House of Commons - Communities and Local Government Committee

Select Committee on Communities and Local Government Committee Fourth Report

9 Joint working with other emergency services

116. The Civil Contingencies Act 2004 laid duties on the emergency services to work together in planning for, and responding to, major incidents. This Act, together with the Control of Major Accident-Hazards Regulations 1999, provides a statutory framework for joint working between the emergency services at a strategic and operational level.[283] There are also examples of joint working between emergency services in other key areas of FRS activity, including community safety, response to non-major incidents and procurement. Joint working has clear potential to deliver efficiency savings and improved service, whilst also enhancing civil resilience. Joint working practice is highly variable across the country, and there is scope for improvement. As the CFOA stated: "there are economies of scale to be realised…[there are] examples of good practice around the country but[…]there are still more tangible benefits yet to be realised in saving lives."[284]

Resilience planning and response

117. The FRS is represented both on the Regional and Local Resilience Fora. These "analyse the risk profile of the national threats and hazard in their region or locality" on the basis of risks identified by the Cabinet Office's National Risk Assessment.[285] The ACPO told us that participation in these fora ensures close co-operation between the police and fire service (amongst others) in planning for a wide range of emergencies.[286] The ACPO also cited examples of ongoing collaboration between the FRS and the Police including:

"Home Office Model Response Plan for CBRN [Chemical, Biological, Radiological, or Nuclear] incidents.
The National CBRN Training Centre at Winterbourne Gunner, which is jointly staffed by representatives from the 'blue light' services.
CFOA representation on the ACPO Emergency Procedures Portfolio (strategic forum within ACPO to develop policy and guidance for the Police Service in relation to the response to emergencies and major disasters)".[287]

Stoke on Trent and Staffordshire FRA told us:

"In Staffordshire, we have a good record of effective liaison, with all responding agencies being committed to the Staffordshire Integrated Emergency Planning (SIEP) arrangements, that have now been transformed into the Local Resilience Forum following the introduction of the Civil Contingencies Act. A revised Staffordshire Resilience Forum/Civil Contingency Unit has been established and is collaboratively resourced, demonstrating a real commitment by all Staffordshire [Category] 1 Organisations to improve resilience across the County".[288]

Operational collaboration: co-responding

118. Direct operational collaboration between the FRS and other emergency services is relatively infrequent and is generally in relation to serious road traffic accidents, fires, chemical incidents, entrapments and major emergencies. The Ambulance Service Association told us that this type of incident represents "only about 2% of the incidents responded to by ambulance services".[289] However, the ambulance service uses co-responder schemes to help ensure a very fast response to certain types of emergency:

"To increase the chances of survival from immediately life-threatening conditions such as cardiac arrest, the ambulance service prioritises calls aiming to respond to the most urgent within eight minutes[…]One of the tools used to achieve this level of performance has been the recruitment and training of local first- and co-responders who may be able to get immediate life support to patients faster than the closest available ambulance. Individuals participating in responder schemes include members of the public as well as members of the other emergency services, particularly retained ?re?ghters, or the armed services".[290]

The LGA outlined the practice of FRS involvement in co-responding schemes:

"Under a 'co-responder' scheme firefighters, when first to arrive at an incident, can administer first aid in the absence of a paramedic. This entails training of firefighters in basic life-support skills, including use of automated defibrillators. An ambulance is still dispatched to every co-responder call. As such, the role and workload of ambulance staff is in no way affected by the scheme, but patient care is greatly improved and lives can be saved by the rapid availability of first-aid (particularly the use of defibrillators for victims of heart attacks)".[291]

The ODPM's draft National Framework for 2006-08 states that "Fire and Rescue Authorities should actively review the opportunities for improving community safety by implementing co-responder schemes in partnership with other agencies".[292] A recent CFOA survey indicated that "37% of Fire and Rescue Authorities in England had initiated co-responder schemes, and that 80% of those who had not done so planned to initiate a scheme at some point in the future".[293]

119. The life-saving benefit of these schemes is widely recognised.[294] Mr Adrian Hughes, Vice-President of the RFU, a serving Retained Fire Officer in Charge, told us:

"My own station has been carrying out co-responder duties since 1998 and it has been tremendously successful. There are widespread benefits to the community, to the Fire Service and to members of the crew on each station in doing that. My own service, Mid and West Wales, now operates 14 co-respondent stations. It is a partnership with the Ambulance Service. We have a greater understanding, the Ambulance Service have a greater understanding and the Fire Service directly, because of co-responder. It is very difficult to quantify success but I think it is reasonably safe to say that each co-responder station saves between five and ten lives a year".[295]

North Yorkshire FRA emphasised that there was particular benefit from the schemes in rural areas.[296]

120. The role of the FRS in co-responding schemes has however been seen as problematic by some in the FRS, most notably the FBU:

"There is a big difference between cooperation and collaboration and taking on the work of other emergency services as demonstrated by the different variations of 'co-responding'. Co-responding in practice places the fire & rescue service in a position where it is taking over the role of the ambulance service in attending what are major medical emergencies. In practice it is often driven by the inability of ambulance services (some of them regional ambulance services) to hit target response times for major emergencies. In those areas where co-responding does take place or is being piloted, the fire & rescue service is sometimes sent alone and the incidents can involve anything from serious medical emergencies to members of the public who have collapsed drunk in the street".[297]

