From the Desert to the Forest: First Aid Training in Remote Areas.

In this edition of our “Training Leaders” series, Andy Thompson visits Remote First Aid with Julian Woodall, Owner and Training Director, Medic Services International, a Health & Safety Training consultancy.

What is the origin of Medic Services International?

I served in the Royal Artillery from 1990 until 2005 and trained as a Medic. When I left, I set up a Medic Services International, which started off by providing first aid training. Since then, it’s developed into a Health and Safety Training consultancy. I also work as a Remote Areas medic. We now specialize in Remote Areas First Aid. We train a multitude of Engineering, Construction and Arborist clients, and we’re looking, next year, to expand into Rail and Windfarms, not only in the UK but overseas. I have excellent connections with a number of freelancers, who I use as and when needed, depending on the job size or location.

After I left the Army, I won a contract to work with the Royal Navy as a civilian contractor to teach Ship’s Company, the Royal Marine Commandos, and the RFI, the Royal and Fleet Auxiliary, basic Advanced First Aid, and I also taught the OPTAG – the operational training teams, going overseas, into conflict zones.

All that experience is where our training has come from. Each company gets a very high level of training. We do a Training Needs Analysis to look at what they do, do some research and then give them the training on site. We feel that on site saves the company money and has minimum disruption to their working day.

We provide our clients with real-time training. We do 40 percent in the classroom and 60 percent is outside doing practical exercises. We tailor the courses to each client. With Rail, we focus on track-side workers. For the construction industry, we focus on things like crush injuries caused by collapses. So we have a large and expanding client base.

How have you developed professionally, after leaving the Army? What civilian qualifications have you pursued?

In the Military, I went from the Medics course to the CMT course, but on leaving on the military and swapping over in to the commercial environment, I took the First Person on Scene (Intermediate) course, the Medicine in the Remote Areas (MIRA) course, the Ship’s Medical Course, to work with the Royal Navy. You keep yourself updated doing CPD [Continuing Professional Development]. In July I did a refresher MIRA course and FPOSi Course, so it is actually a constant learning process.

What level of competence are you starting from with the people you instruct?

Some start from scratch. They’ve never done any first aid before. We build in “pyramid” fashion. We start off with the basics. If it’s an Emergency First Aid or First Aid at Work course, we start by teaching them about health and safety regulations and the best first aid kits or trauma kits that they need. We also go into a bit of anatomy and physiology – how the human body works as we feel that is important. We started to bring team management in an emergency into the construction industry so, for example, the First Aider, the Site Supervisor, all know what they have to do. X’s is going to go organise the ambulance, for example, and we emphasis the importance of having a runner, as well, to deliver messages and, obviously, a good handover to the emergency services. So we start off basic and we build up.

What can people expect from your courses – how long are they?

It depends. It’s tailored to the client need. As an example, in 2017 I was flown out to Iraq, to Basra, to deliver a four-day Remote Areas First Aid Course at an oil refinery. It transpired it was for four people only. I had to tailor the course on site, because we didn’t get a lot of information from the client beforehand, so I had to understand more from them, on arrival – asking them what their emergency procedures were, and so on. We then had a to write a risk assessment and provide recommendations for improvement.

So that was insightful. Sometimes, in a remote area, you won’t get all the information from the client. When you get there, you have to change the course completely – which is not a problem: you’ve simply got to “improvise, adapt and overcome”. We found a constraint was that they couldn’t provide all four people at the same time, so we had to cover two people, and split the course, which extended the time. But it wasn’t a problem.

So, again, all the training was changed in situ. I had to say, okay, you’ve got “this package”, what you actually need is “this alternative package” for keeping the casualty alive even longer, until the emergency services turn up … if they turn up!

What’s the typical size of class? Four seems rather small!

Typically, I wouldn’t deploy overseas for four people. It doesn’t make economic sense. But it all depends. We plan to take a maximum of 10 people. What I have found, after COVID lockdown, I was taking a maximum of 6 people on the Tree Surgeons course in the UK because it was deemed operationally essential – first aid for Tree surgeons, Engineering, Construction – is deemed operationally essential and high risk. They need the training more than an office staff.

I found that six people, even though it’s not financially as lucrative, from a delivery and learning perspective, you can concentrate more, you can go into depth more. The exercises are easier to control. Three “casualties” and three “first aiders” works well. I think six to eight is right. Ten becomes too many people. The perfect number is between six and eight, because also you’ve got to consider quality as well. You might get ten people, but there is always that person who’s not interested or the person who’s not taking in that information. All they will do is sit at the back of the class and keep quiet. When you’ve got six people, there’s no hiding!

