HAMPSHIRE Ambulance Service was awarded no stars in last month's NHS performance indicators. For the ambulance crews busy responding to 999 calls and saving lives, it was a bitter pill to swallow. Health reporter Sarah Cole joined a Southampton shift to see the challenges they face...

THE little girl had fallen more than six feet down the stairs at her Southampton home. After landing head-first, she had lain unconscious for about a minute before her frantic mother managed to rouse her.

Dazed and complaining of a hurt head and back, the two-year-old was carefully lifted into a Hampshire ambulance, still clutching her favourite handbag and a cuddly Winnie-the-Pooh.

It was when she was laid on a stretcher that the tears started.

The crew needed to fit a brace around her neck but she was having none of it.

Then suddenly paramedic Pete Warren had a brainwave.

He asked her: "Does Winnie-the-Pooh have a headache? Shall we put a bandage on him?"

Instantly, the girl stopped crying and nodded her head.

She watched quietly as Pete and colleague Les Goddard wrapped a small bandage around her favourite bear's head.

With her attention diverted, the pair were then able to gently slip the neck brace on to their young patient.

And after that, she was as good as gold - even allowing the pair to put an oxygen mask around her mouth.

It is tricks like this that come with years of experience.

Pete, a qualified paramedic, has seen it all in his four years with Hampshire Ambulance Service.

Les, who has just qualified as an ambulance technician, has seen most of it - in just a year on the road.

Diabetics, asthmatics, road crash victims, women in labour, drug addicts, drunks, heart attack victims and elderly people who have fallen over are all in a day's work.

It is stressful, relentless and often thankless.

Customers are often worse the wear for drink or drugs and can be less than co-operative.

And although Hampshire's ambulance crews could probably earn far more money elsewhere, they wouldn't do anything else.

Pete, based at Southampton's main ambulance station in East Park Terrace, took a large pay cut and gave up his company car when he joined up.

Recently, he was bitten by a patient. Yet still he loves his job.

In Southampton, crews work in pairs for each ten-hour shift, which can be anything from 7am-5pm to 10pm-8am.

Traditionally, Friday and Saturday evenings are busiest, with drunken nights out in town leading to punch-ups and late-night incidents.

But Pete said Sunday nights could be just as bad - or any night when people had just been paid and were hitting the beer.

"It's also true what they say about the full moon," said Pete, meaning there were often calls involving strange individuals on certain nights of the year.

Often, there is barely time for a half-hour meal break and a quick re-charge of the batteries before hitting the road again for the next 999 call.

In order to meet their targets, crews have just eight minutes from the moment a call comes through to reaching the patient.

The driving alone is mentally and physically demanding, with sirens blaring as the ambulance weaves through the jammed city streets.

All too often, other road users do not get out of the way and lose the crew potentially crucial seconds.

A pet hate of Pete and Les is car drivers who do not use their rear-view mirrors.

"I can understand drivers sometimes cannot hear where the sirens are coming from but how they manage not to see the blue flashing lights right behind them is beyond me," said Pete.

Brief details of each job and address are sent through from the service's control centre, and flash up on a screen on the dashboard.

As soon as the crew gets a shout, it is action stations.

Les and Pete usually share the driving, with one doing the first half of the shift and the other the second.

If a hospital transfer is needed, whoever is not behind the wheel will be busy at work on the patient or filling in paperwork to pass on to accident and emergency staff.

A hi-tech MobiMed machine in the back of the ambulance links up with each of the main hospitals in the area, allowing essential information such as heart monitor and blood pressure readings to be sent on ahead.

Although based in Southampton, the crew can easily be sent further afield if necessary.

Les and Pete have attended incidents in the New Forest near the Dorset border, Basingstoke and Portsmouth.

The number of calls they deal with in a shift tends to vary between five and 13, depending on the time of day, but is frequently around the ten mark.

Les completed a driving course as well as extensive medical training before being allowed out on the roads with Pete. But he says it is this time dealing with patients - rather than in the classroom - where he has learned most.

"The driving bit is the easy bit really," said Les.

"It is the talking to people and touching people that is really important. Pete gave me lots of hands-on stuff to do in my first few days."

The pair are among around 50 staff based at Southampton Ambulance Station.