Autumn Keeping Britain Safe 24/7

Hello, if you can hear me, but you can't speak, tap on the phone.

64 million people, 365 days

and 31 million calls to 999.

That's the scale of the task faced by Britain's emergency teams.

And for one exceptional year,

we'll be following their frontline workers.

Not just our police, our firefighters and our paramedics.

We've been with our other critical emergency teams as well.

Teams we rely on sometimes without ever noticing.

The specialist teams that keep our railways moving,

despite the dreaded leaves on the line.

Notting Hill bin men with just seven hours to clean up

after our liveliest carnival.

National grid controllers responsible for powering

20 million homes, 24 hours a day.

The Greater Manchester Police Dog unit,

controlling 75,000 fans at the height of the football season.

Life boat crews at Britain's busiest station,

with just 90 seconds to respond.

We'll show you how these specialist teams work under pressure

to protect us from danger on their most demanding days.

This is the story of one year with our emergency teams.

A year with the heroes keeping Britain safe.

Tonight it's Autumn. The days are shorter,

the temperature is plummeting, and it's flood season.

Ohhhh!

So we're in Yorkshire and North Wales with the emergency response teams

battling the worst floods in years.

We're joining the Cleveland Fire Brigade for their busiest shift

of the year...Bonfire Night,

when they receive a six-fold increase in calls.

Ah, right, thank you. We're on our way.

And as traffic accidents hit a peak in November,

we're in the Midlands with one of the country's busiest air ambulances.

Keep your legs straight for me.

But first...

Rail travel has undergone a bit of a renaissance in the last few years.

In fact, over the last decade, it's gone up by 43%.

We, the British public,

now take 1.3 billion train journeys every year.

So with such large numbers of us travelling,

who are the people whose job it is to keep us safe on the railways?

It's Wednesday afternoon,

and here at the Wimbledon signalling centre in the South London,

nine signal men and women are gearing up for the evening's rush hour.

There are 800 signalling centres across the country,

from the one-man signal box with old-fashioned levers,

to this, a busy signalling centre co-ordinating 2,000 trains

into London and the south-east of England.

Trains leave Waterloo in the evening peak about every two minutes

to go to places like Bournemouth, Exeter, Portsmouth,

about 1,000 passengers on board each train.

Lights on this panel show the path of each train.

The signallers carefully monitor these lights,

and can contact the train drivers directly.

Yeah, 12.40 - that's one, two, four, zero.

As delays occur, they're making instant adjustments

to the train schedules.

Train service is good.

As long as we get people travelling on the railways, safely,

from point A to point B, that's all that I'm interested in,

and that's all these guys are interested in.

Now, seeing as it's autumn that we're talking about,

of course Network Rail has another challenge on its hands -

these chaps, the commuter's worst nightmare.

This is a busy station.

Hundreds of thousands of people pass through here every day.

And yet, I still reckon I will struggle to find anyone

who has any sympathy for Network Rail

over their ongoing battle with leaves on the line.

-An excuse for why trains can't run.

-An excuse?

Do I believe it? Probably not.

Leaves fall in autumn every year. Have done for years on end.

Why is it only a problem fairly recently?

It's frustrating that you think that leaves can cause such delays,

it's just leaves on a track at the end of the day,

it's surely not that hard to clear.

So, what's going on?

And why are leaves on the line such a serious headache for Network Rail?

I'm starting with this man, Dr Neil Strong,

Network Rail's only arboriculturist. And that means tree and leaf expert.

When you hear the announcement on the train,

you just think, "Leaves on the line, that's just pathetic."

Surely we can deal with a few leaves?

It's not a leaf on the line.

You can see from just these trees here,

you get all those building up

and you have the pressure of the train wheel,

squashing those between the wheels and the rails,

and you end up with some black paste that bakes really hard like Teflon,

like black ice.

So they actually end up like a little sort of pate on top,

-and then that bakes onto the rail itself?

-Yeah.

It's the train equivalent of black ice.

It makes the rail slippery, and means trains can over-shoot stations.

But there's another problem.

The signal that tells control where trains are

is sent as an electric current through the track itself.

For the signal system to work,

there must be a good metal-on-metal contact between train and track.

Leaves on the line can stop that happening.

If you've got this build-up of leaf material on the rails,

you're insulating the rails. So basically you run over it

but the signal doesn't know you've gone past it.

All the trains are stopped on red

until we've found the one that's missing,

and then everybody can be started up gradually.

It can cause massive delays, cos you can't really start again

-until you've found your missing train.

-Exactly.

So, effectively, one of our trains is missing.

-You don't know where it is.

-Yeah.

-Is it before the signal or after?

Exactly.

This is no small problem.

Britain has a total of 20,000 miles of rail track,

enough to reach to Australia and back again.

Quick bit of mental arithmetic for you.

The average mature tree holds around 300,000 leaves,

and there are two and a half million trees on or around the rail network.

