Hero is an often overused word to describe the actions of someone who has done something brave or admirable. We use it as a compliment to the partner who takes the bins out in the rain, or the bus driver who waits at the stop while you frantically wave and try to catch up.
Throughout the coronavirus pandemic, however, the term took on a new meaning thanks to the nation’s key workers, who continued to show up on the frontline day after day when this unknown illness, which became one of the world’s deadliest viruses, was rampaging through the country.
One of the professions at the sharpest edge of the pandemic were the ambulance service, which continued to help others by attending serious incidents and entering people’s houses – often putting themselves at risk. In normal times, this is honourable, but throughout the COVID-19 pandemic, it was nothing less than heroic.
So who’s responsible for the heroes’ safety and making sure they’re fit to fight another day? For the South East Coast Ambulance Service, this assignment landed at the feet of Ali Mohammed, who became chief people officer two months before the pandemic took hold.
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Of the 3,000 frontline ambulance staff in the South East Coast service, 550 people were off work at the peak of the pandemic, due to either contracting the COVID or having to self-isolate. For Mohammed, this represented a logistical nightmare in which his HR team had to juggle making sure the service could still operate, while attempting to prevent complete staff exhaustion.
“It was absolutely manic in terms of intensity. People worried about coming in, didn’t feel protected enough or had concerns around isolation,” Mohammed says.
“The issue about hospitals being overwhelmed was a real one. At our peak, we had 20 ambulances queueing to get into Medway Hospital (the largest in Kent) – the road was blocked up with patients in the back waiting seven to eight hours to go in.
“A paramedic is supposed to pick up someone and do their best to get them to the hospital. But some of those people had to wait for hours, which had a huge effect on the crew. There were lots of welfare issues for both the crew and patients.”
To make matters worse, Mohammed was extremely poorly with COVID-19 just four weeks into the pandemic, which he realises has now encouraged him to be a more empathic HR leader. He says: “I was laid up for three weeks with it and on the edge of being hospitalised. In fact, I still have Long COVID now and often feel tired and washed out.
"That sort of experience brought it home just how serious the virus was. It changes your mind about other people as well. It made me realise that we’re all human, we’re tired, we forget things. Having COVID brought out the humanity in me.”
"Having COVID brought out the humanity in me."
Once the hospital admission rates began to decrease, Mohammed had to once again switch the focus of his HR team, this time to help support those in the service who were now suffering with the mental toll of the pandemic. One of the main challenges was supporting staff who were unable to get their patients to a hospital in time to save them.
He says: “There was a case of [patient] suicide because one of our crews couldn’t get there in time, so the mental health impact of that on the crew is serious. People were literally working all hours god sends to keep the service running. We had so many staff working overtime to cover those who were off with COVID.
"The national response time [for an ambulance to get to a patient] is seven minutes and we were well behind that. These paramedics came into the job for the patient care. In terms of how bad they feel about the fact they can’t get there, it’s in their core. It’s the difference between losing someone and not. It’s serious stuff when you think about it.”
But issues of mental health in the service is something that has existed a lot longer than COVID. Ambulance workers have one of the highest tendencies for suicide of any other profession in the NHS, with GPs representing the highest proportion.
Research by Mind found that emergency services staff were twice as likely to identify problems at work as the main cause of their mental health problems, compared with the general workforce – a huge challenge for Mohammed to tackle.
He says: “We have seen it within our own service. It’s absolutely tragic. There is always a combination of factors [with suicide] with home life, work, sometimes drink is involved. When someone has had enough and can’t cope, it can trigger something deep inside them. But every staff member lost is a tragedy and it’s something we need to do better.”
Although good mental health is vital for a healthy workforce, frontline workers such as those in the emergency services often need extra hardiness and tenacity about them. Being exposed to a potentially life-altering situation is certainly not for the faint-hearted, so how does the ambulance service recruit the right sort of people for the role?
Mohammed says: “The recruitment process definitely attracts a different type of person. You have to be a certain way to take an ambulance out for 12 hours with just one other crew member. This attracts people who are self-sufficient and by nature pretty robust.
“These people have a higher level of resilience than someone who does an office job. But of course we’ve got a comprehensive range of health and wellbeing services and there’s a large amount of public spending that goes on wellbeing support for our staff.”
And it’s not just the mental health of the services’ staff Mohammed is keen to improve. He also stresses the importance of HR looking after its own mental health, which is not talked about enough. “HR people need to look after their own mental health. We have a monthly case meeting where we look at our most difficult cases and then talk through it.
"HR people need to look after their own mental health."
"Every case HR deals with is serious, whether that’s a serious mental health case, or a disciplinary or dysfunctional situation. Every one of these takes a little bit out of you, so you need to find ways to bring back something with a deficit. I’d encourage HR to find its own support network and find someone to decompress with and have a cathartic moment with.”
Another stigma attached to the ambulance service is the lack of diversity, particularly when it comes to ethnicity, Mohammed says.
“’It used to be a working-class profession filled with lots of white males. This is changing, but we have still got real intergenerational issues now as the older ones who are more experienced are often male and white.”
Mohammed does acknowledge that things are changing, with the service now recruiting more young women and ethnic minorities. He adds: “When you’re looking at the pathway to education and doing a paramedic degree, generally speaking, people from ethnic minorities would rather do medicine than be a paramedic.
"It’s a complicated subject, but it’s not very diverse, even in management. At South East Coast, there are only two managers who are non-white.”
This echoes Mohammed’s experience at other NHS trusts, having previously worked at Great Ormond Street, St Bartholomew’s and NHS Leadership Academy. He says: “Great Ormond Street and St Bart’s were very diverse organisations. But the higher you go up in management, the less diverse those places are. The NHS has an issue on that.”
Despite diversity and inclusion being very much a part of daily conversations across the workplace, Mohammed is sceptical how useful these conversations are. He says: “When I started in the NHS, we never really saw any equalities experts, but now every organisation has two or three.
"There’re 225 NHS Trusts and 700 people working in equalities, but the issue is the data hasn’t changed. More and more people working on the subject has changed nothing, it’s just brought more light to the data. What needs to change is people’s attitude and their practice. In my view, that’s the key to it.”
And it’s this challenging nature that makes him such a perfect fit for a profession such as the ambulance service that, by its own acknowledgement, has a lot to improve when it comes to employee engagement and wellbeing.
“There’s a few things we’re not very good at in our HR and OD field. Number one, which will make more difference than any other thing, is around management development. No one’s ever done the work to create something that lasts more than a year. So I have developed a range of activities around leadership development and master classes.
“Part of my job is to hold a mirror up and say ‘you think we’re really good don’t you’, but we’re not. So that’s the challenge I’ve been setting down and say we need to think about what to do that’s different. I want to hear whether the team are committed or not. Because if you’re not, I say let’s go out and tell the staff that this isn’t a priority to us and let’s see how they feel.”
Though working among heroes, he isn’t afraid to pull any punches, which can often go with the territory of a HR professional who has spent years being embedded in the NHS.
He adds: “The job of the HRD can be where angels fear to tread – sometimes you just have to go there.”
This piece appears in the July/August 2021 issue of HR magazine. Subscribe now to get all the latest issues delivered to your desk.