Peter Stajic

Dear Mr Oliver PETER STAJIC (DECEASED) I am writing in response to the preventing future deaths report received at the Association of Ambulance Chief Executives and I respond as our Director of Operational Development and Quality Improvement on behalf of AACE. On behalf of AACE, I would like to extend our sincere condolences to the family of Peter Stajic. It may be helpful for us to explain that AACE is a private company owned by the English and Welsh NHS ambulance services. Its purpose is to support its members, UK NHS ambulance services, in the implementation of national agreed policy and to act as an interface, where appropriate at a national level, between them and their stakeholders. It is a company owned by NHS organisations and possesses the intellectual property rights of the Joint Royal Colleges Ambulance Liaison Committee UK ambulance service clinical practice guidelines (the “JRCALC guidelines”). AACE is not constituted to mandate or instruct ambulance services however it has national influence via the regular meetings of ambulance chief executives and chairs along with a network of national specialist sub-groups. We respond in relation to your matter of concern: Although detailed expertise concerning a herald bleed is specialist vascular knowledge that the paramedics who attended Peter at his home on the morning of 26th February 2022 would not be expected to possess, the evidence to the inquest was they would not have had any training in identifying one, nor any protocol for them to follow. Firstly it is important to note that the JRCALC guidelines are advisory and have been developed to assist healthcare professionals inform patients and to make decisions about the management of the patient’s health, including treatments. This advice is intended to support the decision making process and is not a substitute for sound clinical judgement. The guidelines cannot always contain all the information necessary for determining appropriate care and cannot address all individual situations; therefore, individuals using these guidelines must personally ensure they have the appropriate knowledge and skills to enable suitable interpretation. All our JRCALC guidance is updated on a regular basis. The guidance is available to all UK ambulance paramedics and is used on an App. We often respond to incidents and issues raised so that we can improve the guidance towards improving patient care. We currently have specific JRCALC guidance for vascular emergencies and this details conditions such as aortic aneurysm, aortic dissection, ischaemic limbs, AV fistula bleeds and diabetic foot problem. We discussed your matter of concern at our JRCALC meeting on 9th April 2024. JRCALC consists of expert advisors including those with vascular and surgical knowledge. It was decided that we will develop some new guidance for paramedics to be more aware that some surgical wounds, particularly those

Chairman: Managing Director: around blood vessels, can become infected and be at risk of catastrophic bleeding. It is likely this will be included in our existing vascular emergencies guidance. We will follow our existing process for the review and update of our guidance and this is expected to take around three months. When the guidance is updated it will be pushed out as a clinical update onto the App following our usual process which involves approvals from JRCALC and our National Ambulance Medical Directors group (NASMeD). If you have any further questions please do not hesitate to get in touch.