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MERIT doctors provide senior clinical advice to commanders during incidents that go beyond normal day-to-day ambulance operations. These can include major incidents, hazardous environments, or situations where decision-making is particularly complex or time-critical.

Rather than delivering hands-on patient care, MERIT doctors provide remote support by offering specialist medical input. This helps ensure that clinical, ethical and legal considerations are built into decision-making, particularly when information is limited or evolving.

Established in 2014, MERIT strengthens the link between frontline clinical care and command decision-making across operational, tactical and strategic levels. The team comprises around 40 experienced doctors from different specialities, including emergency medicine, paediatrics, anaesthetics, intensive care, general practice, and pre-hospital emergency medicine. They operate 24/7 across the North West, and many also bring experience from military, humanitarian or major incident environments.

Introducing Doctor Anisa

Dr Anisa Jafar is a consultant in emergency medicine and paediatric emergency medicine at Salford Royal Hospital, and a recent addition to MERIT. We spoke to Anisa about her work, her career journey, and what it’s like supporting some of the most complex incidents the ambulance service responds to.

What first drew you into emergency medicine?

Emergency medicine was a bit of a revelation for me early on in my career. I realised quite quickly that I wanted a speciality that gave me variety, pace and a real team environment, somewhere I could do a bit of everything.

But emergency care doesn’t start at the hospital doors. A big part of it happens in the community, and the ambulance service plays a critical role in that. I was really interested in how emergency systems work in different settings and countries, particularly where pre-hospital and hospital care are more closely integrated. MERIT felt like a natural extension of that, a way to use my skills alongside ambulance colleagues in a different environment.

How would you describe a typical day in your job?

A typical day doesn’t exist, which is why I chose the career path I did. One day, I might be working clinically in the emergency department, looking after patients who are seriously unwell or have major trauma, right through to those with minor injuries and illnesses. Next, I could be involved in global emergency medicine work, research or training, or focus on skills development such as airway management and leadership. I also sometimes get the chance to present at international conferences.

MERIT adds another layer on top of that, involving everything from simulation exercises for chemical incidents to observing advanced paramedic practice or learning more about responses to major incidents.

MERIT doctors don’t usually provide hands-on care. What does your role involve in practice?

It’s mainly about gathering information, turning that into useful intelligence, and helping commanders make informed decisions about patient care.

Most of the time, that support is remote, over the phone, radio or Teams, although occasionally it can be on scene. The aim is always the same though, to help ensure the safest and most appropriate decisions are being made during complex incidents.

At what point in an incident would you typically be called?

We can be called very early on, sometimes while an incident is still developing and information is limited. On other occasions, we may be stood down quite quickly once more details come through, which is useful, as it helps us keep practising those early decision-making processes.

We tend to be involved in a wide range of incidents, from fires involving large numbers of building occupants to road traffic collisions with high numbers of injuries.

What helps you manage the responsibility of supporting high-stakes decisions?

You’re never making decisions in isolation, which really helps. There’s always a wider team involved, and that shared responsibility is important.

A lot of it also comes back to experience, both mine and that of others around me. It’s similar to the emergency department, where rapid decisions are made as part of a team caring for critically unwell patients.

Finally, what does it mean to you to work in this way with the ambulance service?

It’s a real privilege to work so closely with colleagues in the ambulance service and to be welcomed into this part of emergency care. It also gives me the chance to work alongside people I wouldn’t usually meet in my day-to-day role.

The breadth of experience, skill and professionalism across NWAS is genuinely impressive, and I’m constantly astounded by the level of expertise within the service. For me, it’s really energising to be using the emergency medicine skills I have developed clinically in a different way, as there is a huge amount of transferability.

This article was featured in the latest edition of our Your Call magazine.

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The SCAS presence at the event was organised by David Vickery, Emergency Care Assistant, with three members of staff and four Community First Responders supporting activities throughout the day. Huw Pateman, Public Governor, also attended, spending time engaging with visitors and supporting colleagues at the event.

The event was well attended throughout the day, with positive feedback from visitors and many families returning for a second visit after enjoying their experience earlier in the day.

SCAS staff and volunteers engaged with people of all ages, answering questions, sharing information and providing interactive demonstrations to help visitors better understand the ambulance service and the different stages of emergency care.

