyone involved in the police response clearly understands what they are required to do, how they are required to do it and when. This is particularly important where a multi-agency response is required, as confusion and uncertainty can lead to command paralysis where commanders are unable to make and/or communicate decisions effectively.

Command structure

Depending on the needs of the situation, the command structure may or may not include all elements of GSB. Similarly, it may also involve local or basic command unit police officers and staff, partner agencies and, ultimately, the government.

The command structure should be clearly articulated to all those involved in the operation. Where it is appropriate, briefing notes or flow charts showing the structure can aid people's understanding of it. Any change in the command structure should be discussed before it is undertaken, and then documented.

Complex incidents and operations

In more complex incidents and operations where the police response is likely to comprise a number of different elements, or where the police response requires officers to be deployed across force boundaries, the GSB command structure may become stretched and command responsibilities less clear.

To avoid this, consideration should be given to establishing a supporting chain of command for each element of the police response, which should be underpinned by clearly defined command protocols. The command structure should be appropriate to the needs of the operation and sufficiently resilient for its purpose.

The issues of span of command, span of control, command resilience and interoperability must be considered.

Example

Below is an example of a command structure when responding to more complex incidents or operations. The example ensures that any interdependencies or potential conflicts are managed effectively, while ensuring clarity of command throughout the duration of the incident or operation.

Role not rank specific

The command structure is role rather than rank specific. Officers of a senior rank to those nominated to undertake one of these three roles should not automatically assume superiority solely on the basis of rank or territorial responsibility. However, they are accountable for any information or advice given to commanders.

Flexibility

The GSB model offers flexibility and can be applied to any type of incident or operation. It is important to ensure that command structures are subject to regular review. They should be flexible enough to adapt to changes in the nature of the threat, incident or operation without jeopardising clear lines of communication or accountability and ensure that those performing the required roles are sufficiently trained and competent.

Gold (strategic) commander

The gold commander assumes and retains overall command for the operation or incident. They have overall responsibility and authority for the gold strategy and any tactical parameters that silver or bronze commanders should follow. The gold commander, however, should not make tactical decisions. They are responsible for ensuring that any tactics deployed are proportionate to the risks identified, meet the objectives of the strategy and are legally compliant, particularly in terms of the Human Rights Act 1998. The gold commander chairs the gold group or the strategic coordinating group ( SCG).

Gold (strategic) commander roles and responsibilities

These vary according to the nature and scale of an incident:

strategic firearms commander

gold public order commander

gold commander for an emergency or major incident (see civil emergencies)

gold commander for a CBRN incident

gold commander for counter-terrorism.

Where the police respond to an emergency or major incident, a gold commander assumes overall command and has ultimate responsibility and accountability for the response to that incident. The gold commander chairs the SCG, which is the multi-agency forum operating at the gold tier of command.

Silver (tactical) commander

The silver commander commands and coordinates the overall tactical response in compliance with the strategy, and is the tactical commander of the incident. Generally, there should be one tactical commander, but it may not be practical or desirable in large-scale incidents or operations to have a single silver commander. The gold commander (when appointed or in a position to assume command) decides how many silver commanders are appointed and their individual span of command.

Silver (tactical) commander roles and responsibilities

These vary according to the nature and scale of an incident:

tactical firearms commander

silver public order commander

silver commander for an emergency or major incident (see civil gencies)

silver commander for a CBRN incident

silver commander for counter-terrorism.

Silver commanders should liaise with bronze commanders when developing the tactical plan. Silver commanders should also ensure that bronze commanders understand the strategic intentions, the key points of the wider tactical plan, and tactical objectives that relate specifically to their area of responsibility.

Bronze (operational) commander

The bronze commander is responsible for the command of a group of resources, and carrying out functional or geographical responsibilities related to the tactical plan.

The tasks identified by the silver commander are delegated to bronze commanders to deliver in accordance with the priorities set by the silver commander and/or tactical coordinating group. The number of bronze commanders and their roles/specialisms is determined by the scale and nature of the incident.

Bronze roles are created and disbanded throughout the period of an incident/operation and can be allocated based on geographic (commands a geographic area) or functional (commands a specific task, eg, bronze public order) considerations.

