:00:08. > :00:14.Coming to the rescue, a new type of doctor. I will join doctors in
:00:15. > :00:21.Cambridgeshire leading the way in emergency care. They saved my life.
:00:22. > :00:29.If they did not act as fast as they did, I would not be here now. I am
:00:30. > :00:33.very grateful. Dying of ignorance, why young people are rigged again at
:00:34. > :00:41.risk from Aids. Things are rising again. And unless we do something
:00:42. > :00:47.about it, we will be back to where we were, or worse. And tiny
:00:48. > :00:56.creatures no bigger than your thumb. We will reveal the latest finds of
:00:57. > :01:10.Norfolk's chalk reef. Revealing the stories that matter on Inside Out
:01:11. > :01:18.for the East of England. Tonight, Inside Out is in Norfolk. Hello,
:01:19. > :01:24.welcome. Ambulance crews are out there saving lives every day, but
:01:25. > :01:28.even their skills are limited, but thanks to pioneering work from
:01:29. > :01:33.doctors in Cambridge, the most severely injured patients stand a
:01:34. > :01:36.better terms of survival. It is attracting interest from all over
:01:37. > :01:47.the world. We have exclusive access to find out how it works. All the
:01:48. > :01:51.time you get distressed you tighten your tummy muscles and it will make
:01:52. > :01:54.you saw. The team in orange jumpsuits are a new generation of
:01:55. > :01:56.the emergency services, trained to deliver treatment usually possible
:01:57. > :01:59.only in a hospital A Today they've been called to help Karen
:02:00. > :02:06.who has a complicated knife injury in her tummy. It's in a very
:02:07. > :02:13.precarious situation as to whether it has gone inside or not. The
:02:14. > :02:20.chances of it going in deeper. By moving her, it is much higher. We
:02:21. > :02:27.have managed to get intravenous access and give her pain relief so
:02:28. > :02:31.she is stable. Observations are fine at the moment so we have got much
:02:32. > :02:38.more time to play with at the moment. Carrying Karen downstairs is
:02:39. > :02:41.too risky, so the Fire Service remove her from the bedroom. Usually
:02:42. > :02:45.if you call an ambulance, you'll get a highly trained paramedic. But Dr
:02:46. > :02:47.Monojit Choudhury and paramedic Simon Standen are pre`hospital
:02:48. > :02:53.emergency specialists who can do even more than regular paramedics.
:02:54. > :02:56.For the paramedics to give any strong pain relief beyond morphine
:02:57. > :03:05.would be difficult so we give her enhanced painkillers. But if she had
:03:06. > :03:16.deteriortaed from an air way point of view, we could have intubated her
:03:17. > :03:18.until we reach the hospital. Pre`hospital emergency medicine can
:03:19. > :03:22.help the most severely injured patients and it is being pioneered
:03:23. > :03:27.here. This is the major trauma centre for the East of England, at
:03:28. > :03:31.Addenbrooke's A unit. It is the best place to be in the region if
:03:32. > :03:34.you are badly injured. But there are some injuries that can be treated
:03:35. > :03:40.even before the patient leaves the scene of their accident. 11`year`old
:03:41. > :03:43.Brandon Gravett was hit by a bus, leaving him with life` threatening
:03:44. > :03:49.head injuries. The care he received at the roadside reduced brain damage
:03:50. > :03:52.and kept him alive. They saved my life and if they didn't act as fast
:03:53. > :03:59.as they did, I wouldn't be here right now. I am actually very
:04:00. > :04:04.grateful. Basically, they said that they were going to put him to sleep,
:04:05. > :04:08.put him in a coma straightaway at the side of the road, said they are
:04:09. > :04:11.not going to wait until they get to hospital, we're going to do this
:04:12. > :04:14.right now, said we want to protect his brain function and it's the
:04:15. > :04:18.safest option for him. And to get the machine doing the breathing for
:04:19. > :04:21.him so that his brain has very little to do.