The Advanced Life Support (ALS) demonstration proved particularly popular and generated a great deal of interest and discussion. Visitors were able to learn more about the equipment and clinical interventions used by ambulance clinicians when responding to seriously ill or injured patients.

The event also provided an opportunity to use SCAS’s Ambulance Journey books when engaging with children and people with learning disabilities and autism. The books helped staff explain what happens when an ambulance is called and what someone might experience during their journey with the ambulance service in an accessible and reassuring way.

Bringing the emergency services together created a welcoming and informal environment where families could meet responders, ask questions and learn more about the organisations working together to keep their communities safe.

The positive response from visitors, particularly the number of families who returned during the day, demonstrated the value of events such as the 999 Day in building relationships, increasing understanding and creating positive experiences between emergency services and the communities they serve.

SCAS would like to thank David, Huw, all the staff and Community First Responders who supported the event, our emergency service partners and everyone who came along and helped make the day such a success.

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Despite the hot summer weather, the SCAS team enjoyed a busy and successful day, engaging with hundreds of visitors of all ages. 15 staff and volunteers attended the event, including two Call takers from Southern House and two members of the SCAS BASICS team, providing interactive demonstrations, sharing lifesaving advice and speaking to the public about the work of the ambulance service, community first responders and volunteering opportunities.

The event logistics were expertly coordinated by George Carr, Emergency Care Assistant, with support from Ben Cole, Community Education and Training Officer.

Visitors were warmly welcomed by SCAS colleagues, who answered questions about emergency care, demonstrated CPR and the use of automated external defibrillators (AEDs), and encouraged people to gain the confidence to act in an emergency. The stand proved extremely popular throughout the day, with many families taking the opportunity to learn new lifesaving skills and meet ambulance staff.

George Carr said:

“It was fantastic to see so many people visiting the SCAS stand despite the high temperatures. The public were incredibly supportive and engaged, with lots of people keen to learn CPR and find out more about the ambulance service. Events like this are a great opportunity to build relationships with our communities and help people feel more confident in knowing what to do in an emergency.”

SCAS would like to thank everyone who visited the stand and to the organisers at HMS Collingwood for hosting another excellent community event. We are also grateful to all of the staff and volunteers who gave their time to represent the trust and help inspire more people to learn lifesaving skills.

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Running from 10am to 4pm, the event takes place on Car Parks 10 and 11, which are part of the Orient Car Parks*. It’s a free, family-friendly event that brings a full day of action, hands-on activities, and insights into the work of emergency services across the region.

We’ll be joining colleagues from Greater Manchester Fire and Rescue Service, Greater Manchester Police, the British Army, the RNLI, and many other organisations.

Visitors will be able to meet representatives from a wide range of our teams and services on the day, including our Hazard Area Response Team (HART), emergency ambulances, patient transport service ambulances, call handlers, Careers and Education Team, NWAS Charity, staff networks, and ambulance museum curator Glyn, who will be showcasing a range of memorabilia and vintage ambulances. We will also be celebrating 20 years of NWAS.

Families and visitors will also have the chance to meet frontline staff, explore emergency vehicles, learn about careers in the ambulance service, and discover lifesaving skills such as CPR with our Community Resuscitation Team.

Emergency Services Day offers a unique opportunity to get an inside look at the services and people who keep our communities safe every single day. It’s a free, fun and educational day out perfect for all ages during the summer holidays, and a chance to learn how to save a life. We look forward to seeing you there.

*Orient car parks are located on the southern side of the shopping centre and provide the closest access to The Orient leisure and dining area, The Great Hall, and the Trafford Centre food court.

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This week the National Ambulance Volunteer Responder Leadership Group (NAVRLG) spent two days at the RNLI College in Poole. This provided a valuable opportunity for volunteer leaders from both the ambulance and lifeboat services to share learning and forge closer links that could form the basis for greater collaboration in the future.

The gathering was facilitated by Donna McCreath, Head of Volunteering and Inclusion at RNLI, and Joe Crook, National Ambulance Volunteer Lead at the Association of Ambulance Chief Executives (AACE).

Volunteer leads discussed a wide variety of topics including reward and recognition for volunteers, training and onboarding, and demographic changes to the volunteering population.

Ambulance volunteer leads also went on a tour of the fabulous training facilities at RNLI, including spending time in a training simulation.

The ambulance volunteer leads would like to thank the team at RNLI for their generous hospitality and warm welcome.

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