That means Network Rail has to deal with 750 billion leaves.

So, Neil runs a massive maintenance programme.

Today he's in Cornwall.

These will hold whatever you previously cut.

Use the weight of the thing just to push it through.

With train services halted,

this team of Network Rail engineers have a short window to remove

a number of problem trees from a heavily overgrown stretch of line.

Clears his way through,

then you can see the wood from the trees, literally.

And this whole process begins in the skies above us.

All right, that's on the screen now.

Lovely, yeah.

Because with 20,000 miles of rail track to maintain,

the easiest way to survey the rail network is from above.

It's right underneath us.

All right.

Neil certainly clocks up the air miles.

Today he's up in skies over Kent, on the hunt for offending vegetation.

-It's basically hanging down in between trains, isn't it?

-Yeah.

Massive spreadsheets of data...

Using laser technology mounted on the aircraft,

Neil then maps all the greenery along the trackside.

He also helps to create a leaf fall weather forecast,

issued twice a day through the worst weeks of autumn.

And that forecast finds its way to the inboxes

of 30 Autumn Leaf Controllers up and down the country.

Network Rail Autumn Control, Glasgow.

Like Joanne here in Glasgow.

I'm the Autumn Controller for six, seven weeks of the year.

There's 17% of the leaves still on the trees at the minute, yeah.

I don't know who the person is that goes round picking up the leaves

counting them.

I mean, I'll drive to work and I'll be like, "Oh, my gosh,

"look at all these leaves everywhere."

And I'll go home and I'll say, "Look at that back,

"look all them leaves. Oh, I'm going to have a busy day tomorrow."

Yeah, I do. I talk about it, yeah. I tell people about it, yeah.

You know, everyone in this office doesn't like this time of year.

They get absolutely overwhelmed with delays.

People do think it's a bit of a joke, leaves on the line,

but it really is very serious, you know.

It really does have a big impact on the train services during autumn.

PHONE RINGS

That's my phone.

Network Rail Autumn Control, Glasgow.

These controllers co-ordinate a huge cleaning effort,

undertaken by a fleet of more than 50 specialist treatment trains.

Twice a day each section of track is jet-washed and sprayed

with a special cleaning agent.

In the last ten years there's been

an increase of one million train journeys on our railways.

The network is packed, but Network Rail still has to find room

in the autumn schedule for the treatment trains

to cover 700,000 miles. And it's all to combat

the dreaded leaves on the line.

In autumn, there's one night when we light up the gloom.

Up and down Britain, in our cities, towns and back gardens,

Bonfire Night brings out the crowds.

But for Britain's 50 fire brigades, this national celebration

is the most challenging night of the year.

Lighting up their switchboards like our skies.

There are almost 2,000 fire stations up and down the country

manned by 43,000 firefighters.

And on Bonfire Night, one of Britain's busiest brigades

is Cleveland, serving the north-east.

Here, over the next six hours, they're anticipating

a six-fold increase in their nightly calls.

And so I'm in Middlesbrough, along with Matt,

to experience this incredibly stressful night

with the Cleveland firefighters.

I hope they answer a bit quicker than this tonight if there is a fire.

That's all I'm saying.

This brigade has to deal with one of the highest arson rates

in the country, and at this time of year they get run ragged

by nuisance fires started by a small number of mischief-makers.

Yeah, they might get a little bit excited tonight,

cos obviously it's Bonfire Night,

and we're seen as their enemy

cos we're going to destroy their fun, as they see it,

cos it's their bonfires and they just want to be left alone.

It's like with everything, you get a minority

that put a dampener on the majority.

Unfortunately.

Fire brigade. What's the address of the fire?

Hiya. It's on the field next-door to my house.

But are the youths still there, do you know?

Oh, yeah, there's about 20 of them.

All right, thank you. We're on our way.

It's 5.30 at the start of Bonfire Night.

I've only been here for minutes,

and we're on our way to the first shout of the evening.

The Cleveland Brigade has 15 stations

and 21 fire engines,

but these resources protect half a million people

across the area.

Tonight promises to stretch them to their limit.

There's a cutting down through here to an open space,

and there's also about 20 or 30 kids down there as well,

so we don't know what we're going into. We're going to take a look.

So even a tiny, what was it, a mattress and a couple of doors

still takes out half your resources for half an hour,

-we get there and sort it out?

-Yeah.

SIRENS BLARE Oh, what's that?

That was Charlie One, that's the other appliance

at Grangetown Station. They're obviously going to another incident,

so that's Grangetown station empty now.

That's the whole fire station in use, and it's only...

..just about six o'clock.

For the next five hours, the screw tightens.

As the evening unfolds, we're called out repeatedly

to a series of often unattended do-it-yourself bonfires.

A tricky one, this, because it's actually out of reach, really,

of the unit, the wagon itself.