:04:22. > :04:33.Do you believe that had it not been for the rapid response, Brandon may
:04:34. > :04:36.not be here today? Absolutely. Whether he got through that depended
:04:37. > :04:46.on the care he got then and there. Because they put him to sleep, he is
:04:47. > :04:49.still here. A relatively small number of people will benefit from
:04:50. > :04:52.this treatment, about 700 a year. But for those who do need it,
:04:53. > :04:55.pre`hospital treatment could change their lives. It is focused on people
:04:56. > :04:58.who are really, really sick. I often say whose needs exceed the
:04:59. > :05:00.capability of the normal NHS Ambulance Service responses. By
:05:01. > :05:07.definition a relatively small group of people, but they are really
:05:08. > :05:10.important. The first training course of its kind has been set up in
:05:11. > :05:14.Cambridgeshire, training doctors and paramedics. It was started and
:05:15. > :05:18.funded by medical charity, working in partnership with the NHS. Rod
:05:19. > :05:27.Mackenzie from Addenbrooke's Hospital also worked with MAGPAS and
:05:28. > :05:30.helped to develop the scheme. I spent several years providing care
:05:31. > :05:36.as a volunteer doctor when I was free and I started to question what
:05:37. > :05:39.was happening when we weren't there. Could we do this better, could we
:05:40. > :05:42.provide a more consistent level of care and the only way to do that is
:05:43. > :05:50.to make pre`hospital emergency medicine part of the NHS response. I
:05:51. > :05:53.started some work about ten years ago now nationally to develop this
:05:54. > :05:59.area of clinical medicine as a specialist endeavour in its own
:06:00. > :06:06.right. MAGPAS is supporting five trainees in the new specialism. Dr
:06:07. > :06:12.Nick Foster is the first of the trainees. I've always wanted to do
:06:13. > :06:16.pre`hospital emergency medicine and when I started training as a doctor
:06:17. > :06:22.it was to do this. So I am an emergency doctor. I have all sorts
:06:23. > :06:28.of skills at stabilising critically ill and injured patients. My skills
:06:29. > :06:31.are best placed as early as possible in the disease process and this is
:06:32. > :06:39.where I can make the biggest difference. With regards to the
:06:40. > :06:42.public, with regards to the Ambulance Service, we are people in
:06:43. > :06:47.helicopters that fly in orange suits to get them out of trouble. But what
:06:48. > :06:49.we're hoping to do is increase the numbers of doctors involved in
:06:50. > :07:02.enhanced care teams of pre`hospital care and provide a more uniform
:07:03. > :07:05.nationwide level of care. I am a paramedic. Rob Major is a consultant
:07:06. > :07:09.from Addenbrooke's Hospital who supervises training at the MAGPAS
:07:10. > :07:14.centre. We spend a lot of time simulating unwell patients in
:07:15. > :07:17.training. Nick and Phil here are the duty team but in some downtime today
:07:18. > :07:20.we're doing a training scenario very similar to the patients that they
:07:21. > :07:23.have looked after already today. It is practising and re`practising and
:07:24. > :07:26.going through the process of putting someone to sleep at the roadside,
:07:27. > :07:41.which is probably one of our most risky practices in terms of what we
:07:42. > :07:47.do. Vomits, breathes, talks, has a heartbeat, you can collapse its
:07:48. > :07:51.lungs and put modules inside the surgical airways. You can have
:07:52. > :07:56.broken bones sticking out, it is as realistic as it gets. So much so,
:07:57. > :08:02.the first time I perform this on a real patient, it was only when I was
:08:03. > :08:13.putting it in his mouth that I thought, hang on, this is a real
:08:14. > :08:18.mouth. So we practise this a lot. The East of England is leading this
:08:19. > :08:23.in many respects. We were the first people to get the first trainee in
:08:24. > :08:27.pre`hospital emergency medicine. You have to have specialists training
:08:28. > :08:37.the doctors of tomorrow and that is our role and why Cambridge has been
:08:38. > :08:40.so important in this process. And now this new specialism and training
:08:41. > :08:43.is being seen as a model for other regions, not just in England, but
:08:44. > :08:46.around the world. Our colleagues in Australia are looking to now mirror
:08:47. > :08:49.the sub`specialist area of practice or sub`speciality curriculum that we
:08:50. > :08:51.have put in place so even in countries that have got arguably
:08:52. > :08:55.slightly more developed systems people are looking at our experience
:08:56. > :09:04.and saying what can we take from that and how can we apply it to our
:09:05. > :09:06.populations. Now the course is being adopted nationally, Dr Mackenzie
:09:07. > :09:12.believes it will improve emergency response in England. I think the
:09:13. > :09:14.sub`specialty will make a huge difference to pre hospital care in
:09:15. > :09:18.this country over the next ten years. Patients will be able to
:09:19. > :09:24.access consistently a very high level of pre hospital critical care
:09:25. > :09:33.support. Brandon is living proof that this treatment can save lives.