The guys who would normally not be used to the academic work – because, by definition, they are more practical people – they were taking lots of notice because they couldn’t hide anywhere. They didn’t feel stupid asking any questions. So six is a great number because of the learning, the quality and the quantity of the actual learning goes up, because then if someone does make mistake, someone’s not understanding the subject or a drill, you can actually concentrate on them, help them out more. If you got 10 or more, you’ve got to have eyes everywhere.

What’s the outlook for your business?

17th March 2020 was the last course I ran before COVID interrupted us. As soon as June came, and restrictions were lifted, I’ve been non-stop. I think I’ve found a niche in the market that has kept working despite the virus. I’ve been working with the Construction and Engineering and Arborist sectors. They can maintain social distance too, which is perfect.

Internationally, I was in Ethiopia in January / February but, unfortunately, they’ve got a conflict in the Northern region at the moment. A real shame because I love it there, they’re so friendly – the people, the culture, and such a fantastic history as well. A great place.

There are many medical service providers in the market, a lot of freelancers. How do you set yourself apart?

All the work I get is word of mouth. I’ll deliver a course in a certain way and I don’t copy other people’s ways of training. If I deliver a course the clients like, they advertise me!  It’s all recommendations. The feedback I get is great!

Each instructor has got a certain way of delivering, of course. I am highly energetic when doing it – enthusiastic. Because you’ve got to be! I found on my Medics Course in the Army that some of the instructors were fantastic. They invigorated you. They inspired you. You actually wanted to be a Medic! They told you stories as well. “When I was in Oman, I did this” and “when I was in the Gulf War, we has this casualty” and “out in the jungle we saw that casualty” … usually hearing these stories is very motivating.

Other instructors just read off PowerPoint. It’s awful. Now, I only have bullet points. So if I’m talking about heart attacks, I’ve got a bullet point just saying “Heart Attack” and I just then talk about it backed up with visuals and act it out, and so on.

A lot of these people from the Construction sector, for example, have been out of school for years they’re practical hands on people. Just using PowerPoint wont “reach them. You don’t want your class to start switching off, so I do PowerPoint, pay a film, and then it’s practical time. You’ve got to be high energy all through all the day.

What standards do you train to? What certifications, if any, do your students receive?

The reason I’m chosen for training courses is that they get accredited qualifications through OFQUAL (Office of Qualifications and Examinations Regulation). So instead of just having a piece of paper claiming to have completed a first aid course, they have accredited qualifications via OFQUAL. They do a Level 3 Emergency First Aid Course created by OFQUAL. And this provides points towards a college or university course.

Companies want – and need – an accredited course. They want accreditation, so the Emergency First Aid, the First Aid at Work, all the first aid courses I do, fire safety, manual handling, health and safety…. Each one of those is an accredited course.

Do you have to get re-accredited yourself at interval?

Every three years, I am back in that classroom!

Then I have to send those off to NUCO where I’m an accredited trainer / instructor so that I am then allowed to teach a large amount of qualifications each year again. So every three years I have to be assessed. I invest a lot in my accreditation, and also to keep up to date with TTPs because things do change over three years. I learn a few things each time which were actually new, and a few things that the instructor told us I bring back and use in my courses.

I’m also assessed every year. I have another instructor come in and he assesses me on my training course. It all helps keep me current.

How much do things change and how has your training evolved over the years?

Haemostatic dressings have changed. I teach the ECB, the Emergency Care Bandage, I teach the gen 7 cap tourniquet, that’s improved. CELOX is “advanced”. I teach that to the Arborists and the outdoor First Aid course and Remote Areas courses. You have to think of different ways to train people. Arborists, for example, require wound packing, feeding the gauze in, and so on. Some medical companies charge about £700 for a fake arm with a little tube of blood coming out. And a lot of companies, especially independent trainers can’t afford that. And if I’m going overseas and I’ve got to carry all the big arms, it’s not possible.