It's only a little one, I mean, I've had bigger fires in my house.

What is this? I've lost count now.

Seven? Eight...er, fires,

the guys have had to put out.

They may be small, but left to their own devices

these fires could easily spread.

And every time the brigade has to attend.

Fire engines are being drawn out left, right and centre

all over the area, trying to cover little nuisance fires like this,

when they should be out saving lives

and looking after big bits of property.

While Matt's dealing with nuisance fires,

I'm with another crew six miles away.

And I've discovered something disturbing.

As firefighters respond to these shouts,

they can come under fire themselves from bottles and stones.

Tonight, though, there's seasonal ammunition.

Fireworks.

So, this time, the call-out was for youths throwing fireworks

at people, at cars.

-Keep your visor down.

-Oh, here we go.

Youths in this area are firing fireworks across the street.

We've been advised to move on.

The key thing is not to get trapped.

We're reversing in so we can make a swift exit.

It's really tough to get your head around.

Why and how people would feel animosity towards the fire brigade,

and yet tonight, we've got to ride with the windows up

because somebody might chuck a brick at them.

After three intense hours with my crew, I'm leaving them to it.

I want to experience what it's like for the five call-handlers

working tonight back at base.

-ON THE PHONE:

-It's not controlled at all.

There's fire coming over the back fence. They're running wild.

The fire's in the middle of the field,

but as soon as the fire brigade go, they're running all over.

And keeping an overall eye on proceedings

is their Director of Community Protection, Phil Lancaster.

Tonight has been very similar to last year's Bonfire Night.

We've got to anticipate that on Bonfire Night people will go out

-and they'll celebrate and they will have fires.

-And make mistakes.

They will, yeah, they will, and we'll go out and deal with those.

And you've seen probably five hours' worth of mayhem tonight.

We've had a gas explosion in a house tonight.

It takes a lot of resources to deal with that type of incident,.

That's the real serious incidents that we need to get there

very quickly to deal with quickly and make sure people are safe,

and diverting us away from those type of incidents,

our availability to deal with those types of incidents,

is really serious.

And that's the major problem that these firefighters

have to deal with during this period.

-PHONE:

-They've set a bonfire off and it was like out of control.

Right, OK. so Fleet Avenue in which town?

They have to attend to a succession of nuisance fires,

while still being able to react when needed elsewhere.

As Bonfire Night draws to a close,

around 1am, Cleveland's 21 fire trucks

are gradually returning to base.

Over the course of the evening of Bonfire Night alone,

they've responded to 183 separate calls,

their busiest single night of the year.

And that experience was repeated up and down the country.

In Manchester they had 648 calls - five times their daily average.

In South Yorkshire they took 477 calls -

more than double their average.

And in Tyne and Wear they received 476 calls - ten times their average.

But our emergency services have much more than fire calls on one evening

to deal with.

In fact, across Britain, 999 is dialled 85,000 times a day.

That's one call to 999 every second.

Which is 31 million calls to 999 every year.

All of this is a million miles away from the emergency hotline's

humble beginnings, way back in 1937,

all because of an incident over there, in Wimpole Street.

It was early one Sunday morning when a serious fire broke out

in this four-storey family home in central London.

A neighbour witnessed the fire and tried to call a local fire station.

But back then, calls went via an operator,

and the caller was held in a queue.

Tragically, the call went unanswered and the fire proved to be fatal.

Five women perished in the blaze.

The episode caused such an uproar that it was decided

an SOS emergency number should be introduced,

and of course that number was 999.

But in the House of Commons, Sir Sidney Herbert posed

this interesting question - how a lady with a burglar in the house

could be expected to remember the number 999,

and whether it would not be better to have some button to press

on the telephone.

Thanks, Sid, I think we've got a grip on that.

After the Second Word War,

the 999 system was rolled out to the other major cities of Britain.

Emergency, which service, please?

And in 1976, 999 became a truly national system.

I'm going to get police straight round to the address.

Things are on a different scale today.

Call centres filter and route 999 calls.

Is she screaming with the pain in her stomach?

Passing them on to control rooms in seconds.

OK, police, we're on our way, thank you.

It's all a long way from those tragic events on Wimpole Street

more than 75 years ago.

Events that led to the creation of the very backbone

of Britain's emergency response network.

As temperatures start to fall,

there's a rise in the number of heart attacks.

No, no, please. I've got to get up.

And so we're with a trauma team in the Midlands

dealing with a life or death emergency.

And as annual births in Britain reach more than 700,000,

Julia discovers what it takes to be a midwife

in the middle of an annual baby boom.

But first...

Now, it wouldn't be autumn without a spot of rain.

Autumn is traditionally the worst of the seasons for flooding.

Oh, my word.

Oh, no! Look! Oh, my goodness.

Oh!

We're right in the middle of it.

So who's on hand to pick up the pieces

when our towns and cities flood?