:09:34. > :09:38.They say the first two years are crucial in recovery, when the most
:09:39. > :09:43.recovery happens and he is doing very well. He is back at school,
:09:44. > :09:50.having missed one year, pretty much is entire first year. They used my
:09:51. > :09:56.case scenarios and example to train more people, so that others can save
:09:57. > :10:00.lives, as well, which I thought was quite good. Of course, they asked if
:10:01. > :10:10.it was OK with me but I was fine with it. If you want to get in touch
:10:11. > :10:18.about what you think we should be doing a story about, you can get in
:10:19. > :10:22.touch on Twitter, or, by e`mail. You are watching Inside Out. Still to
:10:23. > :10:27.come, the tiny creatures no bigger than your thumb, filmed on
:10:28. > :10:33.Norfolk's chalk reef. We have the latest on plans to protect them.
:10:34. > :10:44.This could be the largest area of marine chalk in Europe, may be the
:10:45. > :10:50.largest in the world. 30 years ago, Aids kills thousands of people but
:10:51. > :10:54.thanks to a health campaign, thousands of lives were saved. It is
:10:55. > :10:57.now feared the warnings are being forgotten all stopped hard, from
:10:58. > :11:13.Cambridge, is determined not to let that happened. `` Todd. Frightening.
:11:14. > :11:16.Devastating. Panic. An epidemic that was just totally unforeseen. And
:11:17. > :11:19.here we are again. In the 1980s, we were all aware of Aids and the
:11:20. > :11:30.devastation it caused people, their families and even communities. Back
:11:31. > :11:32.then, Aids was the shocking killer. Celebrities Freddie Mercury, Rock
:11:33. > :11:36.Hudson, Arthur Ashe and Liberace all died. The government's Don't Die Of
:11:37. > :11:44.Ignorance campaign was one of the most successful ever. But are we now
:11:45. > :11:46.at risk again? Things are really rising again, there's a lot more
:11:47. > :11:54.ignorance and unless we do something about it, we are going to be back to
:11:55. > :11:57.where we were or even worse. Todd, from Cambridge, was diagnosed with
:11:58. > :12:03.HIV four years ago after being raped. He is now on a mission to
:12:04. > :12:10.raise awareness of HIV. He knows how the stigma of this illness stops
:12:11. > :12:14.people getting help. It took me two years to finally seek support and
:12:15. > :12:27.help both for the rape and being HIV positive. During those two years you
:12:28. > :12:42.didn't tell anyone? I didn't tell no`one. It just left me devastated.
:12:43. > :12:45.I thought if I isolated myself and keep it within me, then no`one would
:12:46. > :12:54.know what has happened and I wouldn't have to be reminded of what
:12:55. > :12:58.happened. HIV is now so much more treatable than it was 30 years ago.
:12:59. > :13:03.But once again it seems people still aren't seeking help through either
:13:04. > :13:06.ignorance or fear. Here in the East, we have the highest rate of late
:13:07. > :13:09.diagnosis in country. What that means is someone with HIV can have
:13:10. > :13:17.the virus for years without realising itand that means it
:13:18. > :13:23.continues to spread. Todd supports others with HIV. Andrew, not his
:13:24. > :13:30.real name, waited 12 years before seeking medical help. I couldn't
:13:31. > :14:05.wake up from the bed and walk to the toilet. It was so difficult for me.
:14:06. > :14:09.He was so ashamed of having the illness, he did not try to get
:14:10. > :14:36.better. 25 people in the region with HIV
:14:37. > :14:41.died in 2012. One in five with the virus don't know they have it. It's
:14:42. > :14:43.not just the stigma of HIV, that's the problem. There's a new
:14:44. > :14:54.generation who seem almost ignorant of the dangers. OK, guys, I'm Todd.
:14:55. > :14:58.I'm HIV positive. Todd is trying to drive the message home to these
:14:59. > :15:10.students in Cambridge. How many of you are complacent about safe sex?