This concern over FRS involvement seems to be largely linked to an alleged misuse of co-response which may lie partly in the fact that the FRS has a quicker response time than the ambulance service.[298] The FBU told us that its opposition centred on training, insurance and "the impact on the fire service of attending ambulance calls when other fire service calls come in".[299] It also reported that:

"We have examples again from our experience of firefighters attending ambulance calls and waiting for 20 to 30 minutes for ambulances to turn up dealing with a whole range of incidents which were never part of the original protocol. Normally the co-responding scheme is aimed at dealing with victims of heart attacks and so on, but what actually happens on the ground is a whole number of category A ambulance calls - they can include people being drunk in the street, people under the influence of drugs, trauma, penetrating injuries to the head and trunk, obstetric haemorrhage - a whole range of incidents which firefighters simply have not got the training to deal with".[300]

121. Co-responding schemes are not intended to replace an ambulance service response with an FRS one, and, while the FRS may be first on the scene, they should always be supported by a paramedic as quickly as possible. The Ambulance Service Association emphasised that co-responder schemes should not and cannot mean that firefighters act as paramedics, a role for which they are not trained:

"fire?ghters qualified as paramedics would find it very difficult to undertake the volume of clinical activity necessary to retain the skill levels required by the Health Professions Council, which is a legal requirement to practice as paramedic in the UK[...]there is a strong case, that wherever practical and subject to the wishes of the local fire and ambulance services, fire?ghters should be trained to administer CPR, operate a defibrillator and administer other basic life support skills to sustain life until ambulance clinicians arrive at the scene. The use of these skills can either be used in situations where the fire service is first-on-scene, e.g. at a road traffic accident, or in a situation where the fire?ghter(s) is dispatched to a medical emergency by the ambulance service because their response time will be less than the closest available ambulance resource".[301]

FUNDING AND THE ABSENCE OF A NATIONAL FRAMEWORK

122. North Yorkshire FRA told us: "Although progress [in co-response] has been made at a local level it has been a slow process and would benefit from a clear central policy that prioritises the initiative and provides a joint approach".[302] The call for a national framework was also made by both the CFOA and the FBU.[303] The CFOA stated:

"There is no doubt that the introduction of co-responding schemes and/or the use of defibrillators has benefits for the public. CFOA believe that if the FRS are to extend this role more formally, the ODPM and Department of Health should agree a Memorandum of Understanding on behalf of the FRS for a co-responding protocol".[304]

123. With regard to funding, there is currently no single financial framework to fund co-responder schemes. Apportionment of funding is entirely dependent upon local arrangements between fire services and ambulance services. In some areas the ambulance service reimburses the costs incurred by the FRS, in other areas it does not.[305] As Devon FRA suggested, in light of the ODPM's support for FRS involvement in co-response set out in the draft National Framework (2006-08), it should discuss funding arrangements with the Department of Health.[306] We are convinced of the life-saving benefit of co-response schemes and are concerned at the reluctance of some in the FRS to participate in them. We recommend that the Government, in conjunction with the Department of Health, develop a national co-response protocol which includes guidance on how co-response should be paid for.

Community safety

124. Our evidence highlighted a number of examples of joint-working between emergency services on community safety. East Sussex FRS told us:

"We have seen much success from the results of programmes such as the LIFE project and work with the Prince's Trust in supporting young people, particularly the socially excluded and those referred to the Fire and Rescue Service through Youth Offending Teams[…]Such programmes…are seen as key components of improving social cohesion and community well being".[307]

North Yorkshire FRA and the FBU also drew attention to this aspect of FRS activity.[308] But the sustainability of such projects in the absence of adequate funding or central guidance was questioned. North Yorkshire FRA told us:

"some of the mechanisms that are in place to encourage such work rely on the individual Services choosing to go beyond the minimum level of engagement. This can prove difficult due to competing priorities, different governance models, funding arrangements and a lack of central/joint policies at Government level".[309]

East Sussex FRA stated:

"we would wish to continue supporting such initiatives. However, we are concerned at the continuing impact on existing resources of supporting such programmes and would urge that consideration be given to providing specific grant funding to support and resource what we consider to be significantly beneficial community partnership programmes".[310]

Coterminosity and the impact of wider regionalisation

125. Several witnesses were worried about the negative impact police and potential ambulance service re-structuring may have on joint working.[311] Some stressed that coterminosity, the sharing of administrative boundaries between authorities or agencies, was an essential feature of effective joint working and collaboration.[312] The CFOA stated that

"the main barrier to joint working is the lack of coterminosity between services, the different governance models, the different funding mechanisms and financial regulations and, more importantly, the lack of joint policies at governmental level".[313]

Given the worries about the impact of possible boundary changes, we recommend that the Government commission research into the relationship between coterminosity and the likely workings of Regional Control Centres.

284 Ev 132 Back

285 Ev 13 Back

286 Ev 229 Back

287 Ev 229 Back

288 Ev 93 Back

289 Ev 232 Back

290 Ev 232 Back

291 Ev 174 Back

292 See Ev 174 Back

293 Ev 174 Back

294 See, for example, Ev 93, 138. Back

295 Q 132 Back