The Royal National Lifeboat Institution,

or RNLI, is a charity set up originally to save lives at sea.

But in 2000, it created a specialist flood rescue service.

They have 250 specially-trained volunteers

who are called out to floods across the UK.

And on the morning of the 27th of November, this flood rescue team

was called out to the small community of St Asaph

in North Wales.

And to what looked like a scene from a disaster movie.

We were met with utter devastation when we first arrived on scene.

You could see a lot of people were frightened,

and I think there was quite a bit of disbelief.

There was elderly people.

They were quite surprised to see four burly lifeboat men in lifeboats

knocking at their doors, and telling them they needed to evacuate.

500 people needed help to evacuate their homes

by the emergency services.

It's an eerie feeling at times,

especially when we've got a lot of people out

and we were going back round doing the final checks.

Everything is different. It's alien.

You can see their possessions and all that ruined,

their life-savings, their photos, something that's irreplaceable.

And you're asking them to leave their homes for their own safety.

It's not the nicest of feelings. You do feel for them.

It's...

It's hard. It's very hard.

Despite warnings from the Environment Agency,

here in St Asaph, residents and the emergency services

couldn't prevent their homes from flooding in the face of this deluge.

And that was the story repeated in many parts of Britain.

In the south-west it was the worst flood since 2000

with 29 warnings and 58 alerts,

and countless railways and roads being closed.

In the north-east of England and Yorkshire

almost a month's worth of rain fell in one week.

For years we have been trying to protect ourselves

against major flood events.

We currently spend over half a billion pounds annually

on building and maintaining flood defences like this -

the Thames Barrier.

Just look at the size of this!

These things are like 21st century castles protecting central London

from the threat of flooding.

It's been deployed 124 times to hold back surges in the River Thames.

But even a barrier like this

isn't guaranteed to be effective against flooding.

Because experts say that in recent years we've been experiencing

a new type of flooding - one that's much harder to predict

and to protect ourselves against.

It's called surface water flooding.

Surface water flooding occurs not when a river like this surges

and bursts its banks, but when rainwater falls

and can't drain away. So during a monsoon-like rain,

or when the ground is saturated and can't absorb any more water.

It's the sort of flooding that's hit this unlucky village in Yorkshire.

This is Malton, just outside of York,

on the banks of the River Derwent.

Overnight rains have given these villagers

a terrible surprise this morning.

It's come up about three inches in this last hour.

Chaos.

They've spent over £9 million on defences

to stop the river bursting its banks.

The trouble is, that's not the problem today.

The actual river itself is still within defences.

The thing that is making this exceptional

is the amount of saturation.

So what we see here today

is there's a flood actually occurring here

that is caused by surface water flooding

not being able to get away.

That's river coming up through drainage system in town.

Now it's just flooding all this bottom corner.

Overnight rains have saturated the ground

on the North Yorkshire moors, and the run-off of this water

has overloaded the town's drains.

The drains can't hold it all,

and if you looked over there, you'd be able to see it

sort of like it's just bubbling out over the drains.

Responding to this event are an array of teams.

The fire brigade, the police, the ambulance service, Yorkshire Water,

North Yorkshire Highways, Network Rail and the Environment Agency

are co-ordinating the operation.

It's coming through our walls - you can see it coming through the walls.

Residents like Nick Hinds are having to pump out the water

flowing into their houses.

It's coming straight through into the living room.

Thank God we've got a pump to pump it out.

Eight o'clock it all started,

by half-past eight it was uncontrollable.

I can't stop it.

HE LAUGHS

I don't know who can stop it. I don't think anyone can.

This is the human cost of flooding, and in Nick's case,

it's threatening his prize possession -

his tropical fish collection.

If that goes and breaches that, that will be that cancelled out,

and there's nothing to keep the system alive.

So it will all die.

Ten years' worth of experience gone into it, and a lot of money.

A lot of care... Taken all the time to look after it,

and something like this happens and you just...

It's a nightmare.

You just can't do anything, can you? It just keeps coming in.

Whoa, we're nearly there!

By nightfall, the emergency teams are beginning

to bring down the water levels,

and soon they can start on the next stage - the mop-up.

150 miles away, back in St Asaph in North Wales,

the local community and emergency teams are rallying round.

Here in town, the local council have set up

a rest centre to support the evacuees.

It's staffed by council workers, the Red Cross and volunteers,

and they're being inundated with donations.

We've got all the supplies that have been donated, so people who have

lost everything can come in and get food, toiletries, bedding, clothes.

It's unbelievable that this has all come within 24 hours,

this amount of stuff.

Quite emotional really, I'm just so totally taken aback by it.

Across town, council workers are cleaning up the flood-damaged homes.

While some of the evacuees are allowed to return

to try and salvage valuables.

Devastation is the word, I'd say.

I didn't realise how high the water had come.

It's a good job we got out.

That's...