:15:11. > :15:13.Interesting. Why is that? I don't think everyone is always complacent
:15:14. > :15:18.about safe sex, I think it's just sometimes if we go out for a night
:15:19. > :15:26.out, people sometimes forget. It's not that everyone does it all the
:15:27. > :15:29.time. We do have the education. Even if we don't have facts and figures,
:15:30. > :15:32.we know how it is transmitted and how we can stop it but sometimes
:15:33. > :15:36.obviously on a drunken night, things happen anyway. So for how many of
:15:37. > :15:38.you is this a wake`up call? These attitudes are typical according to
:15:39. > :15:42.the Terrence Higgins Trust. It was set up in the '80s, to raise
:15:43. > :15:47.awareness of the virus and the need to prevent it spreading. There are
:15:48. > :15:50.regular surveys done on people's level of knowledge about things like
:15:51. > :15:57.how HIV is transmitted and we know that knowledge is going down.
:15:58. > :15:59.Because there is such poor sex and relationships education in this
:16:00. > :16:02.country and no general awareness the average member of the public is
:16:03. > :16:09.actually more ignorant about HIV than they would have been a decade,
:16:10. > :16:12.or probably even two decades ago. I think the problem is that a national
:16:13. > :16:17.advertising campaign would cost ?50 million to reproduce the impact of
:16:18. > :16:20.the one that we did in the '80s. And that's just not there when you've
:16:21. > :16:25.got the entire national campaign for HIV prevention is less than ?3
:16:26. > :16:31.million. There is still no cure for HIV. But by taking pills, Todd can
:16:32. > :16:36.slow down the damage the virus does to his immune system. But despite
:16:37. > :16:45.the medical advancements, Todd is worried that some doctors still need
:16:46. > :16:51.reminding it is out there. I think they have become complacent. We've
:16:52. > :16:55.had guys go to the GP, that have explained their symptoms, down to
:16:56. > :16:58.the point of the fact that they may be sexually very active, and not
:16:59. > :17:05.once have they been offered or been told to go and get an HIV test. Todd
:17:06. > :17:10.works for Dhiverse, the official HIV counselling group in Cambridgeshire.
:17:11. > :17:16.Part of his job is raising awareness by offering training session and
:17:17. > :17:19.posters to GPs. Take`up is low. But he's just found one that's accepted
:17:20. > :17:22.it. Considering we have contacted 98 surgeries in this area and they are
:17:23. > :17:37.one of the first to show willing to promote our work that we are doing
:17:38. > :17:40.with HIV. So it was quite good, quite promising.
:17:41. > :17:47.Why do you think people aren't willing? I believe there's still
:17:48. > :17:56.this massive stigma involved and I also believe there's still a need
:17:57. > :17:59.for more awareness and training. The government doesn't see a need for a
:18:00. > :18:06.national awareness campaign for the general public. It says it's clear
:18:07. > :18:09.that the groups most at risk of HIV infection in the UK are gay and
:18:10. > :18:12.bisexual men and some African communities. We fund the Terrence
:18:13. > :18:22.Higgins Trust for a national programme which targets these
:18:23. > :18:25.groups. The slogan for the campaign was "don't die of ignorance" and
:18:26. > :18:29.it's actually the same now. Don't die of ignorance, because you don't
:18:30. > :18:32.find out in time that you have HIV, because HIV is a completely
:18:33. > :18:36.treatable condition now. But you'll be taking pills for the rest of your
:18:37. > :18:39.life and you'll have to deal with the prejudice. If Todd and Andrew
:18:40. > :19:01.hadn't overcome their fears, they may not be alive today.
:19:02. > :19:08.Now Andrew has a job and is preparing to go to university. Todd
:19:09. > :19:15.has a home and a partner. I love my life now. I'm able to walk with my
:19:16. > :19:29.head high. I'm in an amazing new relationship, I'm working again, I'm
:19:30. > :19:33.me again. If you look up at the cliff face,
:19:34. > :19:39.you can see chalk running through it and lumps of it are all over the
:19:40. > :19:43.beach and out there under the cold North Sea is Europe's longest chalk
:19:44. > :19:48.reef, home to wildlife and the several years conservationists
:19:49. > :19:57.wanted it protected. That is proving controversial, still. On a day like
:19:58. > :20:00.this on the north Norfolk coast, it's hard to believe you could ever
:20:01. > :20:06.get under the waves and see anything at all. Visibility is probably
:20:07. > :20:11.awful, but two summers ago we came here to explore Norfolk Europe's
:20:12. > :20:28.longest chalk reef, when we were blessed with new water and the most
:20:29. > :20:36.amazing wildlife. And here it is, a wonderful world a few meters below
:20:37. > :20:41.the surface. Most reefs in the UK are made from hard rock and only a
:20:42. > :20:49.view our chalk, and this is thought to be the longest in the world. We
:20:50. > :21:02.are in a gully, between the chalk. There are so many holes here.
