Is using fire crews in medical call-outs a solution to paramedic response times?

In Oxfordshire they are trained to deal with many other emergency situations, including responding to flooding and attending road traffic accidents.

Oxfordshire County Council’s Fire and Rescue Service recently entered into a partnership with South Central Ambulance Service (SCAS), where crews are available to attend some medical emergencies to administer care before paramedics arrive.

This means quick and immediate trauma care is delivered by firefighters to the public. The casualty is stabilised and has an increased chance of survival. This is a truly joined-up approach to putting people first.

The scheme – First Person on the Scene (FPOS) – was launched last June in Thame after extensive SCAS training. Now about 170 firefighters possess the medical skills to respond in the first instance.

Parts of the country recently have experienced unprecedented demand on ambulance services.

On December 21, Oxfordshire Fire and Rescue Service was asked to assist SCAS more with the initial stages of some emergency calls.

It was of course happy to help, as part of its brief of keeping residents as safe as possible.

The service works closely with the council and its external partners, including with adult social care to identify people who may require some assistance with fitting smoke alarms and close co-ordination with schools to instil important safety messages in youngsters’ minds.

In just over two weeks, local firefighters responded to nearly 300 FPOS calls.

I can understand that some may think that this takes away from the Fire and Rescue Service’s day-to-day work, however at no time was a crew responding to a FPOS call required to deal with a fire call.

As most fire stations locally are staffed by on-call personnel – firefighters who live or work five minutes away from a fire station – then if an emergency fire call came in when they are attending a FPOS incident, they would probably be able to respond to the fire emergency sooner as they are already deployed, leaving a medically-trained firefighter with the casualty administering care before SCAS arrive.

Costs incurred for attending FPOS calls are recouped from SCAS.

I certainly feel safer knowing firefighters are medically-trained, and as Oxfordshire Fire and Rescue Service costs about 11p per day per resident to run, I definitely think that it is fantastic value for money.

While it makes obvious good sense for our emergency services to be helping each other out at times of peak demand, we have to make sure that firefighters being called in to help the ambulance service respond to emergency calls isn’t a short-term fix that stops the underlying problems being tackled, writes Oxford East MP Andrew Smith.

As a longer term solution, it may also be dangerously dependent on questionable assumptions about ongoing spare capacity in the fire service.

It is worrying that during a winter when we have not so far seen prolonged ice and snow, the ambulance service is finding it so difficult to cope.

There are clearly recruitment and retention issues which need to be addressed. I am sure the cuts in front-line pay, when compared with inflation, are not helping, especially with the high cost of housing locally.

The referral procedures for firefighters stepping in also need the most careful management and monitoring.

Otherwise there will be a worry that a firefighter turns up at a medical emergency that they are not properly experienced to deal with, which also puts that firefighter in an impossibly difficult position.

Firefighters also cannot be in two places at once, and the public needs to know what happens if there is a major fire or security incident while a number of firefighters are out attending ambulance calls.

The real solution to all of this is to sort out the recruitment and retention problems and service performance in the ambulance service. Counting on the fire service, or the police, to do some of the work is not a sustainable answer.

We also need to keep an eye on the amount of money the ambulance service is paying the fire service for this work.

In this time of austerity and savage cuts, we have to avoid the danger of this being factored into the fire service budget so they can’t afford to stop providing the cover even when it makes operational sense to do so.

If what is really behind this is a move to a new pattern of service delivery, where paramedics are jointly employed between the ambulance and fire service and deployed flexibly, then this shouldn’t be done by stealth.

There should be full consultation with the public and trade unions, and careful consideration of all the implications. The staff in our emergency services do a wonderful job, and deserve to be treated properly.

As it is, for the fire service to have been responding to a serious or life-threatening ambulance call as often as every 30 minutes, shows the extent of the crisis facing parts of our NHS and the need both to sort out underlying problems and pressures and to have sufficient funding so that every part, including the ambulance service, can perform to the standard which both the public, and the front-line staff concerned, want to see.