So, again, we improvise, adapt, and overcome. Instead of paying for a [specific purpose] fake arm or a fake leg, I went to a company called “I Love Fancy Dress”. I bought fake arms for £6.99! I bought £1 tube of fake blood. I put the fake blood into the holes I make in the fake arm or leg. They get a T-3 Emergency Care bandages that’s got gauze in it, and that’s how I teach wound packing. And the students can get a limb each, and a bandage and a squirt a bit of fake blood. They can really visualize it, and it doesn’t take hundreds of pounds to achieve!

So, do you think these mannequins that are on the market now are a bit of a waste of money because you can just deliver just as equally as good training by improvising?

If you’re a massive training center with a huge budget, then fine. That kind of training, then, is not a problem. But if you’re traveling to a course in, say, Basra, it’s impractical. You’ll be questioned at the airport. You’re not going to get it through. You’ve got to think about what is sufficient to achieve the training objectives.

I went to Basra with a large bag which had all the training equipment for the course I was delivering. You have to be very specific. Like packing a bergan, you have to use every bit of spare space

What challenges do you encounter often in your training courses?

Sometimes you might have people who are not academic or dyslexic. So we approach that differently – asking questions orally instead of written down.

In Ethiopia we had delegates on the course who didn’t speak English as a first language. I had to really slow down my speaking.

So those are the challenges. Especially if you have people who have learning difficulties / dyslexia, and you get them through that course, not by doing the course for them, but getting different ways of teaching them, so they understand the subjects, and after the course, they come up to say, “Thank you so much. We’ve had a great course, we really enjoyed it”. And that’s basically thumbs up.

Sometimes you’ll get people who do not want to be on that course. You try to win those people over. Sometimes it works. They’ll say, “I didn’t want to come on the course. But you’ve made it interactive. We’ve really enjoyed it. There’s been good banter. And actually, we’ve had a great time and we’ve learned a lot”.

Every now and again, not all the time, you get a minority who work against you. Some instructors who don’t want bad feedback, concentrate on those individuals to the detriment of the others on the course. My advice is – don’t! The rest of the course suffers. Especially as the company has employed you, has invested their money in you, to teach their employees. They want the best outcome. Better to report back that an individual had the wrong attitude and didn’t respond well to the instruction being offered.

With many providers on the market, what advice would you give to potential clients about what to look for and what to avoid?

Firstly, my knowledge is my value. I have spent years accumulating that knowledge. That’s important to remember.

Secondly, it’s about course accreditation. You don’t want to spend thousands and thousands [of pounds] on training only to find it’s not accredited, and HSE will refuse to acknowledge it. Understand where the course is coming from. I had one company cancel a course they had booked with me because they said they found a cheaper one on Groupon! Just because you pay less, it doesn’t mean the standard of training is going to be any good. Look hard at the qualifications that you’re actually getting. Have a look at the experience of the instructor. Many are overblown and exaggerated. It’s a real problem.

How do you get round the charlatans?

Have a look at their business address. Because some people operate at their house, which, if they are self-employed or a freelancer, that’s not too bad. But it can be suspicious. All my clients like training conducted on site. So have a look at how professional the setup is. Have a look at the reviews of the companies. What are they doing? Are they offering accredited qualifications? How many people are they taking on a course? If you have 12 people, you can use one instructor, but if you have over 12, then you need two instructors. You just need to see what qualifications instructors have got, what experiences they have, where they worked, what their accreditation is. It is so important not to cut corners. Be vigilant. There are huge fines through the HSE if audits lead to signs that people aren’t correctly qualified. The first thing auditors look at is training certificates, the signatures and the dates on them.

Do you have an example of a training services provider that you admire?

Webbs Training, in Birmingham. They’ve got an excellent centre there (and in Milton Keynes). Well-equipped classrooms, a confined space training area. They do forklift truck training, scaffolding, PASMA, IOSH, and so on. They’re all highly qualified for the construction industry. They’ve all got bags of experience, and everyone gets on really well. Listening to them delivering all the courses, they do it with a sense of humour. They make it fun, in a professional environment. I do admire them. It’s a pleasure to work with them. They also maintain a very good standard, all the time.

And this is crucial point. Many individuals drop prices and compromise standards as a result. In the courses I run, I often go above the required standard, when some tuition is not part of the course deliverable. I give students a higher standard of training because that’s when they start coming back. And you should do because, unlike large trading companies, who can afford to have people go on their course and write a bad review, when you’ve got your own small business, you’ve got to be spot on every time.

Julian Woodall can be contacted about Medic Services International at Julian@medicservicesinternational.com or via his website, www.medicservicesinternational.com

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