:21:03. > :21:11.Everyone of them has a crab. This is crab city. The raised chalk makes a
:21:12. > :21:14.perfect home, rough enough to support weeds and algae, many of
:21:15. > :21:21.which are only found on this kind of rock. They provide food for other
:21:22. > :21:33.animals and, because the rock is soft, crabs and lobsters can make
:21:34. > :21:44.burrows. This is one of the main delicacies, a chrome `` Cromer. This
:21:45. > :21:50.is a female. I will put her back where I found her. All around are
:21:51. > :22:00.creatures and plants with wonderful names such as light bulb sea squirts
:22:01. > :22:04.and the beautiful eyelash weed. We swam over valleys and arches,
:22:05. > :22:10.valuable for wildlife and rare earth of this part of the coast. Local
:22:11. > :22:16.divers were my guides. They have brought this hidden gem to the
:22:17. > :22:21.attention of the whole world. It can be magical to be on the reef. When
:22:22. > :22:26.we found the arches last year, it was a matter of luck. It was
:22:27. > :22:31.exciting to see, the kind of thing you would imagine only seeing
:22:32. > :22:35.abroad. It is not fully known and there is a chance that anybody on
:22:36. > :22:41.any dive could find something special like that.
:22:42. > :22:45.That summer, conservationists found a previously unknown sea sponge. So
:22:46. > :22:51.little wonder they were pushing for the reef to become one of the new
:22:52. > :22:56.marine conservation zones, an underwater nature reserve. I met Rob
:22:57. > :23:01.a few weeks ago to find out what has happened since. It is a little bit
:23:02. > :23:06.cold to go underwater today but you have been out to the reef since we
:23:07. > :23:09.went together. We dive there regularly and try to keep track of
:23:10. > :23:17.the changes. What have been the highlights? The number one
:23:18. > :23:22.highlight, a cuttlefish. On the reef, we have been seeing little
:23:23. > :23:30.cuttlefish, the size of a bumblebee, fearless like a tiger.
:23:31. > :23:35.Look at that, marvellous. It is an awesome predator. As complicated as
:23:36. > :23:41.a full`size cuttlefish. They are masters of camouflage. They hide in
:23:42. > :23:46.the sand and they can squirt ink to distract you and will attract any
:23:47. > :23:54.thing they think they can eat, troops in the sand, awesome. That is
:23:55. > :24:00.a 5`star animal. Look at it, burying itself in the sand, trying to hide.
