A union is opposing plans for firefighters to respond to medical emergencies, branding the idea “half baked”. Avon Fire & Rescue Service (AFRS) wants to expand its partnership work with South Western Ambulance Service (SWAST) where fire crews can reach someone suffering a suspected cardiac arrest before paramedics and administer potentially life-saving treatment.
Firefighters have been driving ambulances and assisting during medical emergencies since the early stages of the pandemic, and this agreement was recently extended until April 2022. Avon Fire Authority (AFA) will be asked to approve a three-year service plan on Wednesday (March 30) including a potential expansion of crews’ medical roles.
But a report to the meeting says the Fire Brigades Union (FBU) is against the proposals, while a circular to FBU members says any additional duties must come with appropriate pay, training and support and that it has not been consulted. The report to the AFA committee says: “The FBU has raised opposition to the introduction of emergency medical response, in a letter to the chair of the fire authority and the chief fire officer.”
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It said feedback from consultation into the draft service plan 2022-25 had been taken into consideration when producing the final version. “The action ‘to implement new ways of working to assist with medical emergencies within the community’ remains in place,” the papers said.
“In recognition of the consultation feedback we have considered an alternative proposal to be included in the service plan to ‘explore and consider how new ways of working would assist with medical emergencies within the community, utilising the skills and capability within the service and building on existing examples of good practice with a view to pilot different models of assistance’.” In a circular to Avon FBU members, brigade secretary Amanda Mills said the fire service’s aspiration in the service plan was for a “response capability to attend cardiac response medical emergencies”.
She said: “To be clear, AFRS had not consulted with the union prior to the statements being included and released in the service plan. This failure to communicate with the union or to respond to the matters raised in the FBU’s letters on this subject has become thematic.”
She said the union’s policy on broadening firefighters’ role to include medical emergencies insisted on proper training, provision of equipment, risk assessment procedures and sufficient government funding to ensure “costs of the additional work is not a burden on fire and rescue services which will detract from the ability to provide core services”. "There is of course the associated other important issue of payment,” Ms Mills said.
“Funding also needs to be provided for additional fully pensionable payment on the grounds of increased responsibility. It's a rare event for anyone to take on the workloads of others without an increase in pay as reward for the increased workload. All fire and rescue service personnel need to be similarly rewarded.
“Because of the necessity for adequate funding, which can almost certainly only be sourced by government, any local scheme introduced at individual FRS level will have to be funded through cuts elsewhere in the FRS budget and will be partial, poorly designed and as a consequence will be poorly delivered. Such schemes, rather than providing a valuable contribution to improved emergency medical service delivery, will result in a medical PR con and worsened core services delivered by the fire and rescue service.”
She said a major problem identified in previous trials elsewhere was that some ambulance services “gamed the system” by redirecting paramedics to other calls knowing fire crews were on hand for cardiac arrests and that this was to the detriment of patients and the fire services. Ms Mills’ briefing note said: “The FBU is supportive of emergency medical work to save lives within the communities that they work, and this work must be properly considered to maintain the high standards expected of the fire and rescue service.
“However, this will only be achieved through collective agreement and thorough ongoing consultation with the FBU for the safety and health of firefighters and the public. A more fundamental factor is that half-baked schemes that purposely don’t involve the FBU will inevitably result in worse patient care, not better.”
In response to concerns during the consultation, AFRS said: “Our proposed action outlines that we will work with SWAST, to provide support to medical emergencies, where required and our staff receive sufficient training to be able to use specialist equipment such as defibrillators. We are committed to implementing new ways of working to assist with medical emergencies to support our ambulance colleagues to keep the public as safe as possible, and to save and preserve endangered life in the widest sense.
“We have sufficient resources to cover our service area and this includes our wholetime and on-call personnel. Currently we have dedicated members of our staff who support the ambulance service by driving ambulances and this has no detrimental impact on our operational resilience and cover.”
