What Is SIMCAS?

In the UK there is no statutory duty to provide a doctor at the scene of an accident or emergency. If people are trapped, the Fire and Rescue Service attends, if people are injured, the Ambulance Service attends and to protect life, property and control the scene, the Police attend. 9 times out of 10 this covers what is needed but there are occasions when the presence of a doctor on scene is vital.

Some ambulance services in the UK are unable to give strong analgesics (painkillers) and those that can are only able to give limited types and amounts of drug according to protocol. Some patients require complicated manoeuvres to produce an airway for breathing which are currently beyond the boundaries open to paramedics. The performing of a tracheotomy, or opening in the windpipe, can be life saving if, for example, a child has inhaled an object which is lodged in the airway.

It is for these and similar situations that SIMCAS exists - namely to provide a properly equipped, experienced doctor or nurse at the scene of the incident.

On occasions, doctors are even required to anaesthetise a patient at the accident to enable their release. This is particularly useful if they are in extreme pain or in distressing situations. For example, particularly with children, it is often possible for them to wake up afterwards with no memory of the event, sparing them further distress.

At other times we are happy to be an extra pair of hands and can be useful in providing a medical overview of the situation.

Many ambulance services in the UK now have an arrangement with local doctors whereby they can be called out, usually by pager to the scene of the accident.

There is no NHS funding of equipment for these schemes and due to complex NHS financing arrangements, many of our members respond completely voluntarily. All items of equipment are provided by donations from the members of the local community.

Once the system is in place, each doctor can be fully equipped with protective clothing, drugs and other vital equipment for use in the "field". We are identified by the use of green or blue flashing beacons on our cars, both to enable progress in traffic and to protect the scene on arrival.

Many areas around the UK now have their own immediate care scheme of doctors and increasingly more recently, attached nurses. Nationally in the UK these are grouped under the BASICS banner. RTA

The local group known as "SIMCAS" covers the whole of Sussex and part of southern Surrey. It currently consists of 19 active doctors and nurses and our treasurer. See our members’ page for more details.

SIMCAS is fortunate in its close links with South East Coast Ambulance Service. At its request we also provide on a rota system, the Medical Incident Commander (or MIC) in the event of a major incident anywhere in the county. There is currently a group of ten doctors, all general practitioners who have extra training to provide this specialist role if needed.

Expansion into Kent

In 2006 it was decided that we should expand into Kent and link up with the fledgling immediate care service there. We have now added two doctors, a nurse and a paramedic to the team and they include as big an area as they can, but Kent is not yet adequately covered.

Special Support Unit

Several years ago South East Coast Ambulance Service formed a small squad which included some members of SIMCAS. This is known as the Special Support Unit. It was organised to deal with particular incidents that warranted medical cover but required special skills, and often in unusual places. We have since worked closely with Sussex Police in civil disturbance training and HM Coastguard as seen here at Beachy Head. Beachy Head is well known locally and indeed nationally as both a beauty spot and unfortunately, as a place from which to leap to oblivion. The cliffs are over 500 ft of vertical chalk in places but occasionally there are ledges which can break people's fall, saving their life but putting them and their rescuers in a dangerous position. As a rescuer, walking off the top of the cliff with only a canvas seat to save you is some experience!

Here you can see Clive Butler of South East Coast Ambulance Service being lowered over the cliff edge in a training exercise.