Dr Graeme Spencer

Founding chairman of Cheshire & Shropshire Immediate Care Group basics and co-creator of the app a2z of immediate care

Five years after starting in GP, I stopped at a fatal rtc on the M6 in the dark and did what I could for an unconscious patient with a clenched airway. It was on the hard shoulder with traffic passing in the snow at 70 mph (and I was in the car in jeans and a dark fleece), I still count it as my most dangerous incident in the subsequent 20 years. I washed the blood from my hands in the next service station, chatted to another GP friend and discovered that he was doing ‘basics’ which I'd never heard of.

Further investigation lead me to the British Association for Immediate Care (basics) who have coordinated the accreditation and training around immediate care since 1997. It originated from GPs returning from war service and attending RTCs in the 1950's - and has evolved massively since then with developments in road safety with the fire, paramedic and ambulance service roles as well as medical and clinical skills in the health service.

Pre-Hospital Emergency Medicine (PHEM) is the latest development is now an official sub-specialty.

So, I joined the local scheme (they are roughly county based franchises providing local immediate care usually to the corresponding ambulance service). Basics trained clinicians work in all sorts of roles - ambulance services, most sports, mountain rescue, search and rescue, cave rescue, RNLI, cruise ships, expedition and remote expeditions and a recent expansion in the number of doctors and paramedics working on the air ambulance services - the list goes on and apologies to the many that I've probably not included. In short, if you can think of an activity or pastime that might need medical support, basics will probably be relevant.

Basics schemes may have some funding but are often fundraising charities. I was funded to do the five day basics course in Cambridge and had driver and major incident training before I went on to cover a patch across East Lancashire for 5 years.

In due course, I moved to be a GP partner in south Cheshire. I was a solo responder for 5 years and met enough keen doctors and paramedics to set up a local immediate care scheme csi basics (Cheshire and Shropshire Immediate Care group) using both counties to get enough people together to form a proper committee. I respond in my own vehicle via automated ambulance service pager/crew/control/trauma desk request.

The training and accreditation has increased over the years. Starting a career in basics now means going for an acute accs career stream and aiming for dual accreditation.

I fly with a paramedic air ambulance crew (the photo is of me next to the helicopter).

If you’re interested, you can find more details on the area scheme.