You wouldn't believe that, would you? A £5 note!

Eh? Lucky fiver.

Down payment on a new home. Thank you. Bye.

There was an estimated £1 million worth of damage

done to this community.

And it could be a year before all these evacuees

can return to their homes.

But in the battle against flooding, all over the country

we still rely on an ingenious piece of Victorian engineering.

In the north-west, I'm with the Environment Agency's

confined spaces divers for a trip down a Victorian culvert.

The only thing that I'm worried about, Carl, is that it's

currently raining, OK? And we'll be going down to where all the rain is.

To infinity and beyond.

Welcome to our world.

It's beautiful down here. DIVER LAUGHS

-Are you ready, Matt?

-Let's go. Let's go.

This feels like a very dangerous environment.

'All year round, the team is responsible for clearing out

'culverts and underground rivers like these, which disperse rainwater.'

-Moving on!

-'They're crucial to prevent flooding.'

Moving on!

'Culverts are tunnels that run under most of our cities,

'and if I kept walking from here - underneath Bolton -

'eventually I'd reach the River Mersey.'

Look at this.

This is coming from your street, or one very much like it.

And it's very straightforward - if this culvert blocks,

then this water fills up,

it goes straight back up the land drain, and it floods your street.

So what Chris and Carl are doing here, absolutely essential,

if you're not going to have a very uncomfortable couple of days.

I didn't know anything about culverts...and now I'm in one.

-Ah, what have we got?

-Start of a potential blockage.

-My God!

-Timber, and someone's Flymo.

-So we've got a Flymo and a log there?

-Yeah.

As the water gets higher, more debris comes down,

wedges at this point, and then you've got a potential hazard.

If you leave it, that's when it causes a problem.

Before you know it, the water is up here backing up,

up the manholes, people's flooded.

Kids toys to cars, you name it.

Moving on!

Who threw their Christmas tree down the drain?

-That's it. Anybody.

-Got it. OK.

-Can we go home now?

-Yeah.

-Brilliant.

-Moving On!

-Moving on!

The job these guys do is something else.

It's hard, it's physical.

And it's absolutely essential if you want your house to stay dry.

If you know one of these guys, give them a hug, buy them a drink,

-because they're doing a fantastic bit of work.

-Coming up!

November sees almost 20,000 injured on British roads.

So I'll reveal the most dangerous stretch of road in Britain.

And I'll meet the teams battling to save lives on our highways.

The Royal London Hospital, East London.

It has one of the busiest accident and emergency rooms in Britain,

and autumn is always a challenge here.

25 years ago, doctors from this hospital came up with

a revolution in emergency response.

Too many people were dying unnecessarily

because they weren't getting the right medical attention fast enough.

Enter their secret weapon.

..an ETA of approximately four minutes now, over.

London's Air Ambulance is a service that works alongside the hospital.

It was Britain's first flying doctor emergency response team,

and it started in 1989.

Since then, deaths from major trauma in London

and along the M25 motorway have dropped drastically.

And it's thanks in part

to this remarkable and ground-breaking charity.

PILOT SPEAKS OVER RADIO

It's not that these helicopters get to the scene first -

a land ambulance could be closer and beat them to it.

What's crucial is that these machines deliver

a highly-trained trauma doctor

directly to the location of the accident,

otherwise the first time the doctor would meet the patient

would be in the hospital.

The service has been so successful that it's been replicated

up and down the country.

There are 37 air ambulance helicopters across Britain,

and they attend an average of 70 serious incidents a day.

During autumn, we filmed with one of the country's busiest.

PHONE RINGS

Helimed 545?

This is the Air Ambulance service that serves

Derbyshire, Leicestershire and Rutland.

Outside of London, this charity covers some of

the most densely populated parts of Britain.

Are you all right there, Dave? Do you need a hand?

Dr Stuart Maitland-Knibb is a trauma doctor on the team.

I want to know the key differences

between working on the helicopter and in the hospital emergency room.

It's a more pressurised environment, surely?

It is, but I like it because it's back to real medicine.

It's hands-on, you do what you have to do right now for the patient.

-It's instant.

-Absolutely.

You go to work, you have no idea what is going to happen.

-HE CLICKS FINGERS

-Bang!

So you can go from sitting having a cup of tea

to absolute carnage, in literally minutes.

Among the most serious medical emergencies Stuart has to deal with

are cardiac arrests.

And it's thought that there's a link

between heart attacks and changes in the climate.

As autumn arrives and temperatures start to drop,

medical researchers have identified something really interesting.

10-14 days after a major fall in temperature,

there's a rise in the number of heart attacks.

As temperatures drop, this can lead to an increase in blood pressure,

which can put an extra strain on the heart.

Looks like somebody is there.

It's a crisp, autumnal Saturday morning.

Stuart and his team have been called to Chatsworth House,

a large estate in Derbyshire.

