Memorandum submitted by the Ambulance
Service Association (1 May 2003)
The Association is grateful for the opportunity
to report back to House of Commons Defence Committee on the important
subject of Defence and Security in the UK and for extending the
time for the response.
A substantial amount of progress has been made
since ASA last gave evidence. In particular the following initiatives
are worth bringing to the committee's attention:
1. A memorandum of understanding to place
on a formal basis mutual aid arrangements between NHS ambulance
services has now been agreed by the National Council of the ASA.
This is an important step forward and reflects a recognition by
all Trusts that the demands of any future catastrophic incident
will require more robust arrangements regarding aid between services
than have been present hitherto.
2. A national doctrine for ambulance Trusts'
reponse to CBRN is nearing completion. This is an important piece
of work that seeks to reflect the need for a common ideology and
common standards across the UK in this respect.
3. The ASA is actively engaged with the Department
of Health in starting work on designing the second generation
of PPE and decontamination equipment following the initial roll
out of this equipment over the last year. This work is essential
as the understanding of the implications of the new demands placed
on all NHS Trusts associated with CBRN preparedness matures and
operational experience begins to influence the debate.
4. Similarly work is going on to understand
how medical aid can be extended into the warm zone in a CBRN type
incident. This is a difficult area given the constraints associated
with working in the confines of PPE both from a clinical and physical
perspective. Nevertheless it is essential to understand the extent
to which such aid can be provided if traditional support to patients
is to be extended to contaminated areas. However such activity
is resource intensive and will require substantial additional
funding if the response in such circumstances is to be effective.
5. Finally funding has been made available
to progress additional training of ambulance personnel at the
combined training centre at Winterbourne Gunner which should improve
the overall resilience of Trusts over the forthcoming 12 months.
On a less positive note there are a few issues
which the Association would like to bring to the Committee's attention.
Firstly insofar as overall funding is concerned for both overall
resilience and specfically for CBRN capacity there remains no
clear view of how this will be dealt with. In real terms Ambulance
Trusts, other than in Scotland, have not received any additional
resources to deal with the new and emerging threats. This compares
unfavourably with colleagues in the other blue light services
who seemingly have received substantial additional funding. This
is particularly concerning given the overall levels of utilisation
of ambulance resources nationally in dealing with life-threatening
calls dealt with routinely on a daily basis, a situation which
leaves little capacity to cope with the additional demand placed
on Trusts by even the most modest of terrorist attacks.
Secondly the proposed Civil Contingencies Bill
seems to have made no provision for the vital work of paramaedics
in managing the outcome of a catastrophic incident. This is despite
representation being made to those responsible for drafting the
legislation and again compares unfavourably with colleagues in
the other blue light services. The work of paramedics is an essential
element to saving life in such circumstances but to date is not
reflected in the bill as it is currently under consideration.
Again thank you for the opportunity to make
comments to the committee. Please do not hesitate to ask for further
information on any of the above areas should you consider it appropriate.
The association would, of course, be more than willing to give
further evidence orally if the Committee would find that helful.
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