Medics get on their bikes to take the load off ambulances
By Eleanor Hayward, The Times of London, November 07 2022, 12.00am GMT, The Times
Matt Hope, left, and Tom Baverstock cycle up to 30 miles a day. Their London unit reaches calls in an average of six minutes. TIMES PHOTOGRAPHER JACK HILL
Every day an elite squad of cyclists roams the streets of central London, cycling up to 30 miles and saving lives in between.
The paramedics in the London Ambulance Service’s pioneering Cycle Response Unit (CRU) are each deployed to about seven emergencies a day, including cardiac arrests and traumatic road accidents.
Flying past heavy traffic and nipping through crowds down narrow backstreets, they get to the scene in six minutes on average. By contrast, the average waiting time for an NHS ambulance endured by heart attack and stroke patients reached an hour in England over summer.
The CRU bikes are loaded with 75kg of equipment, including a defibrillator and electrocardiogram (ECG) machine, so fully qualified paramedics can jump off their bikes and launch into life-saving treatment in the time it takes an ambulance to leave its station.
“We always get there first,” said Tom Baverstock, a paramedic who has worked with the unit for three years. “Pedalling fast can be the difference between life and death.” Baverstock, 35, recalled an incident in August when he was on duty in Kingston and got a 999 radio alert for a woman suffering chest pains in her home a mile and a half away.
“I cycled full pelt and was there in four minutes. As soon as I got there I did an ECG and diagnosed a heart attack. I upgraded the call to the highest emergency category so an ambulance would come within ten minutes.
“In that ten minutes I cannulated her and gave her morphine, so as soon as the ambulance arrived she could be driven to St George’s Hospital to have surgery. She was on the operating table within an hour of calling 999.”
Baverstock later received a letter from the patient’s husband thanking him for racing to them on his bike in such hot weather. It read: “Tom saved my soulmate, for which I will be eternally grateful.”
Between them, London’s 40 cycle paramedics attend 17,000 calls a year. As well as being on hand for life-or-death emergencies, they treat less severely ill patients at the scene.
About two thirds of all calls are resolved without the patient needing a trip to hospital. This spares hundreds of ambulance trips each week, saving precious NHS resources.
Each bike paramedic operates solo, covering their own patch, which is much more efficient than the traditional model of every emergency call being met with two highly qualified medical professionals in a huge vehicle.
Baverstock said: “The days of just taking everyone to hospital are over. We can get to the less sick patients, treat their pain, assess them, put them in taxis or call relatives. We can cancel the ambulance that would otherwise have to come. We’re taking the pressure off A&E and reducing hospital admissions.
“In a typical shift you would see seven patients and cancel four or five ambulances — calling up the control room to say no further resources are needed.”
On any given day, about 15 members of CRU can be found stationed across congested areas of the capital such as the West End, Soho, the City of London and King’s Cross. They are deployed to wherever a patient needs them — including Underground stations, shopping centres and hotels. There is a dedicated team at Heathrow, with one cyclist at each of the five terminals, attending emergencies in places such as baggage collection halls where ambulances cannot reach.
The demands of the job are physically intense. Each shift is ten to 12 hours long and typically involves cycling 20 to 30 miles on custom-made mountain bikes. Joining Baverstock and his colleague Matt Hope for a shift this week, The Times was (just about) able to keep up during a 15-minute dash from Trafalgar Square to Holborn — weaving through tourist hotspots to respond to a 999 call for an elderly man who had a fall — but arrived out of breath, with jelly legs, and in no fit state to leap into lifesaving action. And that was after cycling on a bike that wasn’t weighed down with medical equipment.
“You have to stay fit, you have to be a professional cyclist,” said Baverstock. “You might have to cycle really fast up a hill 11 hours into a 12-hour shift. You have to be able to pedal just as quickly as you would at the beginning of the day.”
Staff in the unit are all super-fit and smiley — they genuinely seem to love their jobs. It is a sharp contrast to the low morale and high staff turnover rates elsewhere in the NHS. The tight-knit unit prove their worth during major London events, including the Queen’s funeral, when ten cyclists patrolled the crowds of mourners. Baverstock and Hope were awarded an NHS “excellence report” for their particular heroics, which involved treating multiple patients at once near the gates of Buckingham Palace.
The Queen’s funeral was the biggest job in the history of the CRU, which launched in 2000 as the brainchild of Tom Lynch, a former European and British BMX champion. Lynch grew increasingly frustrated sitting behind the wheel of an ambulance in heavy London traffic, knowing he could reach the scene quicker on his bike. He persuaded NHS bosses to let him start the pilot scheme, involving one paramedic and his bike in the West End.
Since then, the CRU has gone from strength to strength and is hoping to expand further afield. At a time of record NHS waits, when entire fleets of ambulances are queueing outside gridlocked A&E units, the bike unit is more important than ever. And of course, it is good for the planet as well as patients. The team prevents about 51 tonnes of carbon being emitted each year through saved ambulance trips. The CRU has also recently acquired a fleet of eight e-bikes, allowing paramedics to cycle further and faster.
“There is no reason why cycle response units couldn’t operate in other cities around the UK,” Baverstock said. “Bike ambulances just make sense.”