Nick Hutton, a 64-year-old man

walking in the grounds, has collapsed.

-Lie down, lie down.

-Nick, it's all right,

it's Meryl. No, leave that on.

Paramedics on scene have just used an electric shock

to try to get Nick's heart back into its proper rhythm.

He's now confused and agitated.

NICK COUGHS

We were on an old boys school walk, Nick had organised the walk.

And we were walking along chatting,

and then suddenly we realised he was flat on his back.

Stuart recognises Nick's distress

as a classic fight-or-flight response.

Hello, sir.

As far as his brain is concerned, he is in a death situation

and he wants to get away from that.

All right, sir, just relax, relax.

The more effort that he puts in,

actually, he's doing himself more harm,

because he is using up oxygen quicker,

and where the oxygen is needed is in the brain and the heart,

but it is being surged into the muscle groups, to try and run away.

-NICK:

-No, no, please, got to get up.

-No, no, no.

-Whoa, whoa, whoa!

I must get up. I must get up, please.

Nice and still. Good lad.

The only people that will be talking is Phil and myself.

-Are we all happy to continue?

-Yes.

'As soon as I came out of that helicopter

'I knew that this guy was going to need a general anaesthetic.'

So normally when you have an anaesthetic,

you have a pre-op assessment with the anaesthetist,

they find out about what drugs you are on,

what allergies you've got. I don't have that luxury.

I want to know when we're at 45 seconds.

'What we're doing has a lot of risk associated with it.'

So whatever happens, I am totally responsible for this man's life now.

-45 seconds.

-Stop.

MPAs?

This is it. You are on your own, and you think, "Ugh..."

Sats are dropping, they're coming back now.

OK, bag him, that's fine.

Fantastic, well done, everybody.

This gentleman has had a heart attack, probably,

that has resulted in his heart stopping. Luckily, bystanders have

straightaway recognised that and have been able to pump on

his chest, giving him CPR until the emergency services have got here.

That is what has saved his life, the people that were here first

pushing up and down on his chest.

Sheila started doing CPR on him.

He wasn't breathing, he was going blue and had no pulse,

so I got him onto his back and started CPR.

Wasn't sure that I was doing it properly.

Anybody shout if they want a rest.

And I said, "Does anyone know how to do this properly?"

And Dave took over and did a much better job than I did.

We were walking along there and I saw him go down.

The lady was trying to give him CPR and she didn't know what

she was doing, neither did I, but I thought I could help.

So I just did what I could and what I thought was right.

He started breathing again,

which was a great relief to everybody, I think.

The last time I did it was on a rubber doll

on the floor in the church hall!

With Nick under general anaesthetic, Stuart has to use a mask and bag

to take responsibility for every breath his patient takes.

He is at risk of dying. Hopefully in the next 24 hours

we'll get a better picture of what's going on.

He is hyper-tensive, CO2 has remained about 5.5.

If we look at the statistics, if you have a cardiac arrest

and if you have no bystander CPR,

and the paramedic is more than eight minutes away,

your chances of survival and discharge from hospital

are less than 0.8%.

-So nothing really, you're dead.

-Absolutely.

It shows just how important a very simple piece

of first-aid training can be.

So before I leave Derbyshire,

I've asked Stuart for a CPR refresher course.

Hello, hello, can you hear me? What's your name?

OK, so there's no response.

OK, so now we are going to do a shake and shout.

-LOUD:

-Hello, can you hear me?

We're going to lock our arms, and we're going to press down

onto the chest, about a third of the depth of the chest.

The rate that you need to be doing it is either

the Bee Gees, Staying Alive, or Nellie the Elephant,

-which is my preferred option.

-OK.

# Ah ah ah ah

# Staying alive, staying alive... #

-Just one thing.

-Yeah?

-Don't sing it out loud. It's very disconcerting for relatives.

-Yes.

Just keep going. You're going to just keep going.

-Just keep going?

-Just keep going.

Remember, the emergency services have been called

and they're on the way. But you just have to keep going.

'And because of life-saving CPR given by two members of the public,'

Nick Hutton went on to make a full recovery following bypass surgery.

For the paramedics and doctors of the Air Ambulance Service,

autumn is also the season when they have to deal with

a rise in road accidents.

November is the worst month of all for road collisions.

RADIO CHATTER

And one thing thought to contribute to this is a yearly ritual

that's as regular as clockwork.

On the last Sunday in October, the light on Big Ben goes out...

and the clock is stopped.

After some routine maintenance, while most of us are asleep,

the hands are then advanced.

When Britain wakes up, it's in a new time zone.

Now, that extra hour can take a bit of getting used to,

especially out here on the road.

If you asked most people,

"When is the most dangerous time of year on our roads?"

then they would probably say winter. You've got ice, snow and frost.

But those people would be wrong, because it's autumn.

Autumn roads can bring with them dangers

that we might not necessarily spot.