Bronze commanders must have a clear understanding of the silver commander's tactical plan, ie, what they are required to deliver, in what timescale and with what resources.

Some bronze commander roles require specialist knowledge, skills and expertise and, therefore, should be allocated to individuals or post-holders who are appropriately trained and competent.

Bronze (operational) commander roles and responsibilities

operational firearms commander

bronze public order commander

bronze commander for an emergency or major incident (see civil emergencies)

bronze commander for a CBRN incident

bronze commander for counter-terrorism.

Page last accessed 16 April 2018

# data[].attributes.attachment_link.description
The generic command structure, nationally recognised, accepted and used by the police, other emergency services and partner agencies, is based on the gold, silver, bronze ( GSB) hierarchy of command and can be applied to the resolution of both spontaneous incidents and planned operations. The terms gold, silver and bronze are used in the police service.

# data[].attributes.headline
Emergency
Services Control Room Operator Role.

# data[].attributes.subject
Emergency
Services Control Room Operator Role.

# data[].attributes.attachment_link.readable_text
Police, fire and ambulance services in England should share control rooms to improve their response to 999 calls, a Home Office minister has said.

Mike Penning said it did not "make sense" to have different premises.

It comes as new plans are published to get the services working more closely.

There are also proposals for police and crime commissioners (PCCs) to oversee fire brigades, which could include choosing an officer in charge of hiring and firing fire and police staff.

This top officer post would be open to senior officers from both the police and fire service. They would hold the rank of chief constable - and to allow this the government would remove the current rule that holders of the rank must have served as a constable.

PCCs would get responsibility for fire services "where a local case is made", the Home Office said.

'Costly experiment'

In most parts of England, police, fire and ambulance services have separate control centres and when someone rings 999, they have to tell an operator which service they need.

Emergency services in some areas - including Northamptonshire and Hampshire - are already working on joint schemes, but the Home Office wants more and is introducing a "statutory duty" on the three services to collaborate.

In Northamptonshire, police, fire and ambulance services are sharing "training, premises and a joint operations", the Home Office said. In Hampshire, senior police officers now operate out of the Hampshire Fire and Rescue HQ.

Mr Penning, minister for policing and fire, said: "It simply doesn't make sense for emergency services to have different premises, different back offices and different IT systems when their work is so closely related and they often share the same boundaries."

He said he would also like PCCs to take responsibility for their local ambulance service, but at this stage the Home Office is only planning to extend PCC powers to fire brigades.

'Sledgehammer' plan

The plan for PCCs to oversee fire services was called "dangerous" by the Fire Brigades Union (FBU) when it was suggested last year.

It said the move would be a "costly experiment with no guarantee for success".

Steve White, chairman of the Police Federation of England and Wales, said: "Officers from both emergency services already do pull together, working alongside week in, week out, as has been evidenced most recently by the appalling floods.

"So why the burning need to change the law? It's like using a sledgehammer to crack a nut."

Paul Hancock, Cheshire's Chief Fire Officer and president of the Chief Fire Officers Association, said combining control rooms was "absolutely a good thing".

He said there were "fantastic examples" of emergency services working together across the country, and he welcomed PCCs taking control of fire services when there was a "local case".

But he said there were "some concerns" within the fire service about losing its "unique brand and reputation" due to being associated with the police.

The government's plan also includes abolishing the London Fire and Emergency Planning Authority and giving its responsibilities to the Greater London Authority.

# data[].attributes.attachment_link.description
Police, fire and ambulance services in England should share control rooms to improve their response to 999 calls, a Home Office minister has said. Mike Penning said it did not "make sense" to have different premises. It comes as new plans are published to get the services working more closely.

# data[].attributes.attachment_link.readable_text
Irrationally I had expected gasps, cries - an audible pulse of panic. Instead, the windowless room they call the Pit is remarkably muted. The staff, in their green paramedic-style uniforms, are talking quietly, almost monotonously, into their headphones; more like telephonists in a bank's call centre than folk on the front line. The only sound is from a vacuum cleaner doing its work among the call-takers. There is something eerie about the stillness, because each one of the figures tapping their computer keyboard could, as I watch, be the only barrier between life and death.

