NATIONAL JOINT COUNCIL – BROADENING RESPONSIBILITIES REPORT
This circular introduces the report, Broadening responsibilities: Consideration of the Potential to Broaden the Role of Uniformed Fire Service Employees. This is a report into the emergency medical response (EMR) trials carried out by firefighters in brigades across the UK over the last eighteen months.
This report was commissioned by the National Joint Council (NJC), representing both the FBU and the employers. It was carried out by independent researchers from the University of Hertfordshire. (N.B. It is therefore not a report by the NJC.) They were asked to investigate the impact of firefighters undertaking emergency medical response (e.g. co-responding) and wider community interventions (e.g. dementia awareness) on communities across the UK. Despite any differences between the FBU and the employers, both sides have accepted that any long-term undertaking of this extended role will require adequate and sustainable funding. This report was commissioned in order to assess the trials and to assist the discussion with government ministers about long-term funding. Its purpose is to assist us in lobbying for more funding for the fire and rescue service, including increased pay for our members.
The researchers obtained data from 38 out of 50 fire and rescue services across the UK. In total, the report found:
- Firefighters have attended over 42,000 co-responding incidents during the trial period – about 8% of the total calls for all incidents across the UK during that time and one-in-five calls for stations undertaking co-responding incidents.
- Firefighters generally arrive quicker than the ambulance service to all incidents (62%) and especially to time-critical incidents (93%).
- For the aggregate survey, firefighters were able to respond almost 9 minutes faster than the ambulance service on average.
- Firefighters attended over 10,000 chest/heart/cardiac incidents – including over 4,000 cardiac arrests.
- Firefighters also attended over 218,000 wider health incidents.
The report also contained detailed analysis of a small number of automated external defibrillator (AED) downloads. These showed that firefighters intervening at cardiac incidents (in the sample available) delivered a very high standard of intervention, what the authors call “best in class” when compared with international studies.
Importantly, the researchers identified a whole range of operational matters – many of them on health and safety – which confirm the concerns raised by FBU members and officials during the trials. The FBU concerns are addressed in more detail in a separate circular.
The biggest concerns highlighted by firefighters were:
- Being dispatched to inappropriate incidents where they did not have the necessary skills to support the patient.
- Waiting for an ambulance to arrive and having to provide care firefighters were untrained for.
- Difficulties experienced with fatalities, which has been traumatic for some firefighters.
The report also identified important issues such Hepatitis B vaccinations, disclosure and barring Service (DBS) checks and other matters – especially training – that should be resolved by employers before they expect firefighters to carry out this kind of work.
Health economic analysis
The report also attempts to weigh up the costs and benefits of firefighters carrying out emergency medical response and wider work. The figures researchers were able to obtain were limited, making generalisation very difficult. However, they concluded that the benefits outweigh the costs and therefore support the FBU’s position that government/s should invest in the fire and rescue service if it expects firefighters to carry out this kind of work.
This report was not designed to discuss pay for emergency medical response work. That will be addressed separately. It does note that retained firefighters have been able to receive higher pay as a result of additional call-outs to undertake emergency medical response. It also notes that firefighters have made it clear we want remuneration for carrying out extra responsibilities. This is also an important point to make to central government and one the FBU has made repeatedly during this process.
Overall, the report concludes that emergency medical response is an area of work firefighters could contribute to. The case is particularly strong for Red 1 calls, where time is critical and firefighters could intervene professionally to save lives. They also acknowledge the benefits of other areas of wider work, but this has proven difficult to quantify so far. At present, fire and ambulance services do not record incidents in the same way, making definitive conclusions difficult to draw.
Members should be aware that the report supports the FBU’s stance that national professional standards are required for training and equipment for this work – something we have argued for strongly in all areas of firefighters’ work. The report also supports the need for best practice guidance to ensure firefighters’ standard operating procedures and safety concerns are dealt with professionally.
This report is very long, but I would encourage members to read it and discuss it on stations and in Brigade Committees. The union has to decide on the next steps to take over emergency medical response and we therefore need every member to make their views known.