Written Statement: Broadening the role of firefighters

The past year has seen our public services working closely and effectively together to tackle the unprecedented challenge of the COVID-19 pandemic.  This spirit of collaboration and partnership working has for some time been something that we have wanted to support and enhance in a sustainable way.

There is considerable overlap between the skills, capacity and capability of the FRS and the needs of the NHS which means there is the potential for the FRS to support the NHS in securing positive health outcomes.

Some of that potential is already being realised - many firefighters in mid and west Wales already respond to medical emergencies in support of the Welsh Ambulance Service, while others provide advice on healthy lifestyles and staying safe at home.  But these are often sporadic and localised initiatives.

Last autumn, we commissioned a working group of senior FRS and NHS managers to examine these issues and advise us on the broader role firefighters might undertake.  We are pleased to say that that group has now completed its work.

The overall aim is to utilise the existing specific skills and capabilities that firefighters have to secure better health outcomes and the more efficient and effective use of resources.

Based on the advice of our working group, three areas of work have emerged which firefighters could undertake.  Firstly, firefighters can respond to certain medical emergencies in support of WAST, especially where speed of response is critical to patient outcomes.  This has strong and clear value in cases of cardiac arrest, where rapid defibrillation often makes the difference between life and death.  We also know from UK-wide trials between 2015 and 2017, and longstanding international experience, that a swifter response can yield better outcomes and significant savings in terms of less need for prolonged hospitalisation or dependence on long-term care.  There may also be scope for firefighters to respond to other types of cases, subject to further consideration of the clinical evidence, engagement with relevant healthcare professionals, and meeting relevant training and welfare requirements for firefighters.

Secondly, there is scope for firefighters to respond to people who have fallen at home or in a public place, and who are uninjured but cannot self-recover.  Such incidents are very common, and while there is no immediate threat to life, those experiencing such a fall can become distressed and suffer complications such as hypothermia and pressure sores if they do not receive prompt assistance.  We recognise the concerns of firefighters’ unions about such work and agree that firefighters should not be involved in providing personal care, nor in responding to falls in health and care settings which can be dealt with by the staff there.  Rescuing people in distress or danger is already part of a firefighter’s core duties, and this would be an extension of that to include people who have experienced a fall.

Finally, the FRS has had great success in reducing the number of dwelling fires by educating people about the risks and causes of fire in the home.  Firefighters rightly enjoy a high level of public trust and respect, and are well placed to convey safety messages.  This approach can readily be extended.  Falls at home, for instance, account for around 1,000 emergency admissions to hospital every month; and many of those admitted never recover enough to return home.  Yet many domestic tripping and slipping hazards are easy to identify and remove.  Equally, firefighters are well-placed to provide advice about other hazards and risks to health, especially where these are linked to the risk of fire, like smoking, alcohol and drug misuse, and the use of portable heaters during the winter.  This has potential to prevent accidents and other adverse conditions, and avoid the need for medical treatment altogether, which is always the best possible outcome.

The detailed proposals which the working group has formulated will be subject to discussions with Trade Unions representing firefighters and NHS staff.   The Deputy Minister has met regularly with the FBU and it would be our intention to take forward these proposals in partnership. The related negotiations about terms and conditions must of course take place using the established mechanisms, and that is likely to happen after the Senedd elections.    There is a real opportunity here for our public services to work closely together for the benefit of both those who provide our services and our communities that are served by them.