As the clocks go back,

we can end up driving home in the dark through the rain,

or we can end up heading out in the morning through early frosts.

But if you thought your motorway was the most dangerous road,

then you'd be wrong. It's rural roads like this where we are four times

more likely to be in an accident, and twice as likely to die.

And this - the A537 in Derbyshire - has been judged

to be the most dangerous road in Britain.

A snaking 12km stretch of the road from Macclesfield to Buxton

is both heaven and hell for bikers.

It's Thursday, just after 1pm,

and the Derbyshire, Leicestershire and Rutland Air Ambulance

has just been scrambled.

60 miles from base, at a busy junction on the A17,

a car has gone head-on with an HGV.

The car contains four workers from a local factory

who were travelling home from shift.

As they arrive on scene, trauma doctor Pam Hardy

and paramedic Dave Roberts discover

the driver and front-seat passenger are trapped.

How long until we get the first casualty out?

How long until we get this off?

-Couple of minutes.

-Excellent.

Hi, how are we doing?

We're going to get you out of the car now, all right?

-Can we have some hands?

-Can we have a few hands?

Can we have some hands just to get this lady out?

-We're going to come out feet-first.

-Two, three - lift.

Rest.

The woman in the front passenger seat is conscious

but not responding.

Can you hear me OK? You can't hear me OK?

'You've got engine noise, you've got sirens,

'you have people around the scene,

'so they're all talking to each other, shouting to each other.'

And all of this is very disconcerting for the patient.

Having intravenous drugs, given to them, they might be having

intravenous fluid, they've got an oxygen mask over their face.

And it all becomes quite a scary place to be.

Can you open your eyes for me?

For Pam and Dave, there's an added complication.

I need you to keep your legs straight, darling,

all right? Is that OK?

Their patient is Lithuanian and understands very little English.

We need you to keep your legs straight, it's really important.

Is it sore to do that?

'It's very, very difficult to get that rapport.'

-PATIENT GROANS

-Where's that hurt?

'I took my helmet off, and then actually got over her

'and looked directly into her eyes.

'And that eye contact, it means a lot to some people.'

Where's your pain?

'The tactile touch of a hand when people are scared

'and things are going on,

'it makes a whole lot of difference to that person.'

You just need to be all nice and snug

while we get you to hospital, OK?

Is anything hurting?

PATIENT MOANS

This is a tragically familiar story on our roads.

Across Britain there were more than 13,000 road accidents

in the month of November.

But in this case, there was a positive outcome.

39 year-old Anya suffered injuries to her pelvis,

but went on to make a full recovery.

Her three colleagues also escaped without major injury.

And that's thanks to one of the busiest air ambulance services

in the country,

one of 37 life-saving air ambulance teams up and down Britain.

Now, from Derbyshire all the way to London.

You might not have noticed it, but over the past ten years

Britain has been booming.

The national birth rate is at its highest level since 1971.

Let me show you how many babies are being born every year.

This...is Wembley Stadium.

Britain's largest sporting arena - capacity 90,000.

At the current national birth rate, you could fill Wembley

not once, not twice - but eight times.

Giving us a grand total of over 800,000 newborns in Britain every year.

So I've come to St Thomas' Hospital, one of the busiest

in Britain, as they prepare for their own autumnal baby boom.

This is the biggest single-unit maternity ward in London,

there are more than 6,500 births here every year.

And the midwifery team have an outstanding reputation.

But this is a very special week.

The team are preparing to deliver 146 new babies into the world.

It's projected to be the busiest week of the year.

Midwife here?

Thanks, bye-bye.

Leading the charge on this year's baby boom is senior midwife Gail Roberts,

one of 25,000 midwives across the country.

And we have got at least 20 in there.

Two more coming over from the day assessment unit

in about five minutes time, so...a lot.

Edith, how are you?

WOMAN SCREECHES

I think that lady's having her fourth baby.

So, who else is going to have a baby in the next five minutes?

ALARM SOUNDS

Yeah...?

An emergency bell. Here?

It was?

Someone was feeling sick.

In this case, it seems somebody felt sick and they pulled the wrong buzzer.

But it's always good to have a run.

The team here have a rather simple system to monitor how busy they are -

depending on the number of beds that are filled.

Midwife Fiona Little tells me that they're currently on amber status.

Amber status means that we are busy

and we can cope with our own women,

but if another hospital rang us

we would probably be reluctant to take their women.

If we were on red, that means that we cannot, we cannot accept anyone.

-Under no circumstances?

-No, under no circumstances.

We don't want to close the unit, but we will have to close the unit

if we think that it is dangerous for women to deliver here.

Have you been full to the rafters here, and had births in cupboards and things?

We haven't had births in cupboards. We have had births in the corridor.

I've been on night shifts when you think

if one more person walks through the door, we're in real big trouble.

For some reason, it then just goes psssttt...and stops.

