Operational Concerns with Emergency Medical Response
N.B. This circular addresses operational, safety and other concerns around Emergency Medical Response (EMR). It does not address the wider issues of the NJC five work-streams, pay and conditions. EMR (co-responding) remains outside the role map and contractual obligation of firefighters. The issues of pay, conditions and related matters remain the subject of discussion at the Executive Council and with the employers through the NJC.
The Executive Council has been monitoring the emergency response trials since they began in 2015. This has included regular reports at the Executive Council and National Joint Council (NJC) meetings, as well as discussions between head office officials and brigade officials and with members engaged in the trials.
During the trials, head office requested data from brigade secretaries on feedback from members about the emergency medical response work (2016HOC0389JM, 29 July 2016). Head office received 27 responses from brigades involved in the trials (out of 36), as well as a submission from one brigade with co-responding outside the trial. Many of these responses were detailed 5-6 page commentaries, with very detailed and honest assessments of the concerns raised by members. We are very grateful to those who provide such detailed information.
The results of the survey were discussed by the Executive Council at our 7-9 February meeting. Executive Council members also provided updates on the situation in their regions. A large number of serious concerns have been raised, which FBU officials are taking up through the NJC. The key issues highlighted include:
- Insufficient communication between the ambulance control and fire control staff, leading to firefighters mobilised to the wrong kind of calls or incidents outside of the agreement.
- The late or in some cases non-attendance of an ambulance.
- Failure of the ambulance service to pass on vital information to firefighters – such as ‘do not resuscitate’ orders.
Additionally, although minimum standards of training have been set out, these have not been applied consistently across all participating services. Refresher training programmes will also need to be addressed. Crew size and the type of vehicles deployed has also been raised.
An absolutely crucial set of concerns have been raised around health and safety. These concerns include:
- Immunisation from hepatitis B, tetanus and other infection control measures.
- The provision of suitable PPE.
- Support mechanisms to avoid worsening the mental health of staff.
- Violence towards firefighters.
The FBU survey also identified a number of cases where intervention by local FBU reps has led to important modification of the trials, including inoculation, crew size and mobilisation protocols in cases of repeated fatalities. In some cases management have established a liaison body or committee to oversee the trials, giving FBU officials an opportunity to intervene and make improvements. In other cases, it appears this has not been the case.
External assessment: University of Hertfordshire
The NJC has commissioned a team at the University of Hertfordshire to make a wider assessment of the impact of these trials, examining the data and the effectiveness of the work undertaken. This report has been delayed but is due imminently. This report is also expected to confirm some of the concerns identified through the FBU survey, based on interviews with principal managers involved in the EMR trials.
At national level, the FBU is arguing that if such work were to be developed there would be a need for national professional standards to be developed for emergency medical response, to ensure a levelling up of conditions. There would need to be best practice guidance on this work and memoranda of understanding would need to be improved locally to deal with these issues. It has also been accepted by both sides throughout these discussions that any long-term extension of such work would require sustainable funding. Governments across the UK would need to fund this work properly and provide the central support for such work to be carried out safely and professionally and with the appropriate pay and conditions.