"There's no protocol if someone dies on the phone," says Glen Griffiths. "You have to give what advice you can and afterwards you agonise over whether you could have done something differently and saved the life."

Griffiths has been an emergency medical dispatcher for the London Ambulance Service for two years. His is one of the voices callers hear when they dial 999 and ask for an ambulance and, at 21, he has dealt with almost every emergency conceivable. "Electrocution, explosions, a monkey attack and people getting objects stuck where they shouldn't be. A lot of the calls are about choking," he says. "It puts the heat on me; I get in a panic and try to find out where they are and suddenly they say calmly, 'It's OK, the obstruction's cleared now', and they put the phone down."

Griffiths found his way into the emergency services via Sainsbury's. "I was working in the internet shopping section dispatching deliveries and it was not challenging," he says. "My dad works for the London Ambulance Service and my mother is a nurse, so healthcare is in my blood, and the hair-raising dinner table conversations they had at home mean I'm not squeamish. I'd just never considered being qualified to work in health myself until my dad mentioned there were vacancies."

Here comes the second surprise of the evening. No university degree or healthcare background is required to be a call handler. Four weeks of training in first aid and relevant computer programs and one-to-one support for the first 10 shifts are all that is needed to equip new recruits to cope with medical emergencies. "All the medical knowledge is built into the computer systems and we have a lot of support from our supervisors," says Griffiths. "We're not clinicians."

No training can fully prepare a beginner for the stress of taking calls from casualties or bystanders in desperate situations. "I was extremely nervous the first time," he says. "My first ever call was from a lady who'd fallen over inside a friend's flat and her mobile kept cutting out. I had to try to work out where the building was from call signals.

"There are so many different types of call that until you've taken a handful you're still nervous. Even now, some can throw you into the unknown, like cases breathing difficulties, because there can be a range of causes from seizures to hanging. Then there might be a language barrier or aggression at the scene and often people haven't a clue where they are, especially if they're on a motorway."

It's a strange limbo that the medical dispatchers inhabit. The lack of windows seals them off from the outside world they are so urgently assisting. There is no indication of whether it's day or night, fine or stormy, and frequent 12-hour night shifts mean they go home to dinner as the rest of London is breakfasting. Social interaction with colleagues is conducted in half sentences, severed when a bleep through the headphones announces a new call. "It's odd when we all meet in the pub after a shift," says Griffiths. "We talk hesitantly because we keep thinking we hear a bleep in our ear."

Mostly it's not worth attempting a conversation and the dispatchers sit in silence, poised for the next alert. They talk callers through what is often one of the most desperate experiences of their lives and yet they never meet those they hand-hold and never find out what happened to them after the ambulance has collected them.

Despite this, Griffiths finds the job intensely fulfilling. "It's very satisfying to know that help has arrived for somebody," he says. "Although you often wonder what the outcome was."

Sometimes the outcome is traumatically evident: the casualty dies while still on the line. Griffiths reckons that two years has inured him to most situations, but occasional cases have reduced him to tears and a couple have forced him to take stress breaks. "There was a teenager who called because his 10-year-old sister had taken an overdose and, while I was instructing him in CPR, she vomited blood. She didn't make it," he says. "Different things can hit a nerve. If you're newly wed and someone's wife is taken ill, for instance, or if you've just had a baby and someone calls with a seriously ill child. Supervisors can always tell when someone has taken a difficult call and they send them off for a coffee break."

Pictures of lakes, flowers and seascapes dot the walls of the Pit, although their calming purpose is mocked by the staff. "We call that one Despair, that one Anguish," says a wag beside Griffiths before a call cuts him short, mid-jest.

It's extraordinary to see how Griffiths and his colleagues can switch from a casual conversation to emergency mode, without any alteration in their tone. The prompts from the computer are so familiar - address of the caller, nature of the problem, whether the casualty is conscious - that they can run through them dispassionately while speed-typing each detail on to the screen. The computer does most of the thinking, automatically dispatching an ambulance as soon as an address is typed in, deciding which of several described symptoms is the most critical and classing the case into one of four levels of urgency. A line of icons will click through to diagnostic questions for 35 different scenarios from gunshot wounds to animal bites.