What we're going to do is transfer this lady in an hour down to postnatal.

What makes this, an exceptional week, so challenging,

is that these midwives are not in control of when the babies arrive.

Due dates are of course just an estimate.

One has just given birth about five minutes ago.

So while they're prepared for 146 births this week,

it could be less, or it could be more.

..Other than that, everything's OK.

But what makes autumn so busy?

So let's do a little bit of maths - nine months back from now.

Oh, yeah. Christmas, New Year,

at home with the family, festive cheer and all that.

To experience what these midwives have to cope with at their busiest time,

I'm joining them for their morning shift.

She's 38 weeks, she's been induced for pregnancy-induced hypertension.

-DO I need to follow that up this afternoon?

-Yeah, I think so.

In your mind you're looking after the mums and also the midwives,

-you've got an eye on where everyone is?

-Yes, definitely.

I always think of it like having a filing cabinet,

and constantly moving the most important thing to the front of the drawer.

That's how it works in my head.

Yeah, who's calling...?

Gail's team need to deliver almost one baby every hour this week.

And while some babies arrive early, and others late,

for some, their timing is a little more predictable.

This is Maria, and she's about to have a Caesarean section.

INAUDIBLE

Maria's teenage daughter Kate is with her to provide moral support.

So, baby, because it's lying the wrong way,

might take a bit of time to come out, but that's fine.

I'm excited, cos this one is last time,

so I want to see my baby soon.

I'm just nervous. I'm really nervous.

It's OK...

In the operating theatre they're preparing to deliver Maria's baby.

One in four babies are delivered by Caesarean,

so Maria's baby will be one of around 200,000 born this way this year.

So delivering any baby is special, and that feeling never really goes away

which is why we all do obs and gynae. That's the reason that we're here.

Elsewhere, Gail is doing the final checks on a baby about to leave the ward.

BABY WAILS

Oh, it's OK... I know.

And this is an enjoyable part of this job?

Oh, it's lovely. Yeah. It's really lovely,

cos you get to see the babies, talk to the parents,

meet the brothers and sisters as well, which I really like.

Shall we have a listen to your tummy? What do you think?

It's their ticket home, if you like,

so if you're checking a baby and everything's fine,

you're basically saying, "Here's your baby - take them home, enjoy." Yeah.

In the operating theatre, Maria is just moments away from getting her new baby.

She's having an operation and she's smiling, look at that.

Yeah, I'm very happy. I'm excited.

I'm going to see my baby soon.

Here's your lovely baby.

Congratulations. You've got a little baby brother.

He's looking really healthy, your mum's doing fine and we'll be out in about five minutes or so.

I've finally got my baby.

Got a little present for you.

Oh, my God...

But before I leave the ward, I've been allowed to sit in

on a very different sort of delivery.

Water births are favoured by some women

because they believe it may help them with pain control.

Expectant parents Rebecca and Francis

and midwife Carmella were kind enough to let me share their moment.

And you're at full term, Rebecca? 38 weeks?

I was expecting to go over, because they say first-time mums do.

I started having contractions on... No, Monday even.

Shall I take that for you?

REBECCA GROANS

-If you could swap places with her now, would you?

-Yeah. I would swap.

I would swap.

She's amazing. 23, and completely in control of the situation.

-How many births do you think you've worked on?

-190?

Is this ever a routine job for you?

Never. Every day is completely different, every couple's completely different.

Definitely the best job in the world.

REBECCA BREATHES RAPIDLY

Blow. Like you're blowing out candles on a birthday cake.

So you can practise now. Yeah? Exactly like that, big breaths.

Carmella has been with Rebecca for two hours now.

REBECCA SHRIEKS

Don't be scared - that's the baby's head coming through.

Ohhhhh...!

Yay!

-Oh, my gosh.

-There you go!

-Oh, you're so beautiful.

-Hello!

Look at his eyes. He's opened his eyes at you.

Oh, he's so sweet...

Well done. You're a superstar!

-Thank you.

-You're amazing.

What an absolute privilege to be in that room with all of them.

And Carmella was exceptional throughout.

And you do forget how much pressure the midwives are under

all the time, during that process.

Was that a particularly special birth?

-Cos it felt like it, to the novice in there.

-Yeah, it was.

She's never going to forget today,

and to be part of that is what makes it special, I guess.

Baby Noah was one of 123 babies born at St Thomas' this week -

just short of their projected number.

Across Britain there were 200,000 babies born this autumn.

And the 25,000 midwives up and down the country

are the first emergency workers, keeping us safe.

Next time, it's winter - and party season.

Julia's with the Scottish Ambulance Service

dealing with New Year, and the biggest street party in Britain.

What's happening? What's happening?

Matt's on the River Thames, with the country's busiest lifeboat crew,

and experiences what the water can do to you in winter.

Oh... That's very cold.

And we experience emergency rescues

in the most extreme environment in the country.

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