:24:01. > :24:04.The sweetest bit is when they bring the little tentacles around to bring
:24:05. > :24:11.the sand over their eyes, to get the disguise perfect. You had some
:24:12. > :24:16.disappointing news. We returned to the arches you enjoyed in 2011, and
:24:17. > :24:24.despite a couple of attempts, we cannot find the arts. There have
:24:25. > :24:30.been impact is `` the arch. We think it has been knocked down, probably
:24:31. > :24:37.by lobster pots. They will be broken back and you will lose habitat. I
:24:38. > :24:42.wonder what the local fishermen will make of that. John Davies' family
:24:43. > :24:46.have worked the see here for 200 years and relies on the reef for his
:24:47. > :24:53.living. He took me out to see things from his point of view. We have a
:24:54. > :24:58.reasonably buoyant fishery on our doorstep. They are trying to take it
:24:59. > :25:02.away. We have been left alone for years and suddenly, everybody wants
:25:03. > :25:09.a piece of what we class is our backyard. You can see the healthy
:25:10. > :25:15.fishery. Look at the juveniles and this is early in the season. One
:25:16. > :25:20.good thing about this, everything can go back into the water alive. It
:25:21. > :25:28.makes you wonder how many times they go up and down in a season. Not
:25:29. > :25:32.again! These are too small? That will be long enough. It is a male
:25:33. > :25:38.crab. Put it in the box. Some years ago the fishermen volunteered to ban
:25:39. > :25:47.trawling and that has helped to protect the shore. `` the talk. Are
:25:48. > :25:51.they causing damage now? The diving community have filmed what they say
:25:52. > :25:56.is the potential evidence of damage by lobster pots. What do you think
:25:57. > :25:59.about it? Absolute rubbish. You can look at the promenade and look at
:26:00. > :26:06.the damage along the sea wall and the cliffs, I did not do that with a
:26:07. > :26:11.pot. Mother nature has a way of changing the landscape and it does
:26:12. > :26:16.the same on the sea bed. John and his colleagues do not want a marine
:26:17. > :26:20.conservation zone, fearing restrictions. They were glad when it
:26:21. > :26:26.was not included on a list of locations. We were pleased, as the
:26:27. > :26:35.fishing community because that is our workshop. We were relieved. We
:26:36. > :26:41.know we might have only won the battle, not the war, but we are
:26:42. > :26:47.pleased it was not accepted. It was disappointment for the divers and
:26:48. > :26:50.conservation groups. The official word was there was a lack of
:26:51. > :26:56.information on the extent of the reef but it is evident it is here
:26:57. > :27:03.and there is an total evidence and a lot of diving evidence. Exactly why
:27:04. > :27:08.it was not included is a mystery but we will continue doing a lot more
:27:09. > :27:13.work and we are working with other agencies to fill that deficit of the
:27:14. > :27:19.perceived lack of information. The majority of the East Coast fails to
:27:20. > :27:24.win any protection. Conservationists hope to persuade the government the
:27:25. > :27:29.reef should be included in the next round of zones. We know that
:27:30. > :27:37.designating marine conservation zones and having protected sites, it
:27:38. > :27:44.is a win for the wildlife and also fishing. This could be the largest
:27:45. > :27:49.marine chalk area in Europe. Working in conservation, it is frustrating
:27:50. > :27:53.that yes, we need more evidence, but it is important for wildlife. There
:27:54. > :27:58.are species unknown to science discovered here. It will be a while
:27:59. > :28:06.before we know whether the next bid is successful. In the meantime, the
:28:07. > :28:16.divers are already planning exploration for this summer and I
:28:17. > :28:20.cannot wait to see what they find. It is incredible to think the chalk
:28:21. > :28:28.reef is just out there, teeming with wildlife. You can also get in touch
:28:29. > :28:33.on Twitter and by e`mail. If you think there is something we
:28:34. > :28:41.should look into. Next week, I will find out what happened after the
:28:42. > :28:44.storms. Almost three months after the terrifying night when this home
:28:45. > :28:52.went over the cliff, good news for them. And we meet families torn
:28:53. > :28:58.apart by a system they say is unfair. And from the old vicarage to
:28:59. > :29:01.a corner of a foreign field that is for ever England, the story of one
:29:02. > :29:11.of Hello, I'm Ellie Crisell with your
:29:12. > :29:15.90 second update. Two women and four dogs have been found shot dead at a
:29:16. > :29:19.house in Farnham. An 82-year-old dog breeder has been arrested on
:29:20. > :29:22.suspicion of murder. He's been named locally as John Lowe.
:29:23. > :29:25.Dave Lee Travis is to face a re-trial over two charges of
:29:26. > :29:28.indecent assault and sexual assault. The former Radio One DJ was cleared
:29:29. > :29:32.of 12 other offences earlier this month. He said his "nightmare goes
:29:33. > :29:36.on". They call it a living hell. These
:29:37. > :29:39.are the faces of men, women and children desperate for food. More
:29:40. > :29:42.than 20,000 are trapped in a bombed-out area in Syria. Just 0
:29:43. > :29:47.packets of food made it in today. We've a special report at Ten.
:29:48. > :29:50.Just where is Ukraine's former President? He's on the run after the
:29:51. > :29:55.crisis there. An arrest warrant s out for Viktor Yanukovych. He's
:29:56. > :29:59.wanted for mass murder. Was he just too British for American
:30:00. > :30:00.tastes? CNN is axing Piers Morgan's primetime chat show. The