But occasionally the dispatchers have to veer from the script to calm distraught callers or stabilise an aggressive situation. "You get strange reactions from people under pressure," Griffiths says. "Some are completely deadpan, almost robotic until the ambulance comes and then they break down. Some are abusive and some simply scream and you have to use repetitive persistence, asking the same question over and over, to get through to them. The most frustrating thing is when somebody rings on a mobile to say their friend has been shot, then they put the phone down. People assume you know where they are."

The two dozen staff on each shift sit in pods before two computer screens, one to interpret and act upon the clinical data and one displaying a map of London. On it, coloured circles denote ambulances en route - amber signifies help on its way, red shows the crew has arrived at the scene or are returning to hospital.

The first call of Griffiths' shift is from a carer who has found her elderly charge on the floor with a suspected stroke. Within minutes a moving orange circle shows an ambulance on its way.

"Some people here are superstitious and think that certain chairs attract more trauma," Griffiths says. "I'm a bit of a trauma magnet. The air ambulance crews get sick of me."

The biggest event he has had to cope with was the London riots: "There were a lot of assaults." Other cases stick in his mind because they are so unusual. "A man called because his hand was stuck behind a radiator and he knew his central heating was about to come on," he says. "Another man called because his wife had gone into labour [Griffiths has delivered five babies over the phone]. He was perfectly calm until he realised the baby was going to be born on his new sofa. He began shouting that he hadn't paid it off yet, and his mother-in-law had to send him from the room."

This evening's shift is proving unusually quiet. A woman calls because her brother has a nose bleed and an assault victim rings for a second time because his bleeding chin is staining his carpet. Both cases are ranked low priority by the computer. The casualties will probably get a call from a clinical team dedicated to non-urgent maladies.

"We get a lot of trivial calls - people who have seen a fox run over. But we have to understand that for them it's a frightening experience and we direct them to a more suitable source of help," he says. "Then you get people who have experienced real trauma such as the second world war, who don't like to bother us. My trainer took a call from an elderly lady who had fallen in her bathroom on a Friday evening. She kept herself alive over the weekend by drinking bath water and rang us on the Monday to ask if we were open."

It would be understandable if the continual stream of disasters that filters through Griffiths' headphones made him nervous about life's unpredictability. Instead it makes him sanguine. "It's inevitable that accidents happen and if one occurred around me I'd switch into work mode," he says. "Friends find me unsympathetic if they are unwell because I'm used to so much worse."

He has, however, no desire to put himself on the scene of a crisis and train to be an ambulance technician or paramedic. "I can deal with blood and guts," he says. "But the smell of vomit undoes me. I'd rather be safely on the end of a telephone line."

Curriculum vitae

Pay £23,861-£27,569

Hours Four 12-hour day shifts followed by three days off then four 12-hour night shifts followed by seven days off. "I can't imagine a nine-to-five job.

Work-life balance "12-hour shifts can make the weeks seem to disappear - going home and only having time to eat and wind down before sleep starts calling. On my days off I more than make up for any missed social events or downtime, doing as much as I can before getting back into my shift pattern. I share a house with six friends so there's always someone to around talk to if I've had a difficult day and there's a lot of support at work."

Best thing Seeing the difference made to such a large volume of people every shift.

Worst thing In winter, having to wake up for night shifts in the darkness, going home in the darkness and not seeing sunlight for a week!

Overtime

At the end of a gruelling shift, Glen enjoys reading books, "mostly science fiction or fantasy, never medical dramas". Glen also likes going to the cinema or watching films at home with friends, computer gaming and outdoor activities such as airsofting and paintballing. "I'm a typical 21-year-old male." Glen and his colleagues often go to the pub when they've clocked off: "we always have a laugh. It's easy to switch off when you're on a break and a lot of us have a dark sense of humour, which I guess you need in this job."
Topics

# data[].attributes.attachment_link.title
A working life: the emergency call operator

# data[].attributes.attachment_link.description
Irrationally I had expected gasps, cries - an audible pulse of panic. Instead, the windowless room they call the Pit is remarkably muted. The staff, in their green paramedic-style uniforms, are talking quietly, almost monotonously, into their headphones; more like telephonists in a bank's call